Disability Report Form - Adult

Work History Report Form

Hearing Request Form

Disability Report Appeal Form

Recent Medical Treatment Form

Medication List Form

Recent Work History Form

How To Fill Out Form HA-4486 in New Orleans

Hearing Request Form

View and Download Form HA-4468

If you’ve been denied Social Security Disability benefits, you’re not alone.

Most people get denied the first time they apply. You should consider appealing the decision. One of the most important steps in appealing is talking to a Social Security administrative law judge.

You’ll need to fill out Form HA-4486 when you request a hearing with a judge.

Don’t wait to appeal, because the Social Security Administration (SSA) has a deadline for appeals and could make you start your application again if you’re too late.

An important step in appealing is submitting Form HA-4486 to the Social Security Administration (SSA).

The form is called “Claimant’s Statement When Request for Hearing is Filed and the Issue is Disability.”

You’ll need to fill out that form, along with Form SSA-3441-BK, which is called “Disability Report – Appeal.”


This form will ask you to update what has happened with your medical and work situation since you first applied for benefits.

  • Has your health changed for better or worse?
  • How have your daily activities changed?
  • What new medical treatment have you received?

This form gives you the opportunity to describe your condition, and you should take advantage of the chance to explain your case.

Remember to always keep your medical records as you undergo treatment. When you see a judge at a hearing, your medical evidence and work history will be crucial to your case.


Yes. Applying for Social Security Disability is complicated. Appealing is even more involved.

You can relieve the burden on you and give yourself the best chance at winning benefits by working with a professional disability advocate.

Gary Sells and his team have helped thousands of people win disability benefits. We understand how the system works and where you can run into problems.

We can help you with Form HA-4486 and all the forms you need to apply and appeal for Social Security Disability benefits.

We’ll also help you prepare for your hearing with a judge, gathering all your medical evidence and work history records, ensuring that you have a strong case.

Call us right away if you were denied your disability claim, so you don’t lose time to put together your appeal.

Contact us if youf need help with Form HA-4486.