How to Fill out Form SSA-3381

The SSA-3381 or “Medical and Job Worksheet - Adult”, while not a required part of the application for Social Security Disability (SSD) benefits, is a form that the Social Security Administration (SSA) requires you to complete prior to beginning your formal application for disability. This worksheet contains sections covering your employment history dating back five jobs or fifteen years prior to your medical condition becoming so severe that it prevented you from working.

The SSA-3381 form also asks you to list your medical doctors and other healthcare providers as well as the medical tests you’ve had performed. Additionally, there is a section that covers over the counter medications and prescription drugs you regularly take to manage your condition and the physician who prescribed the treatment.

Whether you complete your SSD application online, via phone, or at an in-person appointment with an SSA representative, the form SSA-3381 is a necessary part of the documentation you must have to successfully complete the application process.

Why Form SSA-3381 is Important

While form SSA-3381 will not be a part of your formal application for SSD benefits, you must complete the form before you begin your application. It helps you collect the essential details that will be required for multiple forms that are part of the formal application process. It also gives you a comprehensive record of your own medical treatments, work history, and other pertinent details you’ll need to reference back to during the disability application and review processes.

This form can also be used as a guide by any Social Security advocate or attorney you work with during your disability case, giving them an easy resource for reviewing the details of your application and ensuring that your forms and other documentation reflect the severity of your medical condition and your subsequent disability.

This form can additionally be used as your own “cheat sheet” should you be required to attend an SSD appeal hearing to be approved for benefits following an initial denial of eligibility by the SSA. You can reference back to it during the disability hearing rather than having to remember all the details.

How to Complete Form SSA-3381

When you fill out the SSA-3381 form, list all the details that fall under each and every section of the form. Collect the accurate contact information for all medical professionals who have treated you over the years and be sure to list the information for hospitals, clinics and other medical facilities you’ve visited over the years as well. Accurate contact information will be required on multiple forms in the disability application, and failure to fully and accurately disclose these details can result in delays with the disability eligibility determination process.

The same is true for all other information required on form SSA-3381. Every piece of information on this form will be required on multiple SSD forms and having the details listed accurately and concisely on the Adult Medical and Job Worksheet makes it easier for you to ensure you provide consistent and accurate information on all other required forms throughout the application process.