TN 5 (11-15)

A. Policy for disclosing information

An individual may consent to disclose his or her records to a legal aid group or private law firm using the SSA-3288 or other consent form that meets our requirements. These entities may elect to become the individual’s appointed representative during the claims process. Prior to that appointment, disclosures from the individual’s record require consent.

NOTE: Do not disclose the requested information to a copying service or other company performing administrative services unless that entity is named separately on the consent form. “In care of” notations on the consent form are not acceptable for purposes of disclosure to a copying service or similar entity.

B. Appointed representatives and designated associates

The SSA-1696-U4 permits individuals to authorize the release of records to an appointed representative and designated associates, who perform administrative duties (e.g. clerks, partners, and or parties under contractual arrangements (e.g., copying services) for or with the appointed representative, by selecting the appropriate box on the SSA-1696-U4. If we receive a notice of appointment (SSA-1696-U4 or equivalent writing) authorizing us to release records to a designated associate, a separate SSA-3288 (or other consent form meeting our requirements) is not required as long as the appointed representative is representing the individual in a matter currently pending with SSA.

The appointed representative must request records or other information from the Social Security FO that services the mailing address ZIP code of his or her client (See GN 03305.020).

C. Disclosure to the appointed representative and designated associate when the appointment ends

We will honor an individual’s request to disclose records to the appointed representative and his or her designated associates, as long as the appointed representative’s appointment has not ended. The appointed representative’s appointment ends when:

1. The individual cancels the appointment;

2. The representative withdraws his or her own appointment; or

3. The appointment expires (See GN 03910.060).

If one of these conditions exists, the individual must provide consent for any subsequent disclosure of his or her records to the representative.

D. Fees for providing records

Charge the full cost or the appropriate standard fee for providing records or other information to third party requesters where the request is for a non-program purpose. For detailed information about charging fees for non-program purposes, see GN 03311.005E.