Form SSA-3441-BK. Disability Report - Appeal

Form SSA-3441-BK, the Disability Report - Appeal, is a form used by individuals who wish to appeal the SSA's decision regarding their disability benefits. The primary purpose of this form is to collect updated information about the individual's medical condition, treatments, and any changes in their ability to work or perform daily activities.

For example, if an individual disagrees with the SSA's decision to deny or terminate their disability benefits, they may use this form to provide additional information and request an appeal. The purpose is to present new evidence or clarify existing information to support their claim for disability benefits.

The parties involved are individuals appealing the SSA's decision and the SSA itself. The form typically consists of sections related to the individual's medical condition, treatments, work history, and changes in their ability to perform daily activities. Accurate and updated reporting is essential for a successful appeal and to provide the SSA with a clear picture of the individual's condition and limitations.