SSDI Appeal Medical Evidence Log PDF (Free Template)

SSDI appeals can stretch for months. A well-organized evidence log helps your representative and the judge see your treatment history at a glance.

When to use this

• You’re preparing for reconsideration or an ALJ hearing and need to track medical evidence.
• You want to be sure every provider’s records were requested and sent to SSA.
• You’re coordinating with an SSDI attorney or hearing representative and want them to have a clean timeline.

How to do it (fast)

1. Add your claimant details, case number, and onset date at the top.
2. Log each provider visit with date, provider type, condition treated, and key findings.
3. Note functional limitations in your own words and whether records were requested or submitted to SSA.
4. Download the PDF and share it with your representative before hearings or medical updates.

Why this helps

• SSDI appeals are evidence-heavy; a log prevents missed records and duplicate requests.
• Clear notes on functional limits help your representative tailor arguments for the hearing.
• Judges and experts appreciate organized timelines—this log keeps everything aligned.

Related tools

• Social Security Disability Appeal Log PDF
• Medical Records Request Letter PDF
• Medical Appointment & Symptom Log PDF

Not legal advice. Courts set their own rules. Keep your original records.