OMB control number

Claimant's Work Background

OMB 0960-0300 · SSA.

OMB 0960-0300

Sections 205(a) and 1631(e) of the Act provide the Commissioner of Social Security with the authority to establish procedures for determining if a claimant is entitled to disability benefits. The administrative law judge (ALJ) may ask individuals to provide background information on Form HA-4633 about work they performed in the past 15 years. When a claimant requests a hearing before an ALJ to establish an entitlement to disability benefits, the ALJ may request that the claimant provide a work history to assist the ALJ in fully inquiring into issues related to the disability. The ALJ uses the information collected from the claimants on Form HA-4633 to: (1) identify the claimant’s relevant work history; (2) decide if SSA requires expert vocational testimony and, if so, have a vocational expert available to testify during the hearing; and (3) provide a reference for the ALJ to discuss the claimant’s work history. The ALJ makes the completed Form HA-4633 part of the documentary evidence of record. The respondents are claimants for disability benefits under Title II or Title XVI who requested a hearing before an ALJ after SSA denied their application for disability payments.

The latest form for Claimant's Work Background expires 2029-05-31 and is listed under ICR 202508-0960-003.

View the official OMB control history on Reginfo.gov.

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202508-0960-003 Revision of a currently approved collection 2026-03-23
202007-0960-003 Revision of a currently approved collection 2020-08-21
201702-0960-004 Revision of a currently approved collection 2017-05-17 Approved without change
201403-0960-011 Revision of a currently approved collection 2014-07-08 Approved without change
201106-0960-009 Revision of a currently approved collection 2011-10-27 Approved without change
200809-0960-002 Revision of a currently approved collection 2008-12-10 Approved without change
200511-0960-005 Extension without change of a currently approved collection 2005-11-22 Approved without change
200209-0960-001 Extension without change of a currently approved collection 2002-09-09 Approved with change
199907-0960-002 Extension without change of a currently approved collection 1999-07-21 Approved without change
199809-0960-016 No material or nonsubstantive change to a currently approved collection 1998-09-30 Approved without change
199606-0960-004 Revision of a currently approved collection 1996-06-12 Approved without change
199305-0960-007 Revision of a currently approved collection 1993-05-10 Approved without change
199005-0960-001 Revision of a currently approved collection 1990-05-01 Approved without change
198704-0960-009 Revision of a currently approved collection 1987-04-27 Approved without change
198511-0960-020 No material or nonsubstantive change to a currently approved collection 1985-11-01 Approved with change
198508-0960-050 No material or nonsubstantive change to a currently approved collection 1985-08-15 Approved with change
198404-0960-005 Revision of a currently approved collection 1984-04-13 Approved without change
198205-0960-002 New collection (Request for a new OMB Control Number) 1982-05-06 Approved without change

OMB Details

HA-4633 - Paper Version

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Information collection instruments
FormNameElectronic accessType
Form HA-4633Claimant's Work Backgroundwww.ssa.gov (mySocial Security Account - Upload Documents)Form

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