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Knowledge Base

SSA Forms Library

The forms behind every disability claim — what each one is for and how to complete it.

HA-501

Request for Hearing by Administrative Law Judge

Form HA-501 asks for a hearing before an Administrative Law Judge after your claim has been denied at reconsideration. The…

HA-520

Request for Review of Hearing Decision/Order

Form HA-520 asks the Appeals Council to review an unfavorable or partially favorable decision issued by an Administrative Law…

SSA-16

Application for Disability Insurance Benefits

Form SSA-16 is the official application for Social Security Disability Insurance (SSDI), the benefit program for workers who have…

SSA-1696

Claimant's Appointment of a Representative

Form SSA-1696 officially appoints a representative, such as an attorney, to act for you in your Social Security claim. Once the…

SSA-3368

Disability Report - Adult

Form SSA-3368, the Adult Disability Report, is the core medical questionnaire filed with every adult disability application. It…

SSA-3369

Work History Report

Form SSA-3369, the Work History Report, documents the jobs you held during the 15 years before you became unable to work. For…

SSA-3373

Function Report - Adult

Form SSA-3373, the Adult Function Report, describes how your conditions affect your daily life. It walks through a typical day:…

SSA-455

Disability Update Report

Form SSA-455, the Disability Update Report, is the short mailer SSA uses to conduct low-intensity continuing disability reviews…

SSA-561

Request for Reconsideration

Form SSA-561 is the first-level appeal of a denied Social Security claim. Filing it asks the state Disability Determination…

SSA-795

Statement of Claimant or Other Person

Form SSA-795 is SSA's all-purpose sworn statement form, used whenever you or someone who knows you needs to put facts on the…

SSA-8000

Application for Supplemental Security Income (SSI)

Form SSA-8000 is the application for Supplemental Security Income (SSI), the needs-based program for people who are disabled,…

SSA-827

Authorization to Disclose Information to the Social Security Administration

Form SSA-827 is the medical release that lets SSA and the state Disability Determination Services collect the evidence your claim…

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