How to Fill out Form SSA-3369

Form SSA-3369 is the “Work History Report” required by the Social Security Administration (SSA) as an essential component of an application for Social Security Disability (SSD) benefits. This form asks for previous positions of employment, including job titles and the dates that you worked in each position, going back 15 years from the time that your disability became so severe that it prevented you from working.

The Work History Report also asks for specific details about each job on your employment history list. Specifically, the form will ask for details about the kind of work you performed and the physical requirements of each job, like the how much weight you were required to lift and how frequently you had to walk, stand, push, pull, or stoop, for example.

Why Form SSA-3369 is Important

The information requested on form SSA-3369 is intended to help the SSA determine how your medical condition affects your ability to work in jobs for which you’re qualified. The report shows the SSA the type of work you’ve done in the past and the job skills and experience you’ve gained over the course of your employment. It also tells the SSA the type of mental and physical requirements of each of the positions you held in the past, giving insight into what kind of job duties you were once able to perform.

While the details that appear on the Work History Report are crucial in the disability eligibility determination process, they are not the only details the SSA will take into account when making a decision on your disability claim. Form SSA-3369 helps establish whether you’re able to perform any kind of gainful work for which you may be qualified.

In other words, the details on the form are necessary for the SSA to not only see that you can no longer work in the last job you held but also that you don’t have the knowledge, skills or experience to find work in another area of the workforce in which your medical condition and the limitations it imposes on you would not prevent you from performing essential job functions.

How to Complete Form SSA-3369

When completing the SSA-3369 form, you should ensure you answer all questions, leaving no sections of the form blank. In areas where questions are not applicable in your case or where you’re not sure of the answer, you should indicate as much by answering “I don’t know” or “does not apply”.

Leaving a question blank will leave the SSA with more questions that must be answered before they can make a decision on your eligibility to receive SSD benefits. By ensuring you answer every question to the best of your ability, you potentially shorten your wait for a decision on your eligibility.

Any question on the form that asks for a more detailed explanation, like the questions on “lifting and carrying”, for instance, should be thoroughly answered. Be sure to provide an explanation whenever you’re asked to do so.

If you need to provide further explanation of any other answers to standard questions on the form, you may do so in the “remarks” section, which appears toward the end of form SSA-3369. However, you may wish to consult with a Social Security advocate or attorney before deciding what information to include in the remarks section of the form to make sure the details you provide are relevant and truly represent your physical, mental or other limitations.

Urgent Case Request

Applications for Social Security Disability (SSD) benefits are processed by the staff at Disability Determination Services (DDS) offices in each state. The DDS staff is responsible for evaluating applications and making eligibility recommendations to the Social Security Administration (SSA).

What Are Urgent Case Rquests?

If an application arrives in the DDS office and is based on a diagnosis which appears on the SSA’s list of conditions that are presumed to qualify for SSD benefits, then the DDS staff will mark the application as an “Urgent Case Request”.

Unskilled Work

The Social Security Administration (SSA) takes a number of factors under consideration when reviewing an application for Social Security Disability (SSD), including: your medical condition, the limitations it places on you, your work history, age, education, experience, and job skills, among others.

The evaluation of your skills is completed so the SSA can determine if you’re completely disabled by your medical condition, or if you may still be able to find and maintain employment in another field in which your skills will allow you to perform the essential job duties despite the limitations of your medical or psychological condition.

With job data obtained through the Department of Labor, the SSA categorizes jobs into broad classifications. The skill set required for successfully performing the work is what determines which job class a position falls under. The classes that the SSA uses are Skilled Work, Semi Skilled Work and Unskilled Work.

Unskilled work is defined as work that doesn’t require you to exercise much if any judgment in order to perform the central job duties. They may or may not require you to have physical strength, dexterity, coordination or other manual labor abilities. Unskilled jobs don’t produce transferable skills and typically require only about 30 days or less to learn to perform all the core job responsibilities successfully.

In reviewing your application for SSD benefits, the SSA will evaluate your medical or psychological condition and the limitations it places on you. The SSA also looks at the job skills you possess. Your skills are compared to the type of jobs available, and your limitations will be reviewed at the same time.

This is done in order to determine if your limitations prevent you from performing work appropriate for your skills. If they do, then you’re disabled according to SSD guidelines and would therefore be eligible for benefits. If however, your skills would allow you to gain and maintain employment, even with your limitations, then you would be denied benefits.

Unearned Income

While an applicant for Social Security Disability (SSD) benefits doesn’t need to be concerned about the amount of their financial assets, and can still qualify for disability benefits with an earned income up to a certain monthly threshold, eligibility for Supplemental Security Income (SSI) does take an applicant’s earned income, financial assets, and unearned income into account.

