Complaint Form for Allegations of Program Discrimination by the Social Security Administration (Form SSA-437-BK) - Dec 2021

The Request for Hearing by Administrative Law Judge (HA-4633) form is used by individuals who want to request a hearing by an Administrative Law Judge for a Social Security or Supplemental Security Income claim that has been denied or partially denied. The form must be completed accurately and submitted to the Social Security Administration.

Individuals who want to request a hearing by an Administrative Law Judge for a Social Security or Supplemental Security Income claim that has been denied or partially denied.

Submit the completed form to the Social Security Administration.