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Social Security Administration Number: 1-800-722-1213
Medicare Forms
Disability Forms
Social Security Disability
Social Security Administration Number: 1-800-722-1213
Medicare Forms
- SSA-44 Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event
- SSA-54 Authorization for SSA to Disclose Tax Information for Your Appeal of Your Medicare Part B Income-Related Monthly Adjustment Premium Amount
- SSA-1020B-INST General Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs
- SSA-1021 Appeal of Determination for Help with Medicare Prescription Drug Costs
- SSA-1021-INST Instructions for Completing the Appeal of Determination for Help with Medicare
- SSA-1021-SP Apelación de la determinación para recibir ayuda con los gastos de los Planes
- SSA-1021-INST-SP Instrucciones - Apelación de la determinación para recibir ayuda con los gastos
Disability Forms
- SSA-827 Authorization to Disclose Information to the Social Security Administration
- SSA-199 Vocational Rehabilitation Provider Claim
- SSA-545 Plan for Achieving Self-Support
- SSA-546 Worker's Compensation/Public Disability Questionnaire
- SSA-820 Work Activity Report (Self-Employed Person)
- SSA-821 Work Activity Report
- SSA-1365 State Agency Ticket Assignment Form Ticket To Work and Self Sufficiency Program
- SSA-3368 Disability Report Adult
- SSA-3369 Work History Report
- SSA-3373 Function Report-Adult
- SSA-3375 Function Report-Child Birth to 1st Birthday
- SSA-3380 Function Report Adult-Third Party Form
- SSA-3381 Medical and Job Worksheet Adult
- SSA-3820 Disability Report, Child
- SSA-3881 Questionnaire for Children Claiming SSI Benefits
- SSA-5665 Teacher Questionnaire
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