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How to fill out form SSA-3441

How to Fill Out Form SSA-3441—Appealing SSD Denial

A high percentage of Social Security Disability (SSD) claims are initial denied. If your application is denied and you wish to continue trying to get SSD benefits, then you must fill out Form SSA-3441, along with any other required documents.

Why This Form is Important to Your Disability Claim

If you receive a notice from the Social Security Administration (SSA) that you have been found ineligible for benefits, you must complete Form SSA-3441 within a defined timeframe in order to keep your claim active by requesting either a reconsideration review or an appeal hearing.

The notice you receive from the SSA informs you of:

  • The reason for your denial
  • Whether you should request a reconsideration review or an appeal hearing
  • The deadline for submitting your request
  • The process for filing your request

You can fill out Form SSA-3441 online or you can submit a paper form. If you appeal the decision online, the SSA’s system walks you through the full process. If you submit a paper appeal, you must complete:

  • Form SSA-3441, Disability Report – Appeal
  • Form SSA-827, Authorization to Disclose Information to the SSA
  • AND one of these forms, dependent upon which your denial notice from the SSA states you should complete:

  • Form SSA-561, Request for reconsideration
  • Form HA-501, Request for a Hearing by Administrative Law Judge

Without filling out and submitting the SSA-3441 and other required documents by the SSA’s deadline, your claim for benefits cannot remain open. If the SSA does not receive your appeal request on time, they will close your SSD case.

Filling Out the Form

The information you provide on your Appeal Disability Report decides how the SSA handles your claim moving forward.

  • Spend the time required to thoroughly complete the form. Although the information the SSA requests may sometimes seem repetitive, it is important that you invest your time in filling out all sections of this appeal form.
  • Respond within the SSA’s defined deadline. Meeting the SSA deadline for appeal is essential to keeping your claim active and open. Whether you submit your form online or as a paper submission, be sure to hit the deadline.
  • Complete all sections of the form without leaving any blanks. If there are sections of the form that do not apply in your case, do not leave them blank. At worst, failing to fill out the entire form can lead to your case being closed without further consideration. At best, it will lead to further delays in the review of your claim.
  • Collect copies of your recent medical records. This form asks you to provide the SSA information about changes in your medical condition since the last time you filed a disability report. Including copies of your new medical records helps support the information you provide on this form and gives the SSA additional details to review regarding your claim.

Consider working with a Social Security attorney or advocate, even before you begin the SSD application process. An attorney or advocate that is well versed in your claim can serve your interests well during an appeal. They can also help you complete Form SSA-3441, including compelling information in the “remarks” section.