Request for Reconsideration and Disability Report - Appeal

These are the forms needed for the first appeal of an SSA decision (e.g., initial denial of benefits). Please note that the Disability Report - Appeal (form SSA-3441-BK) has replaced the old “Reconsideration Disability Report.” In addition to Request for Reconsideration and Disability Report forms, SSA requires Medical Authorization forms (SSA-827) for each of the sources listed in the Reconsideration Disability Report.