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Request for Reconsideration and Disability Report - Appeal

Date: 
10/23/2002
Author: 
SSA
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These are the forms needed for the first appeal of an SSA decision (e.g., initial denial of benefits). Please note that the Disability Report - Appeal (form SSA-3441-BK) has replaced the old “Reconsideration Disability Report.” In addition to Request for Reconsideration and Disability Report forms, SSA requires Medical Authorization forms (SSA-827) for each of the sources listed in the Reconsideration Disability Report.

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AttachmentSize
PDF icon ssa-561_request_for_recon.pdf234.46 KB
PDF icon ssa-827.pdf110.57 KB
PDF icon 9466_ssa-3441.pdf202.57 KB
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