SSA-3368-BK Disability Report- Adult

The Disability Report - Adult form is a crucial part of the Social Security disability benefits application process, and it's important to answer each question as accurately and thoroughly as possible. Here is a brief overview of the questions on the form and some tips for how to answer them:

1. Personal information: This section asks for your basic information, such as your name, Social Security number, and contact information. Be sure to provide all the requested information and ensure that it is accurate.

2. Contact information for someone who knows about your medical conditions: You will be asked to provide the name and contact information of someone who knows about your medical conditions. This could be a family member, friend, or healthcare provider. It's important to choose someone who is willing and able to provide information about your medical history and current condition.

3. Medical conditions: This section asks about your medical conditions, including the names of your healthcare providers and the dates of your most recent medical visits. Be sure to include all medical conditions that affect your ability to work.

4. Medications: You will be asked to provide information about any medications you are taking, including the name, dosage, and frequency.

5. Medical tests: This section asks about any medical tests you have had, including blood tests, X-rays, and other diagnostic tests.

6. Work history: You will be asked to provide information about your work history, including your past jobs and the tasks you performed. Be sure to include any accommodations you received in the workplace.

7. Education and training: This section asks about your education and training, including any degrees or certifications you have earned.

8. Activities of daily living: You will be asked about your ability to perform activities of daily living, such as dressing, grooming, and cooking.

9. Pain and symptoms: This section asks about your pain and other symptoms, such as fatigue, dizziness, and difficulty breathing.

10. Mental health: You will be asked about your mental health, including any diagnoses and treatments you have received.

11. Functional limitations: This section asks about any functional limitations you have, such as difficulty standing or sitting for long periods of time.

12. Other information: Finally, you will be given the opportunity to provide any additional information that you think is important for Social Security to consider in evaluating your disability claim.

Remember to answer each question as accurately and thoroughly as possible. Providing detailed information about your medical conditions, symptoms, and limitations can help strengthen your disability claim. If you have any questions or need assistance, consider working with a representative who can guide you through the process.