Form SSA-3369-BK
Work History Report

Download Form to fill it out online.

How Do I Fill Out Form SSA-3369?

Also known as the Work History Report, Form SSA-3369 is required by the Social Security Administration (SSA) as one of the forms necessary to apply for Social Security Disability benefits. Form SSA-3369 will ask for your job history including job titles and dates you worked at each job. You will need to provide your work history going back 15 years from the time your disability stopped you from working.

The Work History Report will also ask for details about each job you have listed in your employment history. The form will ask for specific details about the work you’ve done in the past and the physical requirements of each job including how much weight you were required to lift and how often you had to stand, push, pull, walk or stoop (among other physical activities).

How Important is Form SSA-3369?

Along with Form SSA-3368, Form SSA-3369 is very important to your Social Security Disability claim. These two forms are the basis for your application.

Form SSA-3369 should help the SSA decide how your medical conditions affect your working ability. The report will illustrate for the SSA the type of work you’ve performed in the past and any job skills and experience you’ve gained during your career. It will also help tell the SSA the type of physical and mental activities required by your past jobs.

The details on your Work History Report are needed to show the SSA that you can no longer work in your most recent job and that you don’t have the ability to adjust to other work because of your disability.

How Do I Fill Out Form SSA-3369?

When filling out Form SSA-3369, make sure you answer all of the questions and leave nothing blank. If certain areas on the form don’t apply to you, just answer by writing “I don’t know” or “Not applicable.”

It’s always better to put some kind of answer rather than leave it blank so you don’t leave the SSA with more questions. Making sure you answer all the questions can help speed up the decision on your application.

Any questions that ask for detailed explanations should be answered with as much detail as possible. Be sure you write in explanations wherever asked. You can give a detailed answer in the “remarks” sections toward the end of the form.

Before you fill out Form SSA-3369, you should consult with one of our experienced disability attorneys at Levine Benjamin.

Our Detroit disability lawyers are here to help you through the complicated Social Security Disability processes. We can help you every step of the way.


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