BASIC (09-05)

A. Policy - General

An individual may authorize a third party to act on his/her behalf in dealings with SSA. This person is known as an “authorized representative” and the individual must name him/her in writing. An authorized representative can be an attorney or non-attorney, but a specific individual or individuals must be designated.

NOTE: Form SSA-1696-U4, Appointment of Representative, is limited to an appointment of an individual, not an entity (see GN 03910.020B.3. and GN 03910.040B.2.). Disclosure based on presentation of a Form SSA-1696-U4 alone only authorizes SSA to release records to the individual named on the form (or the individual who signs the form). In cases where an authorized representative delegates some duties to another individual in his group or firm (an unauthorized assistant), and the assistant contacts SSA to receive information on behalf of the authorized representative, the assistant must present a signed Form SSA-3288 (or an equivalent valid written consent statement) which designates either the entity or the assistant himself/herself before SSA can release the requested records.

REMINDER: Although an “authorized representative” and a “designated representative” may be one individual, the functions of these two types of representative are distinctly different.

See GN 03301.002 for the definition of these terms. See GN 03340.035B. for a discussion of designated representatives; see GN 03340.040A.2. and GN 03900.000 for a discussion of authorized representatives; see GN 03910.060 for when a representative’s authority expires.

B. Policy – What To Disclose

You may disclose to an authorized representative any information an applicant, claimant, beneficiary or representative payee is entitled to receive, subject only to any limitations imposed by the individual (see GN 03910.025 and GN 03910.060). This is not considered access but, rather, disclosure with consent or disclosure for a routine use.

NOTE: Because of the sensitivity of the contents of medical records, these records must be identified as medical records when disclosed. Cover medical records with a completed Form SSA-1994 (Confidential Sheet for Transmittal of Medical Information). If an SSA-1994 is not available, make a cover sheet to identify the records as “Confidential - medical information.”

C. Policy - Limiting Disclosure

In some cases you may need to discuss with the representative what documents are needed. You may also suggest that the representative come to the FO to review the file to determine which items are to be copied.

Although SSA staff normally copies all material made available to a requester, you may allow a visitor to whom you are releasing information to operate the SSA photocopy equipment. The following requirements must be met:

• local management approves the arrangements,

• information in the file pertaining to other individuals is removed from the file before photocopying if there is no authorization to disclose, and

• local management arranges for SSA staff to monitor the representatives’ handling of the file to ensure that he/she does not remove original material from the file.

EXAMPLE: The authorization only provides for release of information about the A beneficiary, and there is information concerning the B beneficiary in file. All material pertaining to B is removed before allowing the requester to photocopy the file.

In all cases, someone on the SSA staff must monitor the representatives’ handling of the file to ensure that he/she does not remove original material from the file (see GN 03360.020., item 1.).

EXAMPLE: The representative is pursuing a medical issue which concerns the beneficiary. No other information in the claims folder is relevant. Rather than copy the entire file, suggest that only the medical records be copied.

However, if the representative declines to come in and/or asks for the entire file, provide a copy (subject to the limitations in this section).

NOTE: While we do not suggest including documents such as Master Beneficiary Record (MBR) printouts and output screens (administrative) when providing a copy of the claims file to the authorized representative, if the representative specifically requests that a copy of such documents be included, it should be provided (subject to the limitations in this section). In some instances authorized representative entities are asking for high volume quantities of MBRs and output screens. While we do not encourage requests of this nature, as long as the authorized representative has presented the proper authority to request the records (e.g., SSA-1696-U4, or a SSA-3288) we will honor the requests. In these cases, only disclose the information that pertains to the individual who is being represented by the authorized representative. Regional offices may wish to develop their own procedures for processing such requests.

D. List of Systems of Records From Which Disclosure May Be Made

Disclosure of information to attorneys and representatives is based on written authorization from the individual via Form SSA-1696 or an equivalent form (see GN 03910.040B.). Relevant information may be disclosed from any SSA systems of records maintaining information falling within the scope of the authorization.

E. Procedure

See GN 03316.001D.