Authorization Forms
HIPPA compliant - Authorization to Release Medical Information (this form is to be used to by our office to request medical records from a claimant’s medical providers).
SSA form #3288 - this form is used so our office can obtain a copy of your file from the Social Security Administration.
Special Programs Available
The DOES Project - this is a program that can assist individuals just release from prison try to get back their SSA benefits.
Interim Disability Assistance Program - IDAP (for Milwaukee County residents only). Person must have a current SSI application pending with Social Security. If approved the person would qualify for a $205/monthly cash benefit.
Social Security Specific Forms
SSA form #3373 - Adult Function Report, this form is used at both the Initial Application and Reconsideration stage of the application process to provide detailed information to SSA about your limitations and daily functioning.
Dire Need Information and Questionnaire-this is used to provide information to SSA regarding any drastic change in your financial or living situations. This information can be used to request a possible “earlier” scheduling of an ALJ hearing.
Appeal Forms
These forms are used to file any appeal with the SSA
Request for a Reconsideration—this form is used to file a Reconsideration appeal with SSA after an initial denial (1st denial).
Request for an ALJ Hearing - this form is used to request a hearing before an Administrative Law Judge.
Request for Review of ALJ Decision - aka request for Appeals Council Review.
Health Diaries
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Location
Disability Benefits Law Center
710 N Plankinton Ave. Ste. 330