0960-0144 - SSA-3441 - Disability Report-Appeal

Removing Inability to Communicate in English as an Education Category

i3441 Screens - Updated

0960-0144 - SSA-3441 - Disability Report-Appeal

OMB: 0960-0813

Document [pdf]
Download: pdf | pdf
i3441 Disability Report

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Change question as follows:
Since you last told us about your education, have you completed or are you
enrolled in any type of GED classes, specialized job training, trade school,
vocational school, or college classes?
Add the following screen(s):
Certificates/licenses/degrees attained, if any:
Date of attainment:

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Rs001 Review and send: summary

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Rs001 Review and send: summary (continued)

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Rs001 Review and send: summary (continued)

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Rs001 Review and send: summary (continued)

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Rs001 Review and send: summary (continued)

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Rs001 Review and send: summary (continued)

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Rs001 Review and send: summary (continued)

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Rs001 Review and send: summary (continued)

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Rs001 Review and send: summary (continued)

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Rs001 Review and send: summary (continued)

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Rs002 Review and send: additional remarks

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Rs002 Review and send: additional remarks (continued)

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Mrf001

Review and send: Medical Release Form

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Mrf002

Review and Send: Medical Release Form

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Rs003

Review and send: submit this appeal

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Rs004

Confirmation and printing

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Msg001

Social Security’s definitions of disability

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Msg002

How the disability Appeals Process works

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Msg003

Social Security’s disability programs

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Msg005

Your right to representation

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Msg007

Checklist: Information you will need

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Msg008

You do not live in the United States

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Msg010

The information you entered does not match our records

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Msg016

Check the Social Security Number you entered

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Msg017

Sign-in problem

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Msg018

There is a pending report for this Social Security Number

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Msg019

You can no longer use the disabilty appeal report

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Msg020

You cannot use the Internet to complete your Appeal Request

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Msg021

You cannot complete this Internet Appeal Process at this time

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Msg022

Tips for using this website

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Msg024

Special instructions for users who are blind

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Msg025

Your session has expired

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Msg026

We Cannot Process Your Request

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Msg027

We cannot process your request at this time

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Msg028

This service is not available at this time

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Msg029

You have reached the limit on the number of requests to enter the Disability Report

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Msg030

We are processing your request

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Msg031

Limit on the number of new reports started

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Msg033

Please confirm (1)

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Msg034

Limit on the number of tries to start the Appeal Disability Report

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Msg035

You have entered a new doctor

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Msg037

Please confirm (2)

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Msg038

Please confirm (3)

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Msg040

What is my notice date?

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Msg041

About your notice

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Msg042

Who is the wage earner?

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Msg043

About your claim number

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Msg044

We cannot match your ZIP code

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Msg045

Hours of operation

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Msg046

Other ways to complete a disability appeal

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Msg047

Please confirm your change of answer

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Msg048

Submitting additional medical evidence

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Msg049

About You: Work History

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Msg050

Changing the name of this test

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Msg051

Contact us

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Msg052

Examples of changes to your condition

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Msg053

Examples of new physical or mental limitations

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Msg054

Examples of new conditions

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Msg055

Medical test descriptions

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Msg056

Examples of ability to care for personal needs

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Msg060

How to complete the medical release form

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Msg072

Paperwork Reduction Act

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Msg072hr

Paperwork Reduction Act (hr)

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Msg072rc

Paperwork Reduction Act (rc)

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Msg080

Print Cover Sheet

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Msg081

Cover sheet

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Msg082

Print the Questionnaire for Children Claiming SSI Benefits (conditional)

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Msg139

Privacy information for Internet Appeals (hr)

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Msg139rc

Privacy information for Internet Appeals (rc)

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File Typeapplication/pdf
AuthorIWS/LAN
File Modified2018-06-20
File Created2018-06-07

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