Medical Forms

The following forms will help you better prepare to present your Social Security Disability Claim.

Click on a link below. The form will open in a new window or tab for you to print.

AIDS / ARC Report

Audiological Report

Cardiac Report

CFIDS - Chronic Fatigue Immunity Deficiency Syndrome Report

Degenerative Joint Disease (Arthritis) Report

Diabetic Report

Epilepsy / Seizure Disorder Report

Fibromyalgia Questionnaire

Gastrointestinal Report

General / Combination Physical Impairments Report

Hypertension Report

Liver Report

Mental Capacities Assessment for Minors

Mental Residual Functional Capacity Assessment

Musculoskeletal Defect / Fractures Report

Neoplasm Report

Neurological Report

Pain Diary -- FOR CLAIMANT ONLY

Pain Report

Peripheral Vascular Report

Physical Capacities Evaluation Report

Post-Polio Syndrome Report

Psychological / Psychiatric Impairment Report

Renal Report

Residual Functional Capacity: Disorders of Spine

Respiratory Report

Sarcoidosis functional capacity Questionnaire

Seizure Description Form - FOR WITNESS ONLY

Visual Impairment Report

• Social Security Disability
  • Medical Forms
  • Medical Conditions
  • List of Compassionate Allowance Conditions
• Social Security Resources
  • Back to Work
  • Taxes
  • Benefits Information
  • Testimonials
• Special Needs Trusts
  • About Special Needs Trusts
  • Special Needs Questionnaire
  • Early Termination of a Special Needs Trust
• Corporate Resources
  • More Information
  • Referral Form
  • Media Relations
• News
  • Social Security Adds 38 New Compassionate Allowance Conditions
  • SSA "Ticket to Work" Program Doesn't Work
  • Zivic lectures on Social Security Disability Law
  • Claim processing times continue to go slow
  • New cochlear implant section planned
• Community
  • Zivic Solutions, Ltd. attends the Linkages Resource Fair
  • Attorney Zivic to speak at Fibromyalgia support group
  • Cancer Wellness Center 2010
  • Autism Society of Illinois Conference
  • 6th annual Disability Price Parade
  • F. Chopin Polish School in Polish Constitution Day Parade
  • Cancer Wellness Center
  • St. Jude Radioathon

Have you been previously turned down for Social Security Disability Benefits?

It is common to be turned down once, twice or more for your Social Security Disability Benefits. It doesn't mean that you don't quality.

Click for more information about reapplying.