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What Information Do I Need for Form SSA-3368? The date your medical condition began. Your symptoms. Your medical history. Details of the medical treatment youve undergone. Names of the doctors youve seen. A list of the medical facilities where youve gone. An explanation of how your health condition keeps you from working.
The SSA-3368: Adult Disability Report helps DDS to obtain a complete picture of the applicants medical history and treatment. Complete information is essential. Be sure to include all information available to you.
You should describe specific examples of how youre limitedphysically, mentally, or bothin your daily activities. Also, be sure to mention your difficulties with daily activities to your doctor, so that they become part of your medical record.
Be honest but dont exaggerate. Be specific about your limitations. If you do not clearly describe your limitations or give vague answers on your Adult Function Report, Social Security will take that to mean your disability really isnt that bad and you should have no problem returning to work.
From your first job to your last, your employer verifies your Social Security number with us to help reduce fraud and allow us to keep track of your work history to ensure you get the benefits you deserve. Open a my Social Security account to verify your personal earnings and watch your future benefits grow over time.
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6 tips for filling out the Work History Report Dont exaggerate or downplay your duties. Be concise. Give specific answers. Keep your answers consistent. Use the Function Report as your guide. Answer all questions. Section 1: Personal information. Section 2: Previous work.
Jobs you had in the past tell them the kind of work you were once able to perform, before you became disabled. The duties you performed provide insight into the physical and mental requirements of your former work as well as your job skills that affect the kinds of jobs you are qualified to do.
How to Fill Out an Adult Function Report for Disability (7 Tips) Answer Every Question and Be Honest! Answer Only the Questions Being Asked. Give as Much Detail as You Can. Be Consistent (Some Questions Overlap) Be Specific on Question 5 of the Function Report. Dont Limit Your Answers to the Space on the Form.

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