Request for Reconsideration and Disability Report - Appeal

Date:
Author:
SSA

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.

Attachment Size
ssa-561_request_for_recon.pdf (234.46 KB) 234.46 KB
ssa-827.pdf (110.57 KB) 110.57 KB
9466_ssa-3441.pdf (202.57 KB) 202.57 KB