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Application & Appeal Forms For Disability Process

Application and appeal forms are listed here in order to help you complete the important paperwork during disability process. These forms are necessary 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. You should 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. Also, we will help you file your appeals. The appeals you will need to file are the “request for reconsideration” and the “request fo hearing.” You only have 60 days to file an appeal after a denial notice.


You can apply for SSD and SSI benefits by calling the Social Security Administration’s toll-free number at 800.772.1213 or you can apply online at  Social Security’s website. If you want to do it by hand, then download the application forms from the website. Or, call the SSA and request they mail the forms to you.

When you fill out and return the forms, you must also mail a copy of your birth certificate. 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.

If your claim is denied, then you should file a request for reconsideration. The request for reconsideration is due within a 60-day deadline from the date you receive your initial denial. If the SSA calls you, make sure it is the SSA. Here is information about fake calls from people claiming to be the SSA.

Do not file a new application just because you receive a denial from the SSA. If you receive a denial at the reconsideration stage, then you need to request a hearing. There is a specific form to request a hearing.

You also need to complete the request for hearing within a 60 day time frame from receipt of your denial. Do not miss the 60 day deadline. If there is something preventing you from filing your paperwork within 60 days, then request an extension of time from the SSA. You can do this in writing or by calling them at 1-800-772-1213.



SSA uses the Disability Report to request your medical records. These are the medical records from your doctors that document your disability. This form gives the SSA a list of all your treating doctors, hospital visits, and Emergency Room visits. Social Security must acquire all of your medical records and you need to provide them the information to obtain your medical records.

The Disability Report form is usually completed at the time you complete your application for benefits. It is submitted with your 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 the Social Security website.

Next, you type the word 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 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 accurately 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 Social Security’s website. Please contact our office if you have questions about this form.


The Function Report documents how you spend a typical day in your life and also documents 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 mental impairments prevent you from going to church or shopping, then they also prevent you from working.

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 on the form. Make sure that you include how many hours you lay down during a normal day, from 9 to 5. There are no jobs in the national economy that allow you to lay down for 2 hours a day on the job.


The Activities of Daily Living form is about what you typically do during the course of a normal day. On this 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 do them. Many people write a list of the hobbies that they used to be able to do. However, 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 on the Social Security website under Forms SSA-3373-BK – Function Report – Adult.


Cannon Disability law can help you complete your application for SSD and SSI benefits. We can also help you complete any appeal forms, such as the request for reconsideration and your request for hearing. However, we cannot complete the forms for you.

Obviously, we are not with you during the day and don’t know how your disability prevents your from shopping, cleaning, or lifting heavy items. Likewise, we also don’t have an automatic list of your doctors or hospital visits.

You need to obtain this information, but we can help you along the way. As we tell all of our clients, going through the disability process is a team effort. You need the team with the most experience to help you win.

Hire our law firm to be your disability legal team in Utah, Nevada, Idaho, and California. We can help you fill out your application and appeal forms.

disability benefits application and appeals forms

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