Social Security Administration (SSA) Requests

What this means

m21-1:XIII.ii.1.A explains social security administration (ssa) requests for medical evidence. In plain terms, the official guidance says 38 U.S.C. 5105 requires that evidence a veteran or claimant files with either the Social Security Administration (SSA) or the VA must be made available to the other agency if needed. It also addresses 38 U.S.C. 7332 requires VA to maintain the confidentiality of medical records it possesses in connection with the performance of any program or activity if the medical records

How this may help with a claim

Use m21-1:XIII.ii.1.A to audit how VA handled social security administration (ssa) requests for medical evidence. Start with the decision date, the issue being reviewed, and the evidence VA was allowed to consider, then compare the record with this rule: 38 U.S.C. 5105 requires that evidence a veteran or claimant files with either the Social Security Administration (SSA) or the VA must be made available to the other agency if needed. 38 U.S.C. 7332 requires VA to maintain the confidentiality of medical records it possesses in connection with the performance of any program or activity if the medical records Cite the exact document and page when raising a factual or procedural error, and use the review rights in the actual notice for any deadline.

What to review in your file

Check the file against this official condition: 1. Handling SSA Requests for Medical Evidence
Confirm that the record or notice addresses this source point: where SSA sends requests for medical evidence in VA's possession
Document how this stated step or exception applies: contents of an SSA request for medical evidence

Important limits

m21-1:XIII.ii.1.A explains VA guidance for social security administration (ssa) requests for medical evidence; it does not guarantee an award or replace the statutes, regulations, binding decisions, and review instructions that control an individual claim. Conditions and exceptions still matter, including this source point: 38 U.S.C. 5105 requires that evidence a veteran or claimant files with either the Social Security Administration (SSA) or the VA must be made available to the other agency if needed. Use the table below to determine actions to take upon receipt of a follow-up request from SSA for completion of Form SSA-827.

Search terms when useful

Phrases that may help when searching your claim file or this library.

Social Security Administration (SSA) Requests for Medical Evidence
m21-1:XIII.ii.1.A
Social Security Administration
SSA Requests Medical
Handling Requests Medical Evidence
requirements U.S.C. 5105
where sends requests medical
contents request medical evidence

Original VA guidance

The official VA text of this section

Overview

In This Section

This section contains the following topics:

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Topic	Topic Name
1	Handling SSA Requests for Medical Evidence
2	Unique Circumstances Regional Offices (ROs) Might Face When Processing Form SSA-827, Authorization to Disclose Information to the Social Security Administration (SSA)

1. Handling SSA Requests for Medical Evidence

Introduction

This topic contains information relevant to the handling of SSA requests for medical evidence, including

requirements of 38 U.S.C. 5105
where SSA sends requests for medical evidence in VA's possession
contents of an SSA request for medical evidence
statutory requirement to maintain the confidentiality of certain medical records
releasing medical records to SSA that are confidential
steps to follow when providing medical evidence to SSA, and
responding to follow-up requests from SSA for completion of Form SSA-827.

Change Date

June 14, 2015

XIII.ii.1.A.1.a. Requirements of 38 U.S.C. 5105

38 U.S.C. 5105 requires that evidence a claimant files with either the Social Security Administration (SSA) or the Department of Veterans Affairs (VA) must be made available to the other agency if needed.

Notes:

A claimant is not precluded from submitting a duplicate set of records/evidence to one or the other agency.
VA does not charge for copies of records/evidence it provides to SSA.

Reference: For more information on the sharing of evidence between SSA and VA, see 38 CFR 3.201.

XIII.ii.1.A.1.b. Where SSA Sends Requests for Medical Evidence in VA’s Possession

SSA sends requests for medical evidence in VA’s possession to the VA regional office (RO) of jurisdiction. These may include requests for medical evidence concerning the status of a child that is incapable of self-support.

Exception: SSA sends requests for hospital reports on Veterans who are currently hospitalized, or who have been discharged within the last 30 days, directly to the VA medical center (VAMC) involved.

XIII.ii.1.A.1.c. Contents of an SSA Request for Medical Evidence

An SSA request for medical evidence consists of Form SSA-827, Authorization to Disclose Information to the Social Security Administration (SSA), and a cover letter. The form should contain

the full name and Social Security number (SSN) of the individual who is the subject of the request
a description of the evidence SSA is requesting, and
the address of the SSA office that submitted the request.

XIII.ii.1.A.1.d. Statutory Requirement to Maintain the Confidentiality of Certain Medical Records

38 U.S.C. 7332 requires VA to maintain the confidentiality of medical records it possesses in connection with the performance of any program or activity if the medical records

identify the patient, and
contain a diagnosis, prognosis, or discussion of treatment involving
drug abuse
alcoholism or alcohol abuse
infection with the human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS), or
sickle cell anemia.

Note: The “program or activity” referenced in the above paragraph specifically includes

education
training
treatment
rehabilitation, and
research.

XIII.ii.1.A.1.e. Releasing Medical Records to SSA That Are Confidential

If medical records SSA requests are “confidential,” according to M21-1, Part XIII, Subpart ii, 1.A.1.d, release them to SSA only if Form SSA-827 bears the signature of

the individual named on the form (or his/her representative), and
a witness (or two witnesses if the individual signed the form with an “X”).

Reference: For more information on the handling of records pertaining to the treatment of HIV or AIDS, alcohol abuse, drug abuse, or sickle cell anemia, see M21-1, Part II, Subpart ii, 2.B.3.

XIII.ii.1.A.1.f. Steps to Follow When Providing Medical Evidence to SSA

Follow the steps in the table below when providing medical evidence to SSA.

