Disability Report for a Disability Application

Part of the disability application process (to apply for SSD) is submitting a Disability Report. This form can be completed online at the www.socialsecurity.gov web site. It can be completed by calling the Social Security Office for a phone interview appointment, or in person at the local Social Security Office. When you call the Social Security office for an appointment, they will send you a Disability Starter Kit. The kit can also be viewed on line at the above mentioned site. This kit will inform you of all the information that you need to bring with you to complete the application, disability report, and complete the interview.

It is very important that you pay attention to what information you will need to fill out the disability application and related forms. Having all the suggestion information from the kit, will help you record accurate information on the disability report. Do not exaggerate or use false information. Wrong information, lack of information, etc. cannot only slow the application process down, but it can cause the application to be declined. In most cases, the Social Security Office will catch missing information, and contact you to get the information. So, keep in mind that the more time they spend searching for your information, the longer it will take for you to get approved and start receiving benefits.

The “Adult Disability and Work History Report” will ask you a number of questions about: personal information, medical information, work history, and education. Carefully complete this information. The information included on this report will be a large part of how the applicant is determined disabled under federal Social Security Law. For example, if you have been diagnosed with Parkinson’s disease, but did not include the doctor, hospital, clinic, address, etc.. the Social Security office will not have a way to confirm the diagnosis…thereby stopping the process to get more information from you, or denying the claim.

Here is the information that you will need to complete the “Adult Disability and Work History Report” Disability Application:

• Social Security number
• Your personal contact information
• The name, address, and telephone number of one person that can attest to your condition.
• You will need to be able to date when the condition started, what the symptoms are, and how the condition stops you from working.
• Title, salary, and job skills for every job you have held in the last 15 years.
• You will need to describe your skills and education level.
• The name, address, and telephone number for every doctor, clinic, hospital, therapist, etc.. that you have seen for your condition.
• You will need to list all medical test related to the condition. Dates, where done, and doctor that ordered it will also be needed.
• List of all non prescription medications, dosage, and reason for taking.
• List of all prescription medications, dosage, reason for taking, and prescribing doctors information.

At the end of the Adult Disability and Work History Report you will find a place to release medical information. Under federal law, health care facilities can not release your information, without your consent.

If you cannot fill out the disability report on your own, you have the right to have a representative or attorney fill it out for you. However, they must specify that they are submitting the form for you on a specific version. There is also a different version for the blind and for children; as they are subject to different guidelines than adults.