Copyright © Schneider, Kerr & Robichaux. All Rights Reserved.

626 SE Alder St. Portland, OR 97214

PO Box 14490 Portland, OR 97293

Call Today: 50​3.255.9092     1.800.630.4SSD

Seek Treatment


Claimant's Medications Form
Claimant's Recent Medical Treatment Form

Medical and Job Worksheet



Track Your Symptoms


Migraine Tracker Form

Seizure Tracker Form

Bowel Movement Tracker Form

Chronic Pain Tracker Form

Find a PDF Tracker Form


Tracking APPS for your phone:

(You can also try searching symptom or pain trackers online, please be sure to select one that will allow you to export files or print out paper reports.)

Chronic Pain Tracker (also tracks other symptoms)

Symple App

mySymptoms



Reports


Function Report Form

Third Party Function Report Form

Work History Report
Work Activity Report Form - for Self Employment
Work Activity Report Form - for Employee
​Residual Functional Capacity Form - Treating Source


Employment Information


Employer Questionnaire Form

​Claimant's Work Background

Work Activity Report Form​

Overpayment Waiver


Overpayment Waiver Form



Authorization to Disclose Information to the SSA


Authorization to Disclose Information to the SSA Form

Appeals Forms


Application to proceed in forma pauperis (OR)

Application to proceed in forma pauperis (WA)

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Treasury Release Form



Travel Reimbursement


Travel Reimbursement Form






Social Security Attorneys