Disability Benefits Guide
How to Complete the SSA Adult Disability Report
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The Adult Disability Report, Form SSA-3368, helps Social Security understand your medical conditions, treatment, education and work history. Start with the instructions on the report SSA asks you to complete, then gather enough detail to identify your providers and explain your work accurately.
Work-history correction: the current paper report asks about jobs in the five years before you became unable to work because of your medical conditions. Earlier guidance on this page said 15 years. Use the five-year period specified in the current form, rather than counting backward from today.
Start With the Right Form and Instructions
The official Adult Disability Report[1] supplies the medical and work information used in deciding a disability claim. Read its directions alongside any request SSA sent you. The paper form’s section numbers and skip instructions may differ from the screens in an online application.
SSA’s Adult Disability Starter Kit[2] includes an optional worksheet for organizing this information. That worksheet is not a benefits application, and its instructions say not to mail it to SSA. Keep it for your interview or online application. Do not delay applying just because you do not have every item; the kit says SSA will help obtain missing information.
Make a Small Preparation File
Use a private notebook or document to gather the items below. This is an optional organizer, not another form you must submit.
- Conditions: list each physical or mental condition that limits your ability to work. Keep different conditions on separate lines.
- Treatment: collect provider and facility names, contact details, conditions treated, first and last visit dates, and the next appointment if known.
- Medicines and tests: note prescription and nonprescription medicines, why you take them and who prescribed them when known. Identify tests already completed or scheduled, who ordered them and their dates.
- Work and education: gather job titles, business types, dates, hours, pay information, schooling and training.
- Contacts: identify people who know about your conditions and can help SSA reach you or understand your claim, if available. The form asks for contacts other than your doctors.
The online disability application checklist[3] covers information for the broader application, including personal and financial details. Keep those details private. Do not send a Social Security number, bank information or completed disability report through this website.
Build the Work List Around the Form’s Five-Year Period
Section 6 of the paper report asks for the most recent job first and separate job titles even when they were with the same employer. It includes self-employment and work outside the United States. Follow its instruction to leave out jobs held for fewer than 30 calendar days from that particular work-history list; answer any other work questions SSA asks you.
Record the months and years, usual hours and days worked, and rate and frequency of pay. If you cannot remember an exact date, the form permits your closest recollection. Do not invent a precise date to make a blank look complete. Keep a note of what you still need to check.
Follow the paper form’s branching instructions. If you listed more than one job, it directs you past questions 6.B through 6.D to Section 7 and explains that SSA may contact you for more information. If you listed only one job, complete those detailed questions. When job details are requested, describe the actual tasks, equipment, contact with others and physical demands, rather than relying on a job title alone.
For a separate work questionnaire, use our guide to completing the Work History Report, Form SSA-3369. Follow the instructions on whichever report SSA actually requests.
Help SSA Find the Medical Records
The report uses provider information to identify where your records can be requested. Check appointment summaries, medical bills or an online patient chart for an office’s address, telephone number and treatment dates. Include scheduled appointments and tests where the form asks for them, as well as treatment already received.
You do not have to buy records you do not have just to complete this report. Its instructions explain that SSA will request records directly from providers if you have consented to that request. The starter kit also asks you to identify records already in your possession. Giving complete provider details and responding to SSA’s requests are separate from assuming that every record has already arrived.
List other organizations that hold relevant medical information when the report asks, such as a veterans agency or workers’ compensation insurer. Follow the directions for sections that apply only to people already receiving SSI.
Handle Uncertainty and Extra Space Clearly
Answer each question unless a skip instruction tells you otherwise. Use the form’s options for an unknown answer, no information or a question that does not apply. Explain further when requested. In Section 11, identify the section and question number whenever you continue an answer, so the reader can connect the extra details to the right place.
A friend or family member may help. SSA’s instructions say not to ask a healthcare provider to complete this report; contact SSA if you need help finishing it. Section 12 identifies who completed the report and records the completion date. A helper should describe the applicant’s circumstances accurately.
Check the Report Before Returning It
Take one final pass through your answers:
- Check that the work-history period matches the question and that the dates are consistent with your explanation of changes in work.
- Check provider names and contact details, and label future appointments or tests clearly.
- Match each remarks entry to its section and question number. Confirm who completed the report.
- Keep a copy and a private note of when and how you returned it. Follow SSA’s request and the official submission instructions for your case.
The paper instructions direct you to send or bring the completed report to Social Security. The separate address for comments about the form’s time estimate is not a submission address for your report. If you are uncertain about where or how to return it, ask the office that requested it.
The Adult Disability Report is also different from the questionnaire about daily activities. If SSA sends that questionnaire, see our guide to the Adult Function Report. Clear, truthful information helps SSA understand what you are reporting; it does not guarantee approval.
This guide provides general educational information, not legal advice. Disability Benefit Guide USA is not affiliated with the Social Security Administration.
AI-assisted research and editorial checks used the official SSA sources linked above. No attorney review is claimed.
Official Sources and References
These SSA.gov links support the explanations above. Official applications, account services, and agency forms are completed through SSA.
- official Adult Disability Report — SSA.gov
- Adult Disability Starter Kit — SSA.gov
- online disability application checklist — SSA.gov