Official form collection
Disability & medical evidence forms and guides
Review disability reports, function questionnaires, medical authorizations, and evidence-development forms.
18 forms in this collection
SSA-16 PDF
Application for Disability Insurance Benefits
SSA-16, Application for Disability Insurance Benefits, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-454-BK PDF
Continuing Disability Review Report
SSA-454-BK, Continuing Disability Review Report, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-455 PDF
Disability Update Report
SSA-455, Disability Update Report, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-546 PDF
Worker's Compensation/Public Disability Questionnaire
SSA-546, Worker's Compensation/Public Disability Questionnaire, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3368-BK PDF
Disability Report - Adult
SSA-3368-BK, Disability Report - Adult, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3369-BK PDF
Work History Report
SSA-3369-BK, Work History Report, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3373-BK PDF
Function Report - Adult
SSA-3373-BK, Function Report - Adult, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3375-BK PDF
Function Report - Child Birth to 1st Birthday
SSA-3375-BK, Function Report - Child Birth to 1st Birthday, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3376-BK PDF
Function Report - Child Age 1 to 3rd Birthday
SSA-3376-BK, Function Report - Child Age 1 to 3rd Birthday, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3377-BK PDF
Function Report - Child Age 3 to 6th Birthday
SSA-3377-BK, Function Report - Child Age 3 to 6th Birthday, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3378-BK PDF
Function Report - Child Age 6 to 12th Birthday
SSA-3378-BK, Function Report - Child Age 6 to 12th Birthday, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3379-BK PDF
Function Report - Child Age 12 to 18th Birthday
SSA-3379-BK, Function Report - Child Age 12 to 18th Birthday, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3380-BK PDF
Function Report - Adult - Third Party Form
SSA-3380-BK, Function Report - Adult - Third Party Form, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3820-BK PDF
Disability Report - Child
SSA-3820-BK, Disability Report - Child, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-3830 PDF
Certification of Low Birth Weight for SSI Eligibility
SSA-3830, Certification of Low Birth Weight for SSI Eligibility, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-4814 PDF
Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection
SSA-4814, Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-4815 PDF
Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection
SSA-4815, Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
Read guideSSA-5665-BK PDF
Teacher Questionnaire
SSA-5665-BK, Teacher Questionnaire, is an official Social Security Administration PDF listed in the Social Security Administration forms directory. This guide explains what to prepare, how to review the form, and where to get the current government download.
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