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How to fill out form SSA-3369—Work History Report

When you apply for Social Security Disability (SSD) benefits, you will provide the Social Security Administration (SSA) basic information about your last 15 years of employment prior to becoming disabled.

There is space to list five jobs on the application, which is also known as the Adult Disability Report, but the SSA will need more information about your past work. Form SSA-3368, or the Work History Report, is designed to give them the details they need to make a decision on your claim for benefits.

Why This Form is Important to Your Disability Claim

The Work History Report asks for the following details:

  • jobs you held in the past
  • duties required in each position
  • skills and experience you gained in each job

From the information you provide on this form, the SSA can learn a number of things:

  • 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.
  • A detailed employment history, including job duties, skills, and experience, give disability examiners a basis for determining how your disability affects your ability to work in any job for which you are qualified.

The SSA reviews your work history report in combination with all the other forms and details included in your disability claim. This form is a key piece of the puzzle in deciding how your medical condition affects your ability to find and keep a job that you are qualified to do.

Filling Out the Form

Every form the SSA requires in the disability application process is important to the final decision made on your claim. Consistency and completeness are crucial concepts to keep in mind when you fill out every form. Follow these steps to ensure your form SSA-3369 meets the SSA’s requirements.

  • Have a master list of your employment information handy when completing all your SSD forms. This will allow you to ensure the job titles, dates of employment, rate of pay, and other information you enter on various forms all matches up. Any inconsistencies in the information you provide may cause the SSA to have more questions, which in turn only delays the processing of your claim.
  • Never leave any question or field in the form blank. Even if you are not sure if the question applies to you, make sure you enter something in every answer section of the form. When blanks are left on the form, the SSA must collect more information before they can make a decision on your SSD claim. This only delays the decision making process. Enter statements like “I don’t know,” “Does not apply,” or “Not applicable” rather than leaving any blanks.
  • Provide additional information, when needed. Some sections of the Work History Report ask for “further explanation” of the answers you provide. Make your responses in these sections thoroughly detailed. For example, the form asks you to explain “lifting and carrying” activities that were part of your job. Ensure your answer includes detailed descriptions of what you lifted and carried, how often, and why.
  • Consider consulting an attorney or Social Security advocate. The SSA provides a “Remarks” section at the end of the Work History Report. This section gives you space to further explain any of the answers you provide in other parts of the form.

This section can also be a spot for making an argument about how your medical condition prevents you from completing typical job duties. Before you write out any information the SSA has not asked for, considering consulting an attorney or advocate.

They can help you make sure your statements improve your chances of receiving disability benefits rather than harming them.