Form SSA-4814. Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection
Form SSA-4814, the Medical Report on an Adult with an Allegation of Human Immunodeficiency Virus (HIV) Infection, is used to report medical information regarding an adult who alleges having HIV infection.
Form SSA-4815. Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection
Form SSA-4815, the Medical Report on a Child with an Allegation of Human Immunodeficiency Virus (HIV) Infection, is similar to Form SSA-4814 but is designed for children.
Form SSA-671. Railroad Employment Questionnaire
Form SSA-671, the Railroad Employment Questionnaire, is used to collect information about an individual's employment history in the railroad industry.
Form SSA-454-BK. Continuing Disability Review Report
Form SSA-454-BK, the Continuing Disability Review Report, serves as a report for individuals receiving Social Security disability benefits. Its main purpose is to conduct a continuing disability review (CDR) to assess the current disability status of beneficiaries.
Form SSA-546. Worker's Compensation/Public Disability Questionnaire
Form SSA-546, the Worker's Compensation/Public Disability Questionnaire, serves as a tool to gather information regarding a claimant's receipt of workers' compensation or public disability benefits.
Form SSA-545-BK. Plan for Achieving Self-Support
Form SSA-545-BK, the Plan for Achieving Self-Support, is used by individuals with disabilities to outline their plans for achieving self-support through employment or education.
Form SSA-437-BK. Complaint Form for Allegations of Discrimination in Programs or Activities Conducted by the Social Security Administration
Form SSA-437-BK, the Complaint Form for Allegations of Discrimination in Programs or Activities Conducted by the Social Security Administration, is used to report allegations of discrimination in programs or activities conducted by the Social Security Administration (SSA).
Form SSA-4162. Child Care Dropout Questionnaire
Form SSA-4162, the Child Care Dropout Questionnaire, is used to collect information about periods when a parent or guardian had to reduce or stop work due to the need for childcare.
Form SSA-3881-BK. Questionnaire for Children Claiming SSI Benefits
Form SSA-3881-BK, the Questionnaire for Children Claiming SSI Benefits, is a questionnaire for parents or guardians of children claiming Supplemental Security Income (SSI) benefits.
Form SSA-4-INST. Reporting Responsibilities for Child's Insurance Benefits
Form SSA-4-INST, Reporting Responsibilities for Child's Insurance Benefits, serves as instructions for individuals who are receiving or applying for Child's Insurance Benefits under the Social Security program.