Social Security Disability FormsSocial Security Administration Form 3368 is an 11-part disability report that adults must complete when applying for Social Security disability benefits. Form 3368, also known as the Adult Disability Report, is a critical part of your disability application and one that you may discuss with your Social Security disability lawyer before submission.

What’s on Form SSA 3368?

Form 3368 contains:

  • Part 1: Information About You. Here, you will provide basic biographic information such as your name, birthdate, Social Security number, address, phone number, email, and information about your English proficiency.
  • Part 2: Provide a Contact. You need to provide the name and contact information for someone, other than one of your doctors, who knows about your medical conditions and can help you with your Social Security disability claim. Your contact may be a friend or relative who can explain how your disability impacts your day-to-day life. This section also asks for the identity of the person completing the form.
  • Part 3: Medical Conditions. In this section, you are asked to list all of the physical and mental conditions that impact your ability to work. You are also asked to provide your height, weight, and indicate whether your physical and mental conditions cause you pain.
  • Section 4: Work Activity. The Social Security Administration requests information about your work history, when and why you stopped working, and details about your current work if you are still employed.
  • Section 5: Education and Training. This is where you will provide information about your education, English language skills, and vocational training.
  • Section 6: Job History. Here, you will describe information about the jobs that you had in the last 15 years. This information includes but is not limited to the job title, type of business, employment dates, and pay rates. Specific questions about your work duties are also asked and must be answered.
  • Section 7: Medicines. In this section, the SSA requests information about the medications you take and why you take them.
  • Section 8: Medical Treatment. This part of the form asks for detailed information about what medical treatment you have sought or you have scheduled. Names of providers, dates of service, tests administered, and other information is requested.
  • Section 9: Other Medical Information. Sometimes people other than doctors have useful information about your medical history and condition. You are asked to provide contact information for workers’ compensation insurers, vocational rehabilitation providers, social service agencies, attorneys, and others who may have this information.
  • Section 10: Vocational Rehabilitation, Employment, or Other Support Services. If you have participated in any of these services, you will need to provide information about them in this section of your Adult Disability Report.
  • Section 11: Remarks. This last section of SSA 368 asks you to provide additional information that was not requested in Sections 1-10 or that you did not have enough space to provide in Sections 1-10.

General Tips for Completing Form SSA 3368

The following tips for completing SSA 3368 may help prevent unnecessary delays or denials of your application:

  • Read all of the directions before completing the form
  • Gather all relevant information that you need to complete the form
  • Print clearly
  • Answer all questions completely
  • Provide explanations where appropriate
  • Do not have your doctor complete the form for you
  • Be honest

Don’t let this form and other Social Security disability application steps overwhelm you. Instead, we encourage you to learn the one tip that may help you more than any other as you proceed through the disability application process.

Our Most Important Tip: Talk to a Social Security Disability Before Completing SSA Form 3368

The outline provided above may seem simple enough. However, the majority of initial Social Security disability applications are denied. Often those denials occur because of technical mistakes on forms such as Form 3368.

An experienced Social Security disability lawyer can help you avoid these mistakes. If you are applying for Social Security disability in Massachusetts, Rhode Island, or New Hampshire, we invite you to contact our Metro Boston Social Security disability law firm for a free consultation about how we may help you and why you can afford to hire us even if you are not currently earning an income.

Are You Looking for a Social Security Disability Attorney in Boston, MA?

If you are looking to apply for social security disability, you need to speak with an experienced social security disability lawyer as soon as possible. Please contact us online or call our Natick Office directly at 508.283.5500 to schedule your free consultation.


John L. Keefe
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Founding Attorney, Massachusetts Social Security Disability Lawyer
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