Form 1836a 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section I, where staff should enter the patient's name, date of birth, social security number, case name, and case number. Ensure all fields are accurately filled to avoid delays.
3. In Section II, physicians must assess the patient's ability to work. Check the appropriate box under Part A based on the patient's capabilities and provide details in Parts B and C regarding any restrictions or diagnoses.
4. Complete Section III by having the patient or their representative sign to authorize the release of medical information. This is crucial for verifying eligibility for benefits.

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