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Client Application & Appeal Forms

The following forms are designed to help our clients complete the proper paperwork during the disability process. These forms are helpful for those who are applying for disability benefits or are in the process of completing appeal forms for the Social Security Administration. If you have specific questions, please feel free to contact Cannon Disability Law.

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 Web site 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

The Disability Report is used by the SSA to request your medical records which document your disability. When filling out the disability report, list all of the doctors and hospitals you have visited for your treatments. Social Security must acquire all of your medical records and you are required to provide the information for obtaining your medical records. Our office 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 or 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.” 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. It is important that you list any difficulties you have while doing everyday tasks, and also how much rest you require. For example, if you typically need to lie down during the day because of pain or disability, make sure that you write that on the form. If you are no longer able to do your past hobbies, do not write them down. Many people will write a list of the hobbies that they used to be able to do, but the SSA will assume that 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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