Form SSA-3441-BK
Disability Report - Appeal

What is Form SSA-3441?

Form SSA-3441 is known as Disability Report – Appeal. If you applied for Social Security Disability benefits and your application was denied, this form is one of the necessary steps to appeal that decision. If you were denied, you’re entitled to an appeal.

If your disability claim was denied, you will receive a letter from the Social Security Administration (SSA) outlining the reason for your denial, whether you should request a reconsideration review or an appeal hearing, the deadline for submitting your request and the process for filing your request.

If you do choose to appeal (in most cases, you should), you can fill out Form SSA-3441 online or fill out a physical form.

If you fail to fill out Form SSA-3441 within the timeframe (usually 65 days) given to you by the SSA, the Administration may not accept your forms and you will have to begin the process from the start.

What Information Do I Need to Complete Form SSA-3441?

On Form SSA-3441 it’s important you spend time to complete every field of the form. It may seem repetitive, but the more time you invest, the stronger your form and appeal will most likely be.

You also need to make sure you appeal by the deadline given to you by the SSA. It’s important your claim stays open and active. Whether you’re filing this form online or with a paper submission, make sure you keep track of the deadline.

It’s very important you don’t leave anything blank on the form – even if they don’t apply to your case. If the question doesn’t apply to your claim, just put “I don’t know” or “Not applicable.” Not filling out every field on the form can lead to a delay in your appeal.

As with any disability case, it’s important you keep copies of all your medical records. Including these copies of your medical records will help support your case in the future. You will most likely have to update your disability case file with medical treatment received since the date you filed your initial application.

Just because your disability claim was initially denied, it doesn’t mean you should give up. Form SSA-3441 is the first step to filing an appeal.

Should I Get a Disability Lawyer to Help Me with Form SSA-3441?

If your disability application was denied, we highly recommend you consult with an experienced disability attorney to help you with your appeal. The Social Security Disability appeals process is very complicated. According to Social Security’s own statistics, you’ve got a better chance of winning your appeal when you have representation.

At Levine Benjamin, we’ve helped thousands of people just like you turn their denials into approvals. One of our experienced disability lawyers can help you with all the forms necessary to form your appeal and present it during your hearing, if necessary.

If your disability application was denied, don’t wait to call us. Let us help you turn your denial into an approval. If you’ve received a denial letter, call us today. The sooner you call us, the quicker we can go to work on your appeal.

Contact our disability lawyers 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