What information do I need to apply for benefits?

We suggest that you have the following information at hand. It will make completing the application much easier.

• Your date and place of birth and Social Security number
• The name, Social Security number and date of birth or age of your current spouse and any former spouse. You should also know the dates and places of marriage and dates of divorce or death (if appropriate)
• Names and dates of birth of your minor children
• Your bank or other financial institution’s Routing Transit Number and the account number, if you want the benefits electronically deposited
• Information About Your Medical Condition
• Name, address and phone number of someone we can contact who knows about your medical conditions and can help with your application
• Names, addresses, phone numbers, patient ID numbers and dates of treatment for all doctors, hospitals and clinics;
• Names of medicines you are taking and who prescribed them; and
• Names and dates of medical tests you have had and who sent you for them.
• Information About Your Work
• The amount of money earned last year and this year
• The name and address of your employer(s) for this year and last year
• A list of the jobs (up to 5) that you had in the 15 years before you became unable to work and the dates you worked at those jobs
• Information about any workers’ compensation, unemployment, work supplied disability benefits, retirement or black lung, and/or similar benefits you filed, or intend to file for. Whether or not they are temporary or permanent in nature.