How to Fill Out Form HA-4631

Form HA-4631 is one of the forms you need to fill out during an appeal process if your claim has been denied. The form is called “Claimant’s Recent Medical Treatment.” This is used to report any new treatments prescribed by your doctor or hospitalizations that have occurred since the last time your case was reviewed by the Social Security Administration (SSA). This form is filled out alongside forms HA-4632
and HA-4633.

Even if you have already filled out a similar form for your initial application, you still have to complete this one as well. If you left out information in your initial application or are unsure if you left it out, include it in the HA-4631.

Why Form HA-4631 is Important

This form is necessary for a hearing with an Administrative Law Judge (ALJ). It’s important because it shows the growing costs of your condition, as well as the time these treatments and hospitalizations take from your daily living activities. If you are at the point of a hearing with ALJ then the SSA has denied your initial claim and your reconsideration. New evidence is crucial to increasing the chances of that judge approving your claim, because it shows them that your treatment regimes could be expensive and ineffective, and the time they and your hospitalizations consume are affecting your ability to work.

How to Complete Form HA-4631

The SSA’s hearing office will send you the necessary forms when you are sent your denial. The personal and claim information are usually filled in by the SSA office, but if it isn’t there or if it isn’t correct, include the correct information yourself.

The form asks you whether or not you’ve been treated by a doctor (outside of a hospital) since your last review date. If yes, include the doctors’ names, addresses, telephone numbers, and dates of treatment. Then detail what the doctor’s have shared with you about your condition and any new findings. It’s good to also include updated reports or tests with this form.

It also asks you to describe any hospitalizations that have happened since your last review. You must include the name and address of the hospital, as well as the reason for the hospitalization and the treatment you received there.