In July 2013, the Social Security Administration revised the Consent for Release of Information form, used to obtain information regarding an individual’s receipt of Social Security disability income benefits, Supplemental Security Income benefits, or Medicare benefits. The fillable form can be found here.
Please note that this form is not the authorization required by the Centers for Medicare and Medicaid Services to submit a Medicare Set-aside Arrangement proposal. Rather, the form is signed by the injured worker to authorize the insurer to obtain information from Social Security Administration regarding the amount of monthly benefits received or to obtain applications for disability benefits to the Social Security Administration.
If you have any questions about the form or any other issues, please feel free to contact me.