Form HA-4632
Claimant's Medications

Download form to fill it out online.

What is Form HA-4632?

Form HA-4632 is known as Claimant’s Medications. If you applied for Social Security Disability benefits and were denied, you have the right to appeal. And one of the forms in any appeal is Form HA-4632.

To appeal your denial, you must complete Form HA-4486 and Form HA-501-U5 (Request for Hearing by Administrative Law Judge).

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

Once you receive your denial letter, it’s important you don’t wait to file your appeal. You have approximately 65 days to request your hearing from the date you received your denial letter. If you miss this important deadline, the Social Security Administration (SSA) may not accept your forms and you’ll need to fill out a new application and start the process all over.

What Information Do I Need to Complete Form HA-4632?

On Form HA-4632, you will be asked to list all the medications you’re currently taking – whether it is one used to treat your disability or not.

You will be asked to name the medication and the dosage, the date it was first prescribed, the daily amount you take, the reason for the medication and the name of the physician who prescribed you the medication.

You will also be asked to list nonprescription medications and the reasons you’re taking them.

In any disability case, it’s important you follow your doctor’s order. If you were prescribed medication, but don’t take it as prescribed, you can harm your case. This form is intended for you to provide an honest insight into the medications you take for the condition(s) for which you’re trying to win disability benefits.

This form is yet another way to paint a clear picture of your medical history. This form along with others regarding your medical and work history will be presented to the Administrative Law Judge (ALJ) who makes a decision on your claim during the hearing.

Should I Get a Disability Lawyer to Help Me with Form HA-4632?

If your disability claim was denied, we recommend you talk to an experienced disability lawyer. The disability process is complicated and according to Social Security’s statistics, you have higher odds of winning your claim when you have representation.

Dealing with medical conditions that prevent you from working is difficult enough. Why make life more stressful by worrying about filling out more forms? Our attorneys can do that for you.

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 wait to call us. Let us help you appeal your denial. If you’ve received a denial letter, call us right away. The sooner you call us, the quicker we can go to work on your appeal.

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