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Click ‘Get Form’ to open the DISABILITY REPORT- APPEAL in our editor.
Begin with SECTION 1, providing your name, Social Security Number, and contact information. Ensure all details are accurate for effective communication.
In SECTION 2, list a contact person who can provide additional information about your medical conditions. Include their relationship to you and contact details.
Move to SECTION 3 to report any changes in your medical conditions since your last submission. Be specific about new or worsening conditions.
SECTION 4 requires details of your medical treatment. List healthcare providers and their contact information, including dates of visits and treatments received.
Continue through the form by answering questions in SECTIONS 5 through 9 regarding other medical information, medications, activities, work history, and support services.
Finally, use SECTION 10 for any additional remarks or clarifications needed for your application.
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