Below is a list of application checklist items.

  • Dates of marriages and divorces
  • Names and dates of birth of your minor children and your spouse
  • Military service discharge information (DD 214) for all periods of active duty
  • W-2 Form (or our IRS 1040 and Schedules C and SE if self-employed from last year
  • Name, address and phone number of someone the Social Security Administration can contact who knows about your medical conditions and can help with your claim
  • Names, addresses, phone numbers, patient ID numbers, and dates of treatment for all doctors, hospitals, and clinics (look at your medical records you have)
  • Names of medicines you are taking and which doctor prescribed them (look at your medicine bottles you have)
  • Names and dates of medical tests you have had and which doctor sent you for them
  • A list of jobs (up to 5) that you had in the 15 years before you became unable to work. Include the dates you worked at those jobs, if possible
  • Information about any insurance or workers’ compensation claims you filed, such as claim number and name, address and phone number of insurance company