How to Fill Out an SSI Work History Report
- 1). Access the Adult Disability Form from the Social Security Administration homepage. Click the "SSI" tab on the top menu. On the following page, click the "Apply for an Adult" button. Select the hyperlink "Adult Disability Report" on the next page to begin the application.
- 2). Select the "Privacy Act Statement" hyperlink inside the top box on the right of the page. Read it and close the window after you finish. Check the small box acknowledging you have read the statement. Click the "Start Report" button.
- 3). Answer the questions on the first page to determine whether you should fill out the form. You must be 18 years or older. You also have to live in the continental United States or in one of its territories and possessions. If you applied for disability before and were denied, at least two months must have elapsed. If you pass the screening, the online system lets you proceed to the Adult Disability Report.
- 4). Fill out sections 1 to 5 of the Adult Disability Report. The system then moves you to section 6, "Job history." List the last five jobs you had in the past 15 years. Include the job title, the kind of work you did, the start and end dates of each job and your work schedule. Also, put down how much you earned. Continue to the other sections of the application. Follow the prompt to submit the form electronically after you answer the last question.
- 5). Download the Work History Report from the Social Security Administration website if you do not want to use the online option. Click "Get a form" on the menu on the left of the homepage. On the next window, scroll to "Disability Forms" and select "SSA-3369 Work History Report." Print the form to complete it. Provide the same information listed in step 4 for the jobs you held in the last 15 years. Submit the completed application to your local Social Security office.
