You can complete an application for Retirement, Spouse's, Medicare or Disability Benefits online. If you do not wish to use the online application, or the application for the benefit you want is not available online, you can: If you live outside the U.S. you can contact the Federal Benefits Unit Social Security Administration. APPLICATION FOR DISABILITY INSURANCE BENEFITS. Page 1 of 7 OMB No. 0960-0618. I apply for a period of disability and/or all insurance benefits for which I am eligible under Title II and Part A of Title XVIII of the Social Security Act, as presently amended. (Do not write in this space) 1. PRINT your name complete online, and you can save your application in the event you need to return later before you submit. The Social Security Administration has taken great care to ensure your personal data is safe online. If you prefer to apply by telephone, the process will take about 30 minutes. A phone representative