Your Information

Thank you for asking us to help you get your social security disability benefits. We will need your help and cooperation during the process of proving your disability. Your call is important to us. Our phone number is 865-247-0432. If we are unavailable when you call, we will call you back as soon as possible. For us to best serve you, please take a few minutes to read this information.

  1. Notify me if your name, phone number, or address changes.
  2. Let me know if you become eligible for and start drawing TennCare, Medicaid, or Medicare, so I can request the medical evidence that led to your being approved for these services.
  3. To prove your disability, it is important to be receiving regular medical treatment. It is not necessary to notify me after each visit; however, please record your doctor’s appointments, medications, etc. on this form.
  4. Call me if Social Security scheduled an appointment for you to be examined by a doctor. I will need to know the doctor’s name, address, phone number, and date and time of the appointment so I can provide the doctor with important information about your claim.
  5. If Social Security sends you any forms, please call me and I will help you complete them over the phone. If you do not do this quickly, Social Security may deny our claim.
  6. If the Social Security Administration notifies you that your claim has been approved or denied, call us immediately. We will tell you what steps have to be taken next.

Keep a complete record of your doctor visits, tests, and medications.

Name and address of doctor:

List of tests, X-rays, MRI, & dates:

When you saw the doctor:

Medications the doctor prescribed:

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