Forms Catalog Document - HA4632 :-: SSA :-: Claimant's Medications

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Claimant's Medications

SSA uses Form HA-4632 to request that applicants for disability benefits provide information to facilitate processing their Title II, Old-Age, Survivors and Disability Insurance (OASDI) and Title XVI, Supplemental Security Income (SSI) claims. The form elicits from the claimants an updated list of medications used by the claimants. It enables the Administrative Law Judge hearing the case to fully inquire into medical treatment the claimant if receiving and the effect of medications on the claimant's medical impairments.

Form #: HA 4632
Agency: Social Security Administration

	TYPE	PAGES	SIZE (KB)	CAPABILITY	WHAT'S NEEDED
	Form Only	2	44	[2] Printable Only	Adobe Reader Download

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