This is an archival or historical document. It may not reflect current policies or procedures.

Some medical conditions are so severe that they automatically mean a person is disabled. Other people qualify for disability benefits under our rules based on a combination of medical conditions. We need to know about any medical conditions you have that limit your ability to work. Please include any mental or emotional conditions.

We will also ask you to fill out some additional forms so that we can get complete information about your conditions, treatment and work history. We will use this detailed information to decide if you qualify to receive Social Security disability benefits.

We will tell you which forms to fill out and how you can get them at the end of this application.