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