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Client Application & Appeal Forms For Disability Process

The following forms, which are client application and appeal forms, are the important paperwork for the disability process. These forms are helpful for those who are applying for disability benefits or are in the process of completing appeals for the Social Security Administration. If you are filling these forms out, call us. Because, we can help you complete the forms correctly. If you have specific questions, please feel free to contact Cannon Disability Law. Not all of the forms that you need to complete are on this page. For a copy of all of the forms, please contact us and we will help you file your application or appeal.

APPLICATION FOR SSD/SSI BENEFITS

You can apply for SSD/SSI benefits by calling the Social Security Administration’s toll-free number at 800.772.1213 or you can apply online at their Web site at http://www.ssa.gov/. Download the required application forms from the website or request they be mailed to you. When you fill out and return the forms, you must also mail a copy of your birth certificate. If your claim is denied, then you should file a request for reconsideration which is due within a 60-day deadline from the date you received your initial denial. Do not file a new application. When you fill out the application form, you should list any children you have who are under the age of 18, because they may also be eligible for benefits on your record. Filing an application with the Social Security Administration and obtaining any of their forms is free. All forms are online at the SSA’s website.

​THE DISABILITY REPORT

SSA uses the Disability Report to request your medical records that document your disability. This form gives the SSA list of all your  treating doctors and hospitals. Social Security must acquire all of your medical records and you need to provide them the information to obtain your medical records. This form is usually completed at the client application and is submitted with appeal forms. Our Salt Lake City Social Security Disability lawyers can help you fill out this form. You can obtain this form by going to http://www.ssa.gov – typing in Forms in the search box and clicking on the item entitled Online – Adult Disability Report, Alternatively, you can print out this form and complete it. – [PDF]Disability Report- Adult – Social Security,

THE WORK HISTORY REPORT

The Work History Report is one of the most important forms you will complete for the SSA. Many people lose their disability case by treating the questions on the Work History Report as if it is a resume. This report is not a resume. Do not overstate your accomplishments or write down you were a manager or a supervisor, when in fact you were not. On the form, you should focus on how much you had to lift on the job and the physical requirements of the job.

A simple description of your past work is better than a lengthy description of every little thing you did at your past job. A one sentence description is usually sufficient. For example, if you were a secretary you could write: “I was a secretary. I answered phones and typed letters.” Most clients who appeal and fill out this form treat it like a job application. That is a mistake.  Resumes highlight your abilities. Therefore, when you submit a job application, you might submit a resume that does not describe what you did on the job. Do not submit your resume. Instead, describe the physical and mental requirements of your past job. That is what the Work History Report is for.

Many people make the mistake of saying they did not need to lift on their past job, when in fact almost all jobs require some lifting. A secretary, for example, may need to lift boxes of paper or supplies which weigh anywhere from 10-20 pounds. Try to be accurate when completing the physical duties of your past jobs. You can find a copy of form SSA-3369-BK Work History Report online at http://www.ssa.gov. Please contact our office if you have questions about this form.

THE FUNCTION REPORT

The Function Report documents how you spend a typical day in your life and the tasks you are able to perform. Social Security uses the form to determine what kind of limitations you have and whether you can work full-time. If you are alleging disability due to mental impairments, write about that. During the day, for instance, you might have trouble watching TV, because you can’t concentrate. You may have memory problems or crying spells. Or, you might have panic attacks and fear of leaving the house. Write down how this prevents you from shopping or going to church.

If you have physical impairments, write down how those stop you from doing activities. For example, you could write that you can’t sit during dinner due to back pain. Perhaps, a family member needs to help you shower, cook your food, or do your laundry. If so, write it down. Additionally, people with back pain often must lie down during the day. If you lie down in your bed or on the couch, tell the SSA that on the form.

It is important that you list how much rest your require and any difficulties you have while doing everyday tasks. For example, if you need to take breaks while driving or standing in line due to pain, write that on the form. If you can’t type, hold onto the steering wheel, or wash your hair because of hand pain, write that down. But, if you are no longer able to do your past hobbies, don’t write them down as if you still are doing them. Many people write a list of the hobbies that they used to be able to do, but the SSA will assume you can still do those hobbies if you include them on the form. Our office can help you complete this form correctly. The Function Report form can be found at http://www.ssa.gov under Forms SSA-3373-BK – Function Report – Adult.

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