Unearned income is any income that is not achieved through employment or from involvement in self-employed business activities. Unearned income can include, but is not limited to:

  • Money provided by someone else for paying your own expenses
  • Housing, food or other essential needs that are provided by someone else
  • Veterans’ benefits
  • Pension or retirement benefits
  • Workers’ compensation benefits
  • Unemployment benefits
  • Life insurance payouts and inheritance, including property and cash
  • Alimony and child support payments
  • Income from rental properties you own
  • Union benefits

Some earned and unearned income is counted in determining your eligibility for SSI, while other income is not. Additionally, earned and unearned income can affect the amount of SSI benefits you’re entitled to receive each month if you are deemed eligible for this program.

SSI is a cash benefit available to SSD recipients who have very limited financial resources. To qualify for SSI, your income from all countable sources – earned and unearned, money and services – cannot exceed the maximum monthly SSI benefit amount for an individual with your particular living and other circumstances. Additionally, your SSI benefit amount may be reduced in proportion the countable resources, including the countable unearned income you have at your disposal.

Survivor Benefits for Widows

The Social Security Administration (SSA) has provisions in place for covering the widows and widowers of deceased workers with Social Security old age or retirement benefits and Social Security Disability (SSD) benefits as well.

Workers contribute to the Social Security throughout the course of their employment. Every year, four work credits can be earned, making 40 credits potentially accumulated over the course of just ten years of employment.

Survivor Benefits for Children

The Social Security Administration’s (SSA) regulations contain multiple provisions for making benefits available to certain survivors of deceased workers. Among these provisions are some that allow surviving children of deceased workers to receive benefits through the Social Security old age/retirement fund and through the Social Security Disability (SSD) fund.

Semi Skilled Work

The Social Security Administration (SSA) takes several factors into account when reviewing any application for Social Security Disability (SSD). The medical records contained in your application are a big part of the process, but not the only important information reviewed by the SSA.

The SSA also evaluates your work skills. This is done to determine if your medical condition truly prevents you from working entirely. By determining your skills the SSA is able to identify jobs you may be able to do even with the limitations your medical impairment may place on you.

The SSA uses job data available through the Department of Labor to categorize jobs into broad groups, based on the skill sets required to successfully perform the work. These categories include skilled work, semi-skilled work or unskilled work.

Semi-skilled work is defined as work that doesn’t encompass more complex duties. While positions in this job classification do require you to be alert and pay attention to details, like monitoring machines or processes, it doesn’t require you to have professional level knowledge, training or education in order to perform the essential job functions.

Semi-skilled jobs may include positions in which you’re expected to perform inspections by looking for errors or irregularities, or may require you to take care of or guard materials, property, or equipment. They may additionally require skills such as manual dexterity or physical coordination, like the ability to perform repetitive tasks or operate equipment or machines.

When the SSA looks at your application for SSD benefits, they will evaluate the limitations imposed by your medical or psychological condition. They will also evaluate the skills you possess, and will compare those with the limitations of your medical or psychological condition. In this way, the SSA is able to determine if you are unable to find and maintain gainful employment, which is a central component of the eligibility criteria for receiving SSD benefits.

Red Book

The “Red Book” is a reference resource published by the Social Security Administration (SSA) that details all of the employment-related rules and regulations associated with the Social Security Disability (SSD) and Supplemental Security Income (SSI) programs. It is intended for use by professionals that help people with disabilities, but the Red Book can also be used directly by SSD and SSI beneficiaries who’re interested in learning more about the employment-related programs of the SSA.

There are provisions written into the SSA’s rules and regulations that support and even encourage disabled workers to find and maintain employment. These provisions are often referenced as “work incentive programs” and each available program is described in the SSA’s Red Book for anyone to review.

The Red Book is updated annually to reflect the most current information on employment supports offered through SSD and SSI. The book contains information on employment supports applicable to SSD only, SSI only, and to beneficiaries who receive both SSD and SSI.

If you wish to return to work, you should review the employment-related provisions of the SSA’s disability programs before doing so. Familiarizing yourself with the Red Book’s details will help you understand how seeking and/or gaining employment will affect your overall benefits. You’ll also learn about specific incentives that can help you seek employment without losing your benefits or decreasing the amount of your monthly disability payment.

Physical Residual Functional Capacity

If you’ve submitted an application for Social Security Disability (SSD) benefits and the condition that’s the basis for your disability claim doesn’t precisely meet the Social Security Administration’s (SSA) Bluebook definition, then you may still be found eligible to receive SSD benefits under a medical vocational allowance. In order to evaluate your condition and determine if you meet the overall disability requirements for receiving SSD, the SSA will assess your “physical residual functional capacity” (physical RFC).