Get Ssa 4486

Filling out the Ssa 4486 is a critical step in the process of requesting a hearing regarding disability claims. This guide provides clear, step-by-step instructions to assist users in accurately completing the form online.

Follow the steps to fill out the Ssa 4486 effectively.

1. Click ‘Get Form’ button to access the Ssa 4486 form and open it in your online editor.
2. Begin by providing your name and Social Security number in the designated fields. If applicable, include the wage earner's name and Social Security number.
3. Review the privacy act and paperwork act notice to understand how the information you provide may be used.
4. Indicate whether you have worked since the date your request for reconsideration was filed by answering yes or no and describing the nature and extent of your work if applicable.
5. Answer whether there has been any change in your condition since the above date and provide a description if necessary.
6. State if your daily activities or social functioning has changed since the above date, providing specifics if applicable.
7. For any medical consultations, list the name and address of the physician, alongside details such as the frequency of visits, dates, and reasons for visits, including types of treatment received.
8. If applicable, provide information on any hospitalization or treatment received at a facility, including details of admissions and reasons for treatment.
9. Complete sections regarding any medical or vocational services received from community agencies, listing their names and contact information as needed.
10. List any prescription and nonprescription medications you are currently taking, including dosages where applicable.
11. Indicate if you have filed for workers' compensation, including any relevant details if you have received an award.
12. If additional space is needed, attach a separate statement as necessary to provide complete information.
13. Once all sections are completed, save your changes, and proceed to download, print, or share the form as required.

Complete your documents online to ensure a smooth application process.