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Disability Report - Appeal
This form is used to secure updated resource and condition information from claimants seeking reconsideration of denied disability benefits. The claimant also has the option of providing the information during a personal interview or through SSA's Internet application. This information assists the State DDS and ALJ in preparing for appeals and hearings and in issuing a decision.
Form #:  SSA 3441 BK
Agency:  Social Security Administration
  TYPE PAGES SIZE (KB) CAPABILITY WHAT'S
NEEDED
html Both Form and Instructions 10 0 [1] Paper Only Internet Explorer  

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