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Step	Action
1	Annotate the cover letter that accompanied Form SSA-827 to show which records VA is providing.
2	Send the records SSA requested, along with a photocopy of the cover letter, to the SSA office that requested them.
3	File the original cover letter and Form SSA-827 in the corresponding claims folder. Note: If the claims folder is entirely paperless, upload the documents into the corresponding electronic claims folder (eFolder).
4	Clear end product (EP) 400 (for work credit).

XIII.ii.1.A.1.g. Responding to Follow-Up Requests From SSA for Completion of Form SSA-827

Use the table below to determine actions to take upon receipt of a follow-up request from SSA for completion of Form SSA-827.

Note: Follow-up requests from SSA consist of

a photocopy of the original Form SSA-827, and
a cover letter with an annotation that reads Second Request.

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If the RO...	Then...
already sent a response to the SSA office that submitted the follow-up request	annotate the cover letter with the statement VA reply forwarded [insert date] return a copy of the cover letter to the SSA office that submitted the follow-up request file the original version of the cover letter in the corresponding claims folder (or eFolder, if the claims folder is entirely paperless), and dispose of the duplicate copy of Form SSA-827 in accordance with RCS VB-1, Part I, Item number 13-052.200.
is awaiting the collection of evidence that SSA requested	annotate the cover letter with a statement indicating the RO can take no further action on the request pending collection of the evidence SSA requested, and an explanation of the reason for the delay in providing the evidence return a copy of the cover letter to the SSA office that submitted the follow-up request file the original version of the cover letter in the corresponding claims folder (or eFolder, if the claims folder is entirely paperless), and dispose of the duplicate copy of Form SSA-827 in accordance with RCS VB-1, Part I, Item number 13-052.200.
referred the initial request for evidence to a VAMC	annotate the cover letter with a statement that identifies the VAMC to which the RO referred the request, and return both the cover letter and the Form SSA-827 to the SSA office that submitted the follow-up request.

2. Unique Circumstances ROs Might Face When Processing Form SSA-827

Introduction

This topic discusses unique circumstances ROs might face when processing Form SSA-827, including

misdirected SSA requests for hospital reports
Veterans who have an insurance folder only
Veterans with claims folders that are unavailable
claims folders that contain only a VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action, and
actions to take if medical evidence is in the custody of an RO and a VAMC.

Change Date

June 14, 2015

XIII.ii.1.A.2.a. Misdirected SSA Requests for Hospital Reports

Follow the steps in the table below if

the Veteran SSA identifies on Form SSA-827 has been discharged from a VAMC more than 30 days following a recent period of hospitalization, and
the corresponding hospital report does not exist in the claims folder or eFolder.

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Step	Action
1	Make a copy of the cover letter that accompanied Form SSA-827.
2	Annotate the copy with a statement that acknowledges receipt of Form SSA-827 identifies the VAMC with possession of the hospital report, and notifies SSA that the form has been referred to that VAMC for a reply.
3	Return the copy of the cover letter to the SSA office that requested the medical evidence.
4	Forward Form SSA-827 and the original cover letter to the appropriate VAMC.

XIII.ii.1.A.2.b. Veterans Who Have an Insurance Folder Only

Follow the steps in the table below if the subject of an SSA request for medical evidence has an insurance folder only.

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Step	Action
1	Make a copy of the cover letter that accompanied Form SSA-827.
2	Annotate the copy with a statement that acknowledges receipt of Form SSA-827, and notifies SSA that the form has been referred to the VA Insurance Center in Philadelphia for a reply.
3	Return the copy of the cover letter to the SSA office that requested the medical evidence.
4	Forward Form SSA-827 and the original cover letter to the VA Insurance Center.

XIII.ii.1.A.2.c. Veterans With Claims Folders That Are Unavailable

Use the table below to determine the actions an RO must take when it receives a request for medical evidence from SSA but the corresponding paper claims folder is unavailable.

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If the claims folder is …	Then the RO must …
located at another RO	annotate the cover letter that accompanied Form SSA-827 with the name and location of the RO that has custody of the claims folder, and return the cover letter and Form SSA-827 to the SSA office that sent it.
on temporary transfer to VA Central Office	send the Form SSA-827 and cover letter that accompanied it to the service within VA Central Office that has possession of the folder. Note: The service having possession of the folder is responsible for processing the request.
on temporary transfer to the Board of Veterans Appeals	send the Form SSA-827 and cover letter that accompanied it to the Director of Compensation Service (211B) for processing.

XIII.ii.1.A.2.d. Claims Folders That Contain Only a VA Form 10-7131

Follow the steps in the table below if only a VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action, relating to the disability and date of onset referenced on Form SSA-827, is in the claims folder.

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Step	Action
1	Make a copy of the cover letter that accompanied Form SSA-827.
2	Annotate the copy with the statement VA Form 10-7131 only on file.
3	Return the copy of the cover letter to the SSA office that submitted the Form SSA-827.
4	forward the original cover letter and Form SSA-827 for processing to the hospital or clinic that executed the VA Form 10-7131.

XIII.ii.1.A.2.e. Actions to Take if Medical Evidence Is in the Custody of an RO and a VAMC

Follow the steps in the table below if

SSA requests both a hospital report and a physical examination report from an RO
the RO possesses only the physical examination report, and
the VAMC possesses the hospital report.

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Step	Action
1	Make a copy of the cover letter that accompanied Form SSA-827.
2	Annotate the copy with a statement that acknowledges receipt of the form, and explains that the form has been referred to the VAMC that possesses the hospital report.
3	Return the copy of the cover letter to the SSA office that submitted the Form SSA-827.
4	Forward the Form SSA-827, original cover letter, and a copy of the physical examination report SSA requested to the appropriate VAMC. Note: The VAMC is responsible for attaching the hospital report to the documents the RO provided, and returning all of the documents to the SSA office that requested the medical evidence.