This form is used to establish a date on which a claimant's eligibility for benefit payments is determined (sometimes called the protective filing date). An application must be filed with the Social Security Administration before one can be entitled to Social Security payments or Supplemental Security Income (SSI). A letter, filed with the SSA, may serve as an application if all of the necessary requirements are met.
California Letter or Statement to Social Security Administration in Order to Establish Claimant's Date of Eligibility for Benefits
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Multi-State
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US-01279BG
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Word;
Rich Text
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How to fill out Letter Or Statement To Social Security Administration In Order To Establish Claimant's Date Of Eligibility For Benefits?
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FAQ
You can get a paper Claim for Disability Insurance (DI) Benefits (DE 2501) form by:Ordering a form online to have it mailed to you.Getting the form from your physician/practitioner or employer.Visiting an SDI Office.Calling 1-800-480-3287 to request a paper form by mail.
SEND THE COMPLETED FORM TO YOUR LOCAL SOCIAL SECURITY OFFICE. The office is listed under U.S. Government agencies in your telephone directory or you may call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). You may send comments on 01 to estimate above to. SS4, 6401 Securin Boulevard Baltimore, MD 21235-6401.
Form DE 2501, Claim for Disability Insurance (DI) Benefits, is a form to request, by mail, worker-funded benefits to eligible workers who have a full or partial loss of wages due to disabilities that are not work-related. Alternate Name: California Disability Form.
If you are under the care of an accredited religious practitioner, obtain a Claim for Disability Insurance Benefits - Religious Practitioner's Certificate (DE 2502) by calling 1-800-480-3287 and ask your religious practitioner to complete and sign it.
Individuals use Form SSA-795 to make signed statements relating to claims for Social Security benefits or Supplemental Security Income (SSI) payments under 20 CFR 404.702 and 416.570 of the Code of Federal Regulations.
Related to Statement of Claimant Claimant means a person or entity who or which submits a Claim Form to the Claims Administrator seeking to be eligible to share in the proceeds of the Settlement Fund.
What is a SSA 795? A Form SSA 795 is known as a Statement of Claimant or Other Person. It will be received and recorded by the Social Security Administration in the United States. The form will be used by a third party to make a statement about the applicant's employment or wages.
Form DE 2501, Claim for Disability Insurance (DI) Benefits, is a form to request, by mail, worker-funded benefits to eligible workers who have a full or partial loss of wages due to disabilities that are not work-related. Alternate Name: California Disability Form.
General filing instructions for the SSA Form 795 are as follows: Indicate the name of the claimant in the first field. Provide the Social Security Number (SSN) of the claimant. If you are not the claimant, enter your name in the box titled "Name of Person Making Statement." Specify your relationship with the claimant.
