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What Social Security forms does Dibcase include?

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Yes, Dibcase includes most forms you'll need to effectively manage your Social Security caseload.

  • SSA-501 Request for Hearing
  • SSA-521Request for Withdrawal of Application
  • SSA-539 Notice of Substitution of Party Upon Death of Claimant
  • SSA-561 Request for Reconsideration
  • SSA-773 Waiver of Right to Appear
  • SSA-789 Request for Reconsideration - Disability Cessation Right to Appear
  • SSA-795 Statement of Claimant
  • SSA-1693 Fee Agreement
  • Multiple customizable versions of free agreements
  • SSA-1695
  • SSA-1696 Appointment of Representative
  • SSA-827 Authorization to Disclose Information to Social Security
  • SSA-3288 Consent for Release of Information
  • Medical Opinion Forms (RFC forms)
  • HA-520 Request For Review Of Hearing Decision/Order
  • HA-1151 Medical Source Statement (Physical)
  • HA-1152 Medical Source Statement (Mental)
  • SSA-8011 Statement of Household Expenses and Contributions
  • SSA-8011 Loan Package

We also have additional PDF forms available on-demand including:

  • SSA-4814 Medical Report on Adult with Allegation of HIV Infection
  • SSA-7008 Request for Correction of Earnings Record
  • SSA-16 Application for Disability Insurance Benefits
  • SSA-632 Request for Waiver of Overpayment Recovery
  • SSA-820-BK Work Activity Report - Self-Employment
  • SSA-821-BK Work Activity Report - Employee
  • SSA-3368-BK Disability Report - Adult
  • SSA-3369-BK Work History Report
  • SSA-3373-BK Function Report - Adult
  • SSA-3441-BK Disability Report - Appeal
  • SSA-3820-BK Disability Report - Child
  • SSA-3881 Questionnaire For Children Claiming SSI Benefits
  • SSA-3885 Government Pension Questionnaire
  • SSA-4111 Certification of Election for Reduced Widow(er)'s and Surviving Divorced Spouse's Benefits
  • SSA-4162 Child Dropout Questionnaire
  • SSA-4815 Medical Report on Child with Allegation of HIV Infection
  • SSA-5665-BK Teacher Questionnaire
  • SSA-5666 Request for Administrative Information
  • SSA-7050 Request for Social Security Earning Information
  • SSA-7104 Partnership Questionnaire
  • SSA-7156 Farm Self-Employment Questionnaire
  • SSA-8001 Appliction for Supplemental Security Income (SSI) (Deferred or Abbreviated)
  • SSA-8240 Authorization For Social Security Administration to Obtain Wage and Employment Information From Payroll Providers
  • SSA-8510 Authorization for the Social Security Administration to Obtain Personal Information
  • SSA-L4201 Request for Wage Information

In addition to SSA forms, we also provide form letters covering a variety of issues and circumstance including:

  • Client and contact letterheads
  • Claim status letters with merge-field data
  • Pre-Hearing briefs
  • Lead rejection letters
  • Notification of representation to SSA
  • Withdrawal letters
  • HIPAA & Hi-Tech releases


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Effective 12-2019, we not offer the ability to import PDF documents with merge capability!

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