Information About the Disabled Person. This includes basic information such as your name and contact information.
Contacts. This section is for information about someone besides your doctor who can be contacted to discuss your medical condition.
Medical Conditions. Here you list all of your physical and/or mental health conditions that affect your ability to work.
Work Activity. This covers your work history, or lack thereof, and how your condition has affected it.
Education and Training. What grade you have completed and whether or not you have been in special education classes.
Job History. This section delves into detail about the jobs you’ had for the last 15 years before you were unable to work.
Medicines. A list of all medications that you currently take.
Medical Treatment. In this section, you will describe all the medical treatment you’ve had by a doctor or other health care professional and what types of treatment and/or tests you received.
Other Medical Information. This section covers anyone else that may have or will have medical information about you.
Vocational Rehabilitation, Employment, or Other Support Services. You only fill out this section if you already receive Supplemental Security Income (SSI). It discusses different programs and support services you may be receiving.
Remarks. This section is for additional information that you did not cover elsewhere in the application.