Disability Report Form Guide

The Disability Report Form (SSA-3368) for Adults is an important part of your application for disability benefits.

On the Disability Report Form, you will provide information about yourself and your medical condition, your health care providers, medications, education, and job skills.

THIS FORM IS NOT AN APPLICATION FOR BENEFITS. TO APPLY, PLEASE CONTACT SOCIAL SECURITY AS SOON AS POSSIBLE.

THIS GUIDE DOES NOT REPLACE INSTRUCTIONS INCLUDED WITH THE FORM.

THE INFORMATION IN THE GUIDE DOES NOT REPLACE FEDERAL LAWS, RULES AND REGULATIONS GOVERNING SOCIAL SECURITY'S DISABILITY PROGRAMS.

When you file a disability application, we will use the information you give us on this form to get medical records and other information that helps us make the correct decision about your disability claim; and to make it as quickly as possible. It helps us understand how your age, education, work experience, and medical condition affect your ability to work.

This Guide has additional tips to help you complete the form, and tells you why we ask for the information on the form and how it's used to help us make a decision about your application for disability benefits.

Click here for steps to consider when using this guide.