Appeal a decision on Disability Benefits with Form SSA 3441 BK

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Form SSA 3441 BK – Disability Report – Appeal

The Social Security Administration has a specially created form for appealing previously adjudicated claims called Form SSA 3441 BK, or ‘Disability Report – Appeal’. There may be several reasons for the Social Security Administration to deny an individual’s claim for disability benefits. Besides obvious factors like fraud, ineligibility explained by ‘substantial gainful activity’, or drug or alcohol addiction, the most common disqualifying factors are insufficient information and failure to follow the prescribed medication.

If an applicant doubts the reasonability of the SSA’s unfavourable decision and they are convinced that they have enough grounds to still get disability insurance, they may appeal their decision. However, due to the gravity of requesting a reconsideration of the already established verdict, it is vital that the claimant should eliminate all inaccuracies or disinformation that may have caused the unfavourable decision on the initial claim.

Who needs an Form SSA 3441 BK?

A person seeking Social Security Disability (SSD) Benefits whose initial claim has been denied can still appeal the decision. In order to make an appeal, an SSD benefits applicant must submit their Disability Report – Appeal (viz. SSA Form 3441-BK). The form was created by the Social Security Administration to enable applicants to appeal a previous rejection of SSD benefits and provide additional details and documents that might aid in the reconsideration process.

What is an Form SSA 3441 BK for?

The Disability Report – Appeal form allows the applicant to update the disability information provided in the initial claim that was denied.

Does an Form SSA 3441 BK require any accompaniment?

The Disability Report – Appeal form should be supported by one of the following attachments depending upon the case:

  • Request for Reconsideration (SSA-561-U2),
  • Request for Reconsideration-Disability Cessation (SSA-789),
  • Request for Hearing by Administrative Law Judge (HA-501).

If there are any statements or documents that can serve as an evidence or confirmation of what is claimed on the form (e.g. medical records), they should be attached.

How do I fill out the Disability Report – Appeal form?

The properly completed form must provide the following details:

  • Information about the disabled person (name, SSN, phone number and address)
  • Contacts of people who can be addressed for reference (name, address and phone number)
  • Medical conditions (how they changed since the initial claim)
  • Medical treatment (how it changed)
  • Information about the health care provider (filled out by the healthcare provider themselves)
  • Other information about the medical condition of the disabled individual
  • Activities
  • Work and education
  • Any remarks

Where do I send the completed SSA Disability Report – Appeal form?

The properly filled out form along with all the necessary attachments should be sent to the local Social Security Administration office.