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Filling Out Form HA-4633

The Social Security Administration’s Form HA-4633 is used to list all of your employers and the types of work you have performed over the past fifteen years. It is important that this form be filled out completely and honestly. The SSA will use the information on this form to determine your work experience, which comes into play when they decide whether your disabilities are severe enough to preclude you from doing work which you have experience with or could be trained for.

If you’re not already working with a Social Security disability lawyer, you should consider contacting one before you fill out this form. Often, the way you word information on Form HA-4633 comes into play when the SSA representatives are deciding what types of work you could feasibly do. If they come to the conclusion that you could reasonably be trained for any type of work which is available, your claim will be denied.

The SSA Office or Hearings and Appeals personnel should have already filled out Section A for you before they give you the form. If they didn’t, bring this to their attention.

You must fill out Section B. As mentioned before, it’s a good idea to have your Social Security lawyer work on this with you, especially when it comes to the “Duties Performed” section.

Fill out everything completely. Don’t leave any of the sections blank. If you don’t know part of the information, it’s better to take the time to find out than to turn in Form HA-4633 with incomplete information. Claims are often denied or delayed because of inadequate information. Delays often last weeks or months.

The actual Section that you fill out is fairly self-explanatory:

  • In the left column, fill in the approximate dates you worked for a given employer. It’s not likely to delay your case if you don’t have the exact date, but you should be as close as possible. If you’re not sure, call your former employer and speak with whoever handles human resources. They should be able to tell you.
  • In the middle column, list the name and location of your employer. If you don’t know the exact address, look it up online or call your former employer to get it.
  • In the right column, list the duties you performed. Bear in mind that the SSA will generally figure that you could reasonably be trained for any job similar to those you have already done. While you want to be complete and honest, this isn’t the time to list job skills like you would on a resume. If you’re not sure what you should include, consult your Social Security attorney.