Form HA-4633 | Claimant's Work Background

tai tro choiWhen you have requested, or are requesting, a hearing before an Administrative Law Judge (ALJ), use this form to tell us about any work you have performed, including work you did before you filed your application and any work you have performed since you filed your application.

HA-4633, Claimant's Work Background

To ensure that we have current medical information, you should also complete forms:

Where to send this form

tai tro choiComplete the form and mail it to the hearing office where your claim is located. The address and telephone number of the hearing office are on the letter acknowledging receipt of the request for hearing that we sent.