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Form SSA-3369-BK (06-2024) UF Discontinue Prior Editions Social Security Administration. Page 1 of 14 OMB No. 0960-0578. WORK HISTORY REPORT. PLEASE READ ALL OF THIS INFORMATION BEFORE ... 68 FR 15784, and 60-0320, entitled Electronic Disability Claim File, as published in the FR on December 22, 2003, at 68 FR 71210. Additional information, and ...
The form you are looking for is not available online. Many forms must be completed only by a Social Security Representative. Please call us at 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday between 8 a.m. and 5:30 p.m. or contact your local Social Security office.
DI 11005.025 Completing the SSA-3369. •. DI 22515.003 Developing Sufficient Vocational Evidence. 2. Information about work history (Section 2) List all the jobs the claimant had in the five years before becoming unable to work because of their illnesses, injuries, or conditions.
Form SSA-3368-BK (06-2024) UF Discontinue Prior Editions Social Security Administration. DISABILITY REPORT - ADULT . Page 1 of 15 OMB No. 0960-0579. PLEASE READ THIS INFORMATION BEFORE COMPLETING THIS REPORT. The office that makes the disability decision on your case will use the information you provide in this report to decide whether you are ...
FUNCTION REPORT - ADULT. If you need help with this form, complete as much of it as you can and call the phone number provided on the letter sent with the form, or contact the person who asked you to complete the form. If you need the address or phone number for the office that provided the form, you can get it by calling Social Security at 1 ...
Form SSA-16 | Information You Need to Apply for Disability Benefits. You can apply: By calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or visiting your local Social Security office. An appointment is not required, but if you call ahead and schedule one, it may reduce the time you spend waiting to apply.
To decide whether you have a disability, we will use a 5-step process. Listed below are frequently asked questions about steps 4 and 5 of the process. We'll need to find out about your past work to decide if you can still do that work. To make this decision, we'll need to know how you did your job. We'll also need to know what skills you ...
The SSA-3368 is used for title II and title XVI disability or blindness claims. Reviewers obtain basic information on an adult claimant's medical conditions medical treatment (including sources of medical evidence), and any other information needed to process the claim to a decision. The form also reserves the claimant’s protective filing ...
Form approved OMB#: 0960-0818. Social Security Disability Insurance (SSDI) or “Disability” provides monthly payments to people who have a condition that affects their ability to work.
How To Apply. You can apply for Disability benefits online, or if you are unable to complete the application online, you can apply by calling our toll-free number, 1-800-772-1213, between 8:00 a.m. and 7:00 p.m. Our representatives can make an appointment for you to apply.