Disability Report--Appeal (EDCS) - Representative Payees

EDCS 

Add penalty of perjury statement here.

"Describe the change(s) in detail

change to medical conditions

Replace language with "medical conditions.

Will collect two names

Replace language with "medical conditions".

Describe the change(s) in detail.

We are adding examples here. (doctor, hospital, clinic, psychiatrist, nurse
practitioner, therapist, physical therapist, or other medical professional).

Include additional examples: Department of Veterans Affairs

This section now asks the person completing this
form to enter their name.