Social Security Forms
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 FORMS
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 FORMS
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)