account
get our app
account sign up sign in

make your free social security application worksheet

make document
social security application worksheet document preview

what is a social security application worksheet?

a social security application worksheet can help you get all the information you need when you're looking into retirement and disability benefits. they're your benefits, but you need to ensure you're taking advantage of them. a social security application worksheet can help you get started and stay organized. 
 
using a social security application worksheet can help make applying for disability or retirement benefits a little easier. keeping track of what benefits you need, and what information you need ready to claim them, can be a challenge, but this easy checklist helps organize your important details. have your social security application worksheet prepared to help fill out your application for social security benefits.

when to use a social security application worksheet:

  • you're applying for retirement benefits.
  • you're about to apply for disability benefits.

sample social security application worksheet

the terms in your document will update based on the information you provide

this document has been customized over 6.3k times
documents and communicates
ask a lawyer questions about your document

 

social security application worksheet

 

 

describe the type of injury or illness:

 

describe how the injury or illness prevents you from working:

 

have you returned to work? yes

 

hospital(s)

 

hospital or clinic:

treating physician:

 

date you stopped working:

 

disability benefits checklist

 

depending on your situation, you may need some or all of the following information when making an application to obtain social security disability benefits. this checklist will assist you in preparing to apply for social security disability benefits.

 

- your social security number;

- your birth certificate or other evidence of your date of birth;

- your military discharge papers, if you were in the military;

- your spouse's birth certificate and social security number if he/she is applying for benefits;

- your children's birth certificates and social security numbers if they are applying for benefits;

- your checking or savings account information, so your benefits can be directly deposited;

- names, addresses, and phone numbers of doctors, hospitals, clinics, and institutions that have treated you and dates of the treatment(s);

- names of all medications you are taking;

- medical records from your doctors, therapists, hospitals, clinics, and caseworkers;

- laboratory and test results;

- a summary of where you worked over the past 15 years and the kind of work you did, including names and addresses of current and past employers;

- a copy of your w-2 form (wage and tax statement), or if you are self-employed, your schedule se from your federal tax return for the past year;

- dates of prior marriages if your spouse is applying.

social security application worksheet document preview

create your document in just 3 easy steps:

build your document

build your document

answer a few simple questions to make your document in minutes

right-facing arrow
save now, finish later

save now, finish later

start now and save your progress, finish on any device

right-facing arrow
download, print & share

download, print & share

store securely, share online and make copies

right-facing arrow

start your social security application worksheet now and get rocket lawyer free for 7 days

get legal services you can trust at prices you can afford. you'll get:

all the legal documents you need—customize, share, print & more

unlimited electronic signatures with rocketsign®

ask a lawyer questions or have them review your document

dispute protection on all your contracts with document defense®

30-minute phone call with a lawyer about any new issue

discounts on business and attorney services