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HA-4632 - Claimant's Medications (10-2012)

HA-4631 - Claimant's Recent Medical Treatment (06-2010)

HA-4633 - Claimant's Work Background (11-2014)

HA-1151 - Medical Source Statement of Ability to do Work-Related Activities (Physical) (04-2009)

HA-1152 - Medical Source Statement of Ability to do Work-Related Activities (Mental) (04-2009) *CURRENTLY AVAILABLE IN WORD ONLY*

HA-539 - Notice Regarding Substitution of Party Upon Death of Claimant (11-2018) *CURRENTLY AVAILABLE IN WORD ONLY*

HA-55 - Objection To Appearing by Video Teleconferencing *CURRENTLY AVAILABLE IN WORD ONLY*

HA-501 - Request for Hearing by Administrative Law Judge (1-2015)

HA-520 - Request for Review of Hearing Decision Order (10-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

HA-85 – Request To Withdraw A Hearing Request (09-2021) *CURRENTLY AVAILABLE IN WORD ONLY*

HA-510 - Waiver of Written Notice of Hearing (4-2020)

HA-4608 - Waiver of Your Right to Personal Appearance Before an Administrative Law Judge (07-2014) *CURRENTLY AVAILABLE IN WORD ONLY*

ALJ Bench Decision Checksheet - Print Version

COVID-19 Public Health Emergency Hearing Agreement Form

NOSSCR Hearing Format Election Form (2023)

Remote Hearing Agreement Form (2023)

SSA-4-BK - Application For Child's Insurance Benefits (05-2023) *CURRENTLY AVAILABLE IN WORD ONLY

SSA-16 - Application for Disability Insurance Benefits (06/2022) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-8000-BK – Application for Supplemental Security Income (05-2021) *CURRENTLY AVAILABLE

SSA-8001-BK - Application for Supplemental Security Income (07-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-10 - Application for Widows or Widowers Insurance Benefits (SSA 10) (10-2019) *CURRENTLY AVAILABLE IN WORD ONLY

SSA-2-BK - Application for Wife's or Husband's Insurance Benefits (07-2018) *CURRENTLY AVAILABLE IN WORD ONLY

SSA-827 - Authorization to Disclose Information to the SSA (06-2024)

SSA-827 - Authorization to Disclose Information to the SSA (Includes Instructions Page) (03-2020)

SSA-8240 - Authorization for the SSA to Obtain Wage and Employment Information from Payroll Data Providers (02-2021) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-1696 - Claimant's Appointment of Representative (08-2020)

SSA-1696-SUP1 - Claimant's Revocation of the Appointment of a Representative (08-2019)

SSA-3288 - Consent for Release of Information (2-2023)

SSA-3368 BK - Disability Report - Adult (11-2020) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-3441 - Disability Report - Appeal (01-2021)

SSA-3820 BK – Disability Report – Child (05-2021) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA 1693 - Fee Agreement for Representation Before the Social Security Administration (11-2022) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-3373 - Function Report - Adult (03-2024) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-3380 - Function Report - Adult - Third Party (12-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-3381 - Medical and Job Worksheet - Adult (12-2009)

SSA-787 - Medical Source Option of Patients Capbility to Manage Benefits (12-2018) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-1560 - Petition to Obtain Approval of a Fee for Representing a Claimant Before the SSA (2-2024)

SSA-3881 - Questionnaire for Children Claiming SSI Benefits (1-2022) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-1696-SUP2 - Representative's Withdrawal of Acceptance of an Appointment (07-2019)

SSA-634 - Request for Change in Overpayment Recovery Rate (09-2019) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-769 - Request for Change in Time or Place of Disability Hearing (09-2017) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-561 - Request for Reconsideration (6-2019) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-789 - Request for Reconsideration - Disability Cessation (06-2024) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-61 - Request for Review by a Federal Reviewing Official (08-2006)

SSA-7050-F4 - Request for Social Security Earnings Information (11-2022) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-7004 - Request for Social Security Statement (04-2013) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-632 - Request for Waiver of Overpayment Recovery or Change in Repayment Amount (09-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-521 - Request for Withdrawal of Application (7-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-795 - Statement of Claimant or Other Person (02-2020)

SSA-754-F5 - Statement of Marital Relationship (12-2019) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-820 - Work Activity Report - Self-Employed Person (04-2012) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-821 - Work Activity Report - Employee (01-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-3369 - Work History Report (06-2024) *CURRENTLY AVAILABLE IN WORD ONLY*

