Claimant's Work Background

OMB 0960-0300

OMB 0960-0300

Form HA-4633 collects information needed in assessing an individual's disability within the meaning of the Social Security Act(the Act). SSA uses the information when an individual has requested a hearing before an administrative law judge (ALJ) on whether or not he or she is disabled. The completed HA-4633 provides an updated summary of the individual's relevant work history, which is information the ALJ requires in assessing the claimant's disability within the meaning of the Act. The respondents are claimants for disability benefits under Title II and/or Title XVI who have requested a hearing before an ALJ.

The latest form for Claimant's Work Background expires 2021-01-31 and can be found here.

All Historical Document Collections
Revision of a currently approved collection 2020-08-21
Approved without change
Revision of a currently approved collection 2017-05-17
Approved without change
Revision of a currently approved collection 2014-07-08
Approved without change
Revision of a currently approved collection 2011-10-27
Approved without change
Revision of a currently approved collection 2008-12-10
Approved without change
Extension without change of a currently approved collection 2005-11-22
Approved with change
Extension without change of a currently approved collection 2002-09-09
Approved without change
Extension without change of a currently approved collection 1999-07-21
Approved without change
No material or nonsubstantive change to a currently approved collection 1998-09-30
Approved without change
Revision of a currently approved collection 1996-06-12
Approved without change
Revision of a currently approved collection 1993-05-10
Approved without change
Revision of a currently approved collection 1990-05-01
Approved without change
Revision of a currently approved collection 1987-04-27
Approved with change
No material or nonsubstantive change to a currently approved collection 1985-11-01
Approved with change
No material or nonsubstantive change to a currently approved collection 1985-08-15
Approved without change
Revision of a currently approved collection 1984-04-13
Approved without change
New collection (Request for a new OMB Control Number) 1982-05-06

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