Form HA-4631
Claimant's Recent Medical Treatment

What is Form HA-4631?

Form HA-4631 is known as Claimant’s Recent Medical Treatment. If you applied for Social Security Disability benefits and were denied, you have the right to appeal. And a crucial form in any appeal is Form HA-4631.

To appeal your denial, you must complete Form HA-4486 and Form SSA-3441-BK (Disability Report – Appeal).

Once you have submitted these two forms to indicate that you wish to appeal, you will be asked to complete Form HA-4631.

Once you receive your denial letter, it’s important you don’t hesitate to appeal. You have approximately 65 days from the date you receive your denial letter to request your hearing. If you miss the deadline to appeal, the Social Security Administration (SSA) may reject your forms and you’ll have to restart the process by filling out a new application.

What Information Do I Need to Complete Form HA-4631?

On Form HA-4631, you will be asked to list all the doctors that have treated you, their contact information and the dates you received treatment. If you were hospitalized due to your disability, you will also be asked to provide the name of the hospital, the address, why you were hospitalized and the treatment you received.

No matter where you are in the disability process, it’s crucial that you keep track of all your medical records. Doing so will strengthen your case. When you go to your hearing, your medical evidence and work history are vital evidence in your disability case.

Should I Get a Disability Lawyer to Help Me with Form HA-4631?

If your disability claim was denied, we recommend you contact a disability attorney. The disability process is complex and per Social Security’s statistics, you have a better chance to win your claim when you have representation.

Dealing with medical conditions that prevent you from working is difficult enough. A lawyer can help you keep track of your medical evidence so you don’t have to worry about doing that.

At Levine Benjamin, one of our experienced disability attorneys can help you with all the forms necessary to present during your appeal. We can also help you gather your medical evidence, prepare you for your hearing and present a clear case to the judge to give you the best chance to win benefits.

If you were denied, don’t give up. Let us help you appeal your denial. As soon as you receive a denial letter, call us. The sooner you call us, the quicker we can go to work on your case.

Contact our office now to schedule a FREE consultation of your disability claim.


Disability Report-Adult

Work History Report

Claimant's Statement when 'Request for Hearing' is filed and issue is Disability

Disability Report Appeal

Recent Medical Treatment

Medication List

Recent Work History