Form to appoint an attorney or representative:
Appointment of Representative Form: www.ssa.gov/forms/ssa-1696.pdf
Forms to file an Initial Application for SSDI or SSI benefits:
Application for Social Security Disability Insurance Benefits (Initial Application for SSDI): www.ssa.gov/forms/ssa-16-bk.pdf
Application for Supplemental Security Income Benefits (Initial Application for SSI): www.secure.ssa.gov/apps10/poms/images/SSA8/G-SSA-8001-BK-1.pdf
Adult Disability Report (Disability Report for SSDI and SSI): www.ssa.gov/forms/ssa-3368.pdf
Authorization to Disclose Information To The Social Security Administration (Medical Release Form/HIPPA Release): www.ssa.gov/forms/ssa-827.pdf
Forms to file an appeal of a denial of your SSDI or SSI claim:
Request for Hearing: www.ssa.gov/forms/ha-501.pdf
Request for Reconsideration: www.ssa.gov/forms/ssa-561.pdf
Disability Report-Appeal Form (Reconsideration Appeal and Hearing Appeal Form): www.ssa.gov/forms/ssa-3441.pdf
Additional forms often requested by SSA to process your claim:
Application for Child’s Insurance Benefits: www.ssa.gov/forms/ssa-4.pdf
Child’s Disability Report: www.ssa.gov/forms/ssa-3820.pdf
Claimant’s Medications: www.ssa.gov/forms/ha-4632.pdf
Claimant’s Recent Medical Treatment: www.ssa.gov/forms/ha-4631.pdf
Claimant’s Work Background: www.ssa.gov/forms/ha-4633.pdf
Function Report: www.ssa.gov/forms/ssa-3373-bk.pdf
Request for Social Security Earnings Information: www.ssa.gov/forms/ssa-7050.pdf
Work Activity Report: www.ssa.gov/forms/ssa-821.pdf
Workers’ Compensation/Public Disability Benefit Questionnaire: www.ssa.gov/forms/ssa-546.pdf
Work History Report: www.ssa.gov/forms/ssa-3369.pdf
Resources:
www.dol.gov/dol/topic/health-plans/erisa.htm
