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Social Security Disability &
Appeals Forms
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General Forms |
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SSA-1695 |
Identifying Information for
Possible Direct Payment of
Authorized Fees |
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SSA-1696 |
Appointment of
Representative |
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Disability Forms |
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SSA-1365 |
State
Agency Ticket Assignment
Form Ticket to Work and Self
Sufficiency Program |
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SSA-199 |
Vocational Rehabilitation
Provider Claim |
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SSA-3368 |
Disability Report, Adult |
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SSA-3369 |
Work
History Report |
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SSA-3373 |
Function Report Adult
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SSA-3375 |
Function Report Child to 1st
Birthday |
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SSA-3380 |
Function Report Adult
Third Party Form |
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SSA-3381 |
Medical and Job Worksheet,
Adult |
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SSA-3820 |
Disability Report, Child |
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SSA-3881 |
Questionnaire for Children
Claiming SSI Benefits |
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SSA-545 |
Plan
for Achieving Self-Support |
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SSA-546 |
Workers Compensation /
Public Disability
Questionnaire |
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SSA-5665 |
Teacher Questionnaire |
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SSA-820 |
Work
Activity Report
(Self-Employed Person) |
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SSA-821 |
Work
Activity Report |
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SSA-827 |
Authorization to Disclose
Information to the Social
Security Administration |
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Reconsideration & Appeals
Forms |
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SSA-561 |
Request for Reconsideration |
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SSA-789 |
Request for Reconsideration
Disability Cessation |
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SSA-3441 |
Disability Report Appeal |
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HA-501 |
Request for Hearing by
Administrative Law Judge |
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HA-520 |
Request for Review of
Decision / Order of
Administrative Law Judge |
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HA-539 |
Notice
Regarding Substitution of
Party Upon Death of Claimant |
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HA-4608 |
Waiver
of Your Right to Personal
Appearance Before an ALJ |
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HA-4631 |
Claimant s Recent Medical
Treatment |
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HA-4632 |
Claimant s Medications |
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HA-4633 |
Claimant s Work Background |
