[PDF] Social Security Disability Application PDF in English

The disability application collects personal details, medical documentation, descriptions of functional limitations, 15-year work history, and authorization to obtain medical/employer information to evaluate if the applicant’s medical conditions prevent them from working.

Social Security Disability Application PDF in English

PDF Title	Social Security Disability Application
Language	English
Pages	7
File Size	140 KB
Format	PDF
Source	ssa.gov
Price	Free

About PDF

• The application asks for personal information like name, contact details, social security number, marital status, medical conditions, work history, etc.
• Supporting medical documentation from doctors about diagnoses, treatments, and test results needs to be provided to show proof of disability.
• A description of how the medical conditions limit the ability to work, activities of daily living, and social functioning is required.
• The work history section provides space to list job titles, duties performed, equipment used, hours worked, etc. for all jobs in the past 15 years.
• Authorization is needed to allow Social Security Administration to contact doctors, hospitals, and employers to obtain applicant’s medical and work information.

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