Social Worker Disability Assessment Form

Art: Robin Mead

A Social Worker or Case Worker can be a big help to your disability case. If you want a Social Worker and don’t have one, here’s How to Get a Social Worker.

Unfortunately, many Social Workers are overworked and many Social Workers are not trained in specific techniques to improve your disability application. Many of our readers report that Social Workers helped them fill out and submit the basic application, but weren’t aware of any other ways to improve their chances.

You can change this! Below are special forms and tools you can use with your Social Worker that can increase your chances of approval.

Amaryllis is a former Social Worker who is now disabled herself, she shared this wonderful advice, along with copies of forms you can print to bring to your own Social Worker.

Social Worker Disability Assessment Forms

– by Amaryllis

This is a form that I filled out for clients and others applying for disability. Then, when I became disabled, I used it for myself.

A version of this form was given to me by a Social Worker before me and given to her by the Social Worker before her. It has been passed down and edited over the years. We have had extremely high success rates with this method.

The disability application process asks very little of what matters. By filling out this form, and adjusting the questions and space for answers to your needs, you can give a clear picture of your disability.

Love, Amaryllis

Amaryllis’ Social Worker Assessment Form

This form can be completed by a case worker, social worker, or any kind of healthcare professional. If at all possible, it is a great help if this form is co-signed by a doctor, psychologist, or psychiatrist.

🌷 Social Worker Disability Assessment Form

🌷 Instructions and Tips

🌷 How to Get a Co-Sign

RFC Function Forms

Another option is RFC forms and medical opinion letters. These can be incredibly important and incredibly helpful for a disability case. If at all possible, it is a great help if this form is filled out or co-signed by a doctor, psychologist, or psychiatrist.

🌷 How to Get a Great Disability RFC Function Form

🌷 Disability Letters from Doctors

🌷 Sample Residual Functional Capacity Forms

🌷 How to Get a Co-Sign

Medical Summary Reports

Another option is to work with your Social Worker to create a Medical Summary report. The SOAR program is a federal program that uses this technique and has a very high success rate. If at all possible, it is a great help if this form is co-signed by a doctor, psychologist, or psychiatrist.

🌷 How to Create a Medical Summary Report

🌷 How to Get a Co-Sign

Home Aide Programs

If you have a home aide through Medicaid or another government program, you will probably have a case worker through this program. This caseworker can be a HUGE help for your disability application. Learn more here:

🌷 How Home Aide Programs Can Help Your Disability Application

Amaryllis’ Self Assessment Form

This assessment you can complete on your own (or with a friend or family member). Social Security will give the most consideration to forms filled out by doctors. However, if what you write is similar to what your doctor and healthcare professionals write, this can also help to your case:

🌷 Self Disability Assessment Form


If Social Security does not already have all of your records, this is a great time to submit any records they are missing. For new applications, submit all records you can get.  Social Security will be looking to see that what is written on this form is backed up by medical documentation:

🌷 How to Collect All Your Medical Records

🌷 How to Submit All Your Medical Records

Submitting Your Forms

Tips from Amaryllis on how to submit:

🌷 If you apply for disability in person, you can bring a copy of this completed form with you to your appointment. Also bring complete copies of all your medical records.

🌷 If you apply online, complete and print this form and submit it by mail. It is best to do this promptly – within a few weeks. Also enclose complete copies of all your medical records. Mail this with a tracking number and signature confirmation so you have record they received it.

🌷 Along with this form, if you gather all of your own records and images and send them to Social Security, you will usually find higher success on the first try and a faster response overall.

Double Check

Tragically, many applications are denied because important forms are lost, misplaced, or never make it to the person making the decision. It’s incredibly important to double check your Social Security file. Even if you have a lawyer, important records can be missing: How to Tell What is (and isn’t) in Your Social Security File

Amaryllis made certain to stay in touch with her disability examiner and be 100% sure everything was in her file. She received her first disability check just one month after she applied! Amaryllis Stays Annoyingly in Touch

More Places to Find Social Workers While Applying for Disability

💠 SOAR for People who are Homeless or At Risk for Homelessness – For people with a mental illness diagnosis (or mental plus physical). Totally free and very high success rate. Most SOAR programs work with new applications and reconsiderations – not hearing appeals.

💠 Legal Aid – If you are low income, check with the legal aide program in your area. They usually won’t help with hearings, but some will provide free help with: New applications, reconsiderations, overpayment issues, or continuing disability review problems.

💠 Disability Advocacy in New York – Free assistance with disability applications and appeals for low income people who live in New York.

Also by Amaryllis

🌷 Social Security Disability Tips from a Former Social Worker

Updated 2019. Please comment below with stories, ideas, questions or suggestions. Please let us know if any links on this page stop working. If you found this page helpful, please share it with others by pressing one of these magic little buttons: 

1 thought on “Social Worker Disability Assessment Form”

  1. This site is so amazing. What a blessing you are with your beautiful artistry and amazingly helpful information. Thank you!


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