The Social Security Administration requires that we submit two forms in our application to be selected as Rep. Payee:
SSA-787: to be completed by a physician who has recently examined the client. Clinician must indicate that the feel a Rep Payee is necessary on pages 2 and 3
SSA-787 - Medical Source Opinion of Patient's Capability to Manage Benefits
SSA-827: authorization to disclose information to SSA, to be signed by client
SSA-827 - Authorization to Disclose Information to SSA
In order to expedite our application, please complete these forms and use the upload button below to submit with this referral.