Information You Need To Complete Your Disability Appeal

If you recently applied for Social Security disability benefits or Supplemental Security Income and were denied for medical reasons, you may request an appeal online.

Use the checklist below to gather the information you may need to appeal our medical decision.

Personal Information

• Name, Social Security number, address, and phone number.
• Date of Denial Decision.
• Representative's name, address, and phone number.

Medical Information

• Name, address, and phone number of a friend or relative who knows about your medical condition.
• Description of any change to your medical condition and any new medical conditions.
• Name, address, phone number, and visit dates of all health care providers, type of treatments and tests since you last gave us medical evidence.
• Name of any medicine (prescription or over-the-counter) you are currently taking, why you are taking it, any side effects, and the name of the doctor who recommended or prescribed the medicine.
• Description of any change in your daily activities, work, and education.

Supporting Documents

• If you have documents that support your appeal, they will help Social Security make a decision on your claim for disability benefits. Supporting documents include any medical report, form, or written statement related to your disability.
• You will be asked if you wish to upload any supporting documents in electronic format prior to submitting your online appeal (.doc, .docx, .tif, .tiff, and .pdf are accepted).
• After you submit your appeal, we will provide a cover sheet you can use to submit any documents you want us to include with your request.