Guide on How to Properly Fill Out Form SSA-3368-BK: Adult Disability Report

When applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), completing Form SSA-3368: Adult Disability Report is essential. This form provides detailed information about your medical condition, work history, and daily limitations. Properly filling out this form strengthens your claim and improves your chances of approval.

What is Form SSA-3368?

Form SSA-3368 is required for adults applying for disability benefits. It helps the Social Security Administration (SSA) assess the severity of your disability and determine whether you qualify for benefits. The form gathers details about your medical conditions, treatments, work history, and daily limitations.

Section 1: Information About You

• Full legal name
• Social Security number
• Date of birth
• Contact details, including phone number and address
• Primary language spoken and whether you need an interpreter
• Indicate if someone is helping you complete this form

Tip: Ensure that all contact details are accurate. Any errors may delay communication and your claim processing.

Section 2: Contacts

• Provide the name, relationship, and contact information of someone who knows about your condition and can help with your claim

Tip: Choose someone familiar with your disability and daily struggles, as they may be contacted for additional information.

Section 3: Medical Information

• List all medical conditions that limit your ability to work
• Provide the date your condition began to affect your ability to work
• Indicate if the condition has worsened over time
• Note any hospitalizations or surgeries related to the condition
• List all medical tests and their results
• Name all doctors, hospitals, and clinics where you received treatment, along with visit dates

Tip: Be as detailed as possible. Missing medical conditions or treatments may weaken your case.

Section 4: Work Activity

• Indicate if you have worked since your condition began
• Describe job duties and physical or mental demands
• Note any job modifications or accommodations received due to your condition
• List any workers’ compensation or disability benefits received from an employer

Tip: Clearly explain how your disability prevents you from working. SSA will compare this to your previous work requirements.

Section 5: Education, Training, and Literacy

• Highest level of education completed
• Any vocational training or special job skills
• Indicate if you received special education services
• Certifications or professional licenses obtained
• Ability to read, write, and understand English

Tip: If you struggle with reading, writing, or understanding instructions, make sure to mention this, as it could impact SSA’s decision.

Section 6: Work History (Continued)

• List all jobs held in the past 15 years
• Include job titles, employer names, and dates of employment
• Indicate if you stopped working due to your disability

Tip: Provide accurate job descriptions. Highlight any physical or mental demands that became difficult due to your disability.

Section 7: Medicines

• List all prescribed medications
• Include the reason for taking each medication
• Describe any side effects experienced

Tip: Mention any side effects that affect your ability to work, such as drowsiness, dizziness, or difficulty concentrating.

Section 8: Medical Treatment

• Name all doctors, hospitals, and medical facilities where you have received treatment
• Include the dates of visits and contact information for each provider
• Provide information about any upcoming medical appointments

Tip: Keep track of all medical visits and tests. SSA will check if you are following prescribed treatments.

Section 9: Other Medical Information

• List any other medical conditions not previously mentioned
• Provide information about any additional treatment or therapies received
• Describe how the condition impacts your ability to work or perform daily activities

Tip: Even minor conditions can contribute to your overall disability. Include everything that affects your daily life.

Section 10: Support Services

• Indicate if you receive assistance from community programs, home care services, or social workers
• List any government benefits, including food assistance or housing support
• Describe any modifications or accommodations received for daily activities

Tip: Showing that you rely on additional support services strengthens your claim by demonstrating the severity of your condition.

Section 11: Remarks

• Provide any additional information that was not covered in previous sections
• Explain any unique circumstances related to your condition or work history

Tip: Use this section to clarify anything that might be unclear in previous sections or provide further details about your daily struggles.

Section 12: Who is Completing This Report?

• Indicate if you are completing the form yourself or if someone else is assisting
• Provide the name, relationship, and contact information of the person completing the form

Tip: If someone else completes the form for you, ensure they are fully aware of your condition and limitations to avoid inconsistencies.

Common Mistakes to Avoid

• Being too vague: Instead of just stating, “I can’t work,” explain how your condition limits specific tasks.
• Leaving out secondary conditions: Many claimants focus only on their primary condition and forget other impairments that affect their ability to work.
• Not providing complete contact details: SSA needs to contact your doctors. Double-check that all provider information is correct.
• Missing deadlines: If you don’t submit forms on time, your case may be denied.

Why Working with a Disability Attorney is Important

Filling out Form SSA-3368 can be overwhelming. Many applicants struggle to explain their symptoms and work history in a way that SSA understands and accepts.

A skilled disability attorney can:

• Help you provide detailed, accurate information
• Ensure that your responses align with your medical records
• Assist in collecting additional evidence to strengthen your case
• Improve your chances of approval

At Nationwide Disability Law, we know exactly what SSA looks for in a disability application. We guide you through the process and make sure your claim is strong and complete.

Need Help with Your Disability Claim?

Completing Form SSA-3368 correctly can significantly impact your claim. A disability lawyer can guide you through the process and help gather the necessary medical evidence.

Get Expert Assistance Today!

At Nationwide Disability Law, we specialize in SSDI applications and appeals. Don’t navigate this process alone.

📞 Call us at 888-585-4555
🌐 Visit www.nationwidedisabilitylaw.com

For more resources, visit Nationwide Disability Law’s Instagram, where we’re dedicated to supporting your journey toward financial stability and peace of mind.

Maximize your chances of approval with expert legal support!