Social Security Disability Forms for Download

Click to download the following Social Security Disability forms

PRE-APPLICATION

Workers Compensation/Public Disability Questionnaire

    SSA-546 Print and fill out by hand (67 kb)
    SSA-546 Fill out online, then print (159 kb)

Disability Report-Adult

    SSA-3368 Print and fill out by hand (125 kb)
    SSA-3368 Fill out online, then print (426 kb)

Work History Report

    SSA-3369 Print and fill out by hand (80 kb)
    SSA-3369 Fill out online, then print (385 kb)

HEARING REQUEST

Claimant’s Statement

When ‘Request for Hearing’ is filed and issue is Disability

    HA-4486 Print and fill out by hand (101 kb)
    HA-4486 Fill out online, then print (157 kb)

HEARING PREPARATION

Disability Report Appeal

    SSA-3441-BK Print and fill out by hand (72 kb)

Medication List

    HA-4632 Print and fill out by hand (46 kb)
    HA-4632 Fill out online, then print (65 kb)

Recent Work History

    HA-4633 Print and fill out by hand (216kb)
    HA-4633 Fill out online, then print (231 kb)

Please Note:
All documents above are stored in Portable Document Format (.PDF) and require Acrobat Reader 5.0 or greater to view. Click on this icon to download Acrobat Reader DC