Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Social Security Administration before sending sensitive documents. FaxFlow is not affiliated with this organization.
Social Security Administration fax number
(833) 950-3567
Representative Payee Program / Protective Payee Services (SSA office)
Used for: Fax SSA-787 Medical Source Statement to SSA for protective payee application; SSA-787 is used to determine need for a representative payee.
Fax destination details
- Department
- Representative Payee Program / Protective Payee Services (SSA office)
- Purpose
- Fax SSA-787 Medical Source Statement to SSA for protective payee application; SSA-787 is used to determine need for a representative payee.
- Form
- SSA-787 — Physician's/Medical Officer's Statement of Patient's Capability to Manage Benefits
- Address
- Social Security Office, 455 SW 5th St Ste F, Riverpoint Ofc Complex, Des Moines, IA 50309
- Voice phone
- +1-866-964-7583
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Form completed by the patient's physician/medical officer detailing the patient's capability to manage benefits and the justification for needing a payee.
Review official form instructionsSources and verification
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