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Rity Number) (Wage Earner and Social Security Number) (Leave blank if same as claimant) The last time we brought your case upto-date was: B. To be completed by the claimant PLEASE PRINT Please Answer the Following Questions: (1) Have you been treated or examined by a doctor (other than a doctor at a hospital) since the above date? --------------------------------------------------------------------------------- Yes No (If yes, please list the names, addresses and telephone numbers of doc.

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You can upload documents by using the Send Response for Individual Case link on the Electronic Records Express Home page. The upload function is also available while accessing a claimant's electronic folder through the Access Claimant's Electronic Folder link.

If you mail any documents to us, you must include the Social Security number so that we can match them with the correct application. Do not write anything on the original documents. Please write the Social Security number on a separate sheet of paper and include it in the mailing envelope along with the documents.

Write a letter to the Social Security offices. In the letter, include your Social Security Number and your claim. The address of the office is: Social Security Administration, Office of Public Inquiries, 1100 West High Rise, 6401 Security Blvd., Baltimore, MD 21235.

A notice will be sent if your benefit amount or eligibility changes and/or terminates. For example, if you receive Supplemental Security Income (SSI) and changes in your living arrangement, other income, or resources affect your benefit amount, you will receive a notice each time your benefit amount changes.

The form asks you whether or not you've been treated by a doctor (outside of a hospital) since your last review date. If yes, include the doctors' names, addresses, telephone numbers, and dates of treatment. Then detail what the doctor's have shared with you about your condition and any new findings.

If you download, print and complete a paper form, please mail or take it to your local Social Security office or the office that requested it from you.

If you are unable to check your status online, you can call us at 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday, 8:00 am – 7:00 pm; or contact your local Social Security office.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232