SSA-546 - Workers' Compensation/Public Disability Benefit Questionnaire (02-2012) *CURRENTLY AVAILABLE IN WORD ONLY*

VA9 - Appeal to Board of Veterans' Appeals (3-2025)

VA21P-601 Application for Accrued Amounts Due a Deceased Beneficiary (08-2022)

VA10-8678 - Application for Annual Clothing Allowance (06-2015)

VA21-0966 - Intent to File A Claim For Compensation

VA21P-530ez - Application for Burial Benefits (08-2022)

VA21-535 - Application for Dependency and Indemnity Compensation by Parent(s) (Including Accrued Benefits and Death Compensation when Applicable) (09-2022)

VA21-534 - Application for Dependency and Indemnity Compensation

VA21P-534EZ - Application for DIC (07-2022)

VA21-526EZ - Application for Disability Compensation and Related Compensation Benefits (11-2022) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-22A - Appointment of Individual as Claimant's Representative (07-2023)

VA21-4142 - Authorization to Disclose Information to the Department of Veterans Affairs (08-2024)

VA0857d - Administrative Closure of Accommodation Request (11-2013)

VA21-0845 - Authorization to Disclose Personal Information to a Third Party (02-2023)

VA - Centralized Intake Coversheet (07-2019) *CURRENTLY AVAILABLE IN WORD ONLY

VA40-1330M - Claim for Government Medallion for Placement in a Private Cemetery (08-2022) *CURRENTLY AVAILABLE IN WORD ONLY

VA40-1330 - Claim for Standard Government Headstone or Marker for Placement in a Private Cemetery or a State Veterans' Cemetery (07-2021) *CURRENTLY AVAILABLE IN WORD ONLY

VA20-0995 - Decision Review Request: Supplemental Claim (06-2024) *CURRENTLY AVAILABLE IN WORD ONLY*

VA20-0996 - Decision Review Request: Higher Level Review (03-2024) *CURRENTLY AVAILABLE IN WORD ONLY*

VA10182 - Decision Review Request: Board Appeal (Notice of Disagreement) (03-2022) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-686c - Declaration of Status of Dependents (09-2018)

VA10-10208 - Document Evidence Submission (10-2020) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-4140 – Employment Questionnaire (07-2021) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-2680 - Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (02-2023)

VA20-10206 - FOIA or PA Request (10-2020) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-4142a - General Release for Medical Provider Information to the Department of VA (7-2021) *CURRENTLY AVAILABLE IN WORD ONLY

VA10-5345a - Individuals' Request For A Copy Of Their Own Health Information (07-2021) *CURRENTLY AVAILABLE IN WORD ONLY

VA21P-0969 - Income and Asset Statement in Support of Claim for Pension or Parents Dependency and Indemnity Compensation (11/2023) *CURRENTLY AVAILABLE IN WORD ONLY

VA21-10210 - Lay Witness Statement (7-2024) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-0538 - Mandatory Status of Dependents (2-2021) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21P-8416 – Medical Expense Report (10-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-0958 - Notice of Disagreement (09-2018) *CURRENTLY AVAILABLE IN WORD ONLY*

VA20-10207 - Priority Processing Request (8-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

VA10-5345 - Request for and Authorization to Release Medical Records or Health Information (10-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

VA3288 - Request for and Consent to Release of Information from Individual's Records (10-1995)

VA674 - Request for Approval of School Attendance (10-2021)

VA20-572 - Request for Change of Address Cencellation of Direct Deposit (03-1996)*CURRENTLY AVAILABLE IN WORD ONLY*

VA21-4192 - Request for Employment Information in Connection with Claim for Disability Benefits (07-2021)

VA 10-10HS - Request for Hardship Determination (07-2021) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21P-0847 - Request for Substitution of Claimant Upon Death of Claimant (12-2021) *CURRENTLY AVAILABLE IN WORD ONLY

VA180 - Request Pertaining to Military Records (07-2023) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-674b - School Attendance Report (10-2021)

VA21-4138 - Statement in Support of Claim (06-2021)

VA21-0781 - Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (PTSD) (03-2024) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-0781a - Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (PTSD) Secondary to Personal Assault (06-2021) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-526 - Veterans Application for Compensation and/or Pension (11-2014) *CURRENTLY AVAILABLE IN WORD ONLY*

VA21-8940 - Veterans Application for Increased Compensation Based on Unemployability (7-2024)

VA21-526b - Veterans Application for Compensation and/or Pension (6-2014)

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