Social Security Disability Forms for Download

Click to download the following Social Security Disability forms

PRE-APPLICATION

Workers Compensation/Public Disability Questionnaire

    SSA-546 (updated Feb. 2012)

Disability Report-Adult

    SSA-3368-BK (updated Oct. 2015)

Work History Report

    SSA-3369 (updated Apr. 2014)

DEVELOPMENT FORMS

Function Report – Adult

    SSA-3373-BK (updated Jan. 2013)

Function Report – 3rd Party

    SSA-3380-BK (updated Sept. 2017)

APPEAL FORMS

Disability Report Appeal

    SSA-3441-BK (updated Apr. 2018)

HEARING PREPARATION

Claimant’s Recent Medical Treatment

    HA-4631  (updated Jun. 2010)

Medication List

    HA-4632  (updated Jun. 2010)

Recent Work History

    HA-4633  (updated Nov. 2013)

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