Form to appoint an attorney or representative:

Appointment of Representative Form: Download Here!


Forms to file an Initial Application for SSDI or SSI benefits:

Application for Social Security Disability Insurance Benefits (Initial Application for SSDI): Download Here!

Application for Supplemental Security Income Benefits (Initial Application for SSI): Download Here!

Adult Disability Report (Disability Report for SSDI and SSI): Download Here!

Authorization to Disclose Information To The Social Security Administration (Medical Release Form/HIPPA Release): Download Here!


Forms to file an appeal of a denial of your SSDI or SSI claim:

Request for Hearing: Download Here!

Request for Reconsideration: Download Here!

Disability Report-Appeal Form (Reconsideration Appeal and Hearing Appeal Form): Download Here!


Additional forms often requested by SSA to process your claim:

Application for Child’s Insurance Benefits: Download Here!

Child’s Disability Report: Download Here!

Claimant’s Medications: Download Here!

Claimant’s Recent Medical Treatment: Download Here!

Claimant’s Work Background: Download Here!

Function Report: Download Here!

Request for Social Security Earnings Information: Download Here!

Work Activity Report: Download Here!

Workers’ Compensation/Public Disability Benefit Questionnaire: Download Here!

Work History Report: Download Here!


Resources:

www.ssa.gov

www.webmd.com

www.medicinenet.com

www.medlineplus.gov

www.nlm.nih.gov

www.dol.gov

www.ssa.gov

Why Work with Us

We Have the Ability to Simplify a Complicated Process and Make Applying for Benefits Easier

  • No travel to our office is necessary
  • We can offer guidance on how to get the appropriate documentation
  • No money upfront – we don’t receive a legal fee unless you win
  • We build as strong a case as possible for a favorable outcome
  • You will have a dedicated case manager to coordinate all aspects of your case

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CLIENT TESTIMONIALS

We have Assisted Hundreds of Clients with Mental and Physical Disabilities

Derek S CervoniReviewsout of 60 reviews
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