OMB control number
Waiver of Right to Appear--Disability Hearing
OMB 0960-0534 · SSA.
Claimants for Social Security disability payments or their representatives can use Form SSA-773-U4 to waive their right to appear at a disability hearing. Respondents complete the SSA-773-U4 through a personal interview with field office (FO) staff; Disability Determinations Service (DDS) staff; or Disability Hearing Unit (DHU) staff to insure the individual understands the due process rights associated with the decision to waive personal appearance at a disability hearing by a DHO. We conduct these personal interviews either in person or via telephone with the claimants or their representatives. Once we obtain the information on the SSA-733-U4, the DHO uses the signed form as a basis for not holding a hearing, and for preparing a written decision on the claimant’s request for disability payments based solely on the evidence of record. The respondents are disability claimants for Social Security benefits or SSI payments, or their representatives, who wish to waive their right to appear at a disability hearing.
The latest form for Waiver of Right to Appear--Disability Hearing expires 2028-07-31 and can be found here.
Document Name |
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Form |
Form |
Supporting Statement A |
| Revision of a currently approved collection | 2024-12-20 | ||
| No material or nonsubstantive change to a currently approved collection | 2024-10-24 | ||
|
Approved without change |
Revision of a currently approved collection | 2021-06-25 | |
|
Approved without change |
Revision of a currently approved collection | 2018-05-14 | |
|
Approved without change |
Revision of a currently approved collection | 2015-04-14 | |
|
Approved without change |
Revision of a currently approved collection | 2012-06-15 | |
|
Approved without change |
Revision of a currently approved collection | 2009-09-30 | |
|
Approved with change |
Extension without change of a currently approved collection | 2006-09-20 | |
|
Approved without change |
Extension without change of a currently approved collection | 2003-11-14 | |
|
Approved without change |
Extension without change of a currently approved collection | 2000-11-17 | |
|
Approved without change |
Extension without change of a currently approved collection | 1997-10-29 | |
|
Approved without change |
New collection (Request for a new OMB Control Number) | 1994-08-29 |
Waiver of Right to Appear--Disability Hearing (telephone and field office interview)
Federal Enterprise Architecture: Income Security - General Retirement and Disability
| Form SSA-773 | Waver of Right to Appear--Disability Hearing | Fillable Printable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.