Claimant's Medications

In cases where a claimant is requesting a hearing after denial of his or her claim for Social Security benefits, SSA uses Form HA-4632 to request information from the In cases where claimants request a hearing after denial of their claim for Social Security benefits, SSA uses Form HA-4632 to obtain information from the claimant about medications they are using. This information helps the administrative law judge overseeing the case to fully investigate (1) the claimant's medical treatment and (2) the effects for the medications on the claimant's medical impairment and functional capacity. The respondents are applicants (or their representatives) for Social Security benefits or payments requesting a hearing to contest an agency denial of their claim.

The latest form for Claimant's Medications expires 2021-11-30 and can be found here.

Claimant's Medication - PDF/Paper Version

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.