Completing Social Security's Adult Disability Report

The Social Security Adult Disability Report (Form SSA-3368-BK, or just SSA-3368) is central to your disability application. Comprised of eleven sections over almost fifteen pages, Form 3368 asks for detailed information about your education, job history, and medical treatment. Social Security uses your answers to help determine whether you meet the agency's definition of disability.

How to Fill Out the SSA-3368 Adult Disability Report Form

You can find a blank copy of SSA-3368 on the Social Security website. The first two pages of the form give you basic instructions on how to complete the form. Read the instructions carefully—they contain useful information to help guide you through the rest of the form. Plan to put several hours aside to fill out the entire form. You don't have to do it all at once. If you're applying online, you can use your "re-entry number" to save your work and return to it later.

Sections 1 and 2: Background and Third-Party Information

Section 1 of Form 3368 asks for your contact information, language preference, and any other names you've used in the past. Section 2 asks for the contact information of a friend or family member who knows about your medical situation and can help with your case. Social Security will send the person you name in Section 2 a Third-Party Report asking what they know about your daily routine, so make sure they have personal knowledge about your limitations and are willing to assist with your claim.

Section 3: Medical Conditions

Here you'll list all the physical and mental impairments that keep you from working. Even if you haven't received much (or any) treatment for a particular condition, it's a good idea to include it. Social Security considers all your impairments—both severe and non-severe—in determining whether you're able to work, so be sure to include conditions that you might not find disabling by themselves. If you need more space to list your medical conditions, you can use the additional space provided in Section 11 ("Remarks") to continue your answer.

Section 4: Work Activity

Section deals with your employment history and your disability onset date (when you had to stop working due to your health). If you had to reduce your hours, take a lesser-paying job, or stop working entirely as a result of your medical condition, be sure to mark this box on the form and give an explanation.

Choosing a disability onset date can be tricky. Many people aren't sure of the exact date when they became unable to work. Try picking an onset date that's linked to a major medical or vocational event, such as quitting your old job, undergoing major surgery, or being involved in an accident. You should try to pick the earliest date possible that is supported by the medical evidence. Don't worry if you "messed up" an onset date on SSA-3368—you can amend the date later.

Section 5: Education, Training, and Literacy

Section 5 asks about your education, training, and literacy because Social Security may need to establish whether you've acquired any transferable skills. This section is especially important if you're 50 years of age or older and may qualify for disability using the "grid rules."

When marking your education level in Section 5, be sure to indicate the highest grade you completed, not the highest grade you started. It sounds like a small distinction, but the issue of whether you finished 11th or 12th grade can make a big difference in a disability claim.

Section 6: Job History

This is the section to list any work you've done in the past five years, starting with your most recent job. If you don't remember the exact dates you worked, your hours, or your rate of pay, you can try to contact former employers or look at past pay stubs. Social Security isn't expecting laser precision here, so do the best you can.

If you've had only one job in the past five years, you'll need to answer detailed questions about the physical and mental demands of your job. (If you had multiple jobs, you can check the box for "more than one job" and skip ahead to section 7). The goal of these questions is to help Social Security accurately classify your past work according to exertional and skill levels.

The first few questions in this section are open-ended, and answering them properly can be challenging. Don't overstate your experience or role at your previous job—telling Social Security that you "supervised others," for example, may lead the agency to conclude that you were in a highly-skilled management position and therefore have transferable skills. This can sink your disability case if your strongest argument is that you can't use what you learned in your past work at another job.

The questions involving the physical demands of your job are more straightforward. This part of SSA-3368 lists about a dozen common actions (such as sitting, standing, walking, and using your hands) and asks you how often you did these movements at work. You'll also be asked to estimate the heaviest weight you lifted on the job and how frequently you lifted objects of that weight.

Sections 7 and 8: Medicines and Medical Treatment

Section 7 asks for a list of all your medications (both prescription and over-the-counter), the reasons why you're taking these medications, and the names of the doctors prescribing them. If you're not sure why your doctor prescribed something, it's fine to write "unsure." You can usually obtain a list of your current and previous medications from your pharmacy.

Section 8, which covers your history of medical treatment, is the most time-consuming part of the ADR. In this section, you'll need to provide the names, dates and contact information for any doctors, clinics, or hospitals where you've received treatment. You'll also need to let Social Security know about any medical tests you've undergone, such as an EKG, X-ray, or psychological evaluation. The agency uses this information to request your medical records, so be as accurate and complete as you can.

Section 9: Other Medical Information

Here you can list any other facility that might be in possession of records related to your physical or mental condition, such as the Department of Veterans Affairs (VA), private insurance companies, or workers' compensation claims. Include prisons (if you've been incarcerated) and social service agencies or vocational rehabilitation programs.

Section 10: Support Services

You only need to complete this section if you're already receiving Supplemental Security Income (SSI) and are now applying for Social Security Disability Insurance (SSDI). It asks about programs designed to help adult SSI recipients get into the workforce or help disabled students meet their education goals.

Section 11 and 12: Remarks and Attestation

Use Section 11 to finish any answers from the first ten sections, or to provide other useful information that you haven't already mentioned. Don't feel like you need to fill out this section just for the sake of filling it out. You can leave it blank if you think everything you want to say has already been covered in the application. Keep any remarks concise and relevant—don't ramble.

Finally, section 12 asks you to identify the person who completed the Adult Disability Report, whether it's you or somebody else. If you didn't complete Form SSA-3368 yourself, provide the contact information for the person who did and have them state their relationship to you, such as family member, friend, interpreter, or attorney.

Consider Getting Legal Help When Filling Out SSA-3368

How you answer the questions on Form 3368 can greatly affect whether or not you get approved for benefits. Because there's a lot on the line, you may want to consult an experienced disability attorney for help with your Adult Disability Report.

Most people don't get an attorney until they've already received two denials and have requested a hearing with an administrative law judge, but there are benefits to having an attorney in the earliest stage of the disability determination process. Your lawyer can sit down with you to complete the form and help you answer the questions in a way that best addresses what Social Security is looking for. Reading the questions out loud with an attorney can be a great way to dig deeper into how your medical condition limits your ability to get through a workday.

An attorney can also help jog your memory about important dates, such as your employment history and doctor's visits, and help you choose an onset date. And by hiring a lawyer early on, you'll have plenty of time to spot and fix any weaknesses in your application, like inconsistent medical treatment. Furthermore, disability attorneys' fees come out of any back pay you receive and only if you win your case, so you have little (if any) upfront, out-of-pocket expenses.