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Information about any workers' compensation, black lung, and/or similar benefits you filed, or intend to file for. These benefits can: Be temporary or permanent in nature;
12. 12. Have a child(ren) who is under age 16 or disabled or handicapped (age 16 or over and disability began before age 22); and. Were married for less than 10 years to the child's mother or father, who is now deceased; and.
Download Fillable Form Ssa-16 In Pdf - The Latest Version Applicable For 2024. Fill Out The Application For Disability Insurance Benefits Online And Print It Out For Free. Form Ssa-16 Is Often Used In U.s. Social Security Administration, United States Federal Legal Forms, Legal And United States Legal Forms.
apply for a period of disability and/or all insurance benefits for which I am eligible under Title II and Part A of Title XVIII of the Social Security Act, as presently amended. 1. PRINT your name. FIRST NAME, MIDDLE INITIAL, LAST NAME. 2. Enter your Social Security Number.
9 sty 2023 · If you file a paper application, one of the main forms you'll need to fill out is the Application for Disability Insurance Benefits, Form SSA-16. If you apply for SSDI online, you'll just answer questions in an online interview and Social Security will fill out the form for you.
18 mar 2024 · You must apply for disability benefits through the Social Security Administration (SSA) by completing Form SSA-16. The application form and process are the same whether you apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
I apply for a period of disability and/or all insurance benefits for which I am eligible under Title II and Part A of Title XVIII of the Social Security Act, as presently amended. 1. PRINT your name
