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Disability Report, Adult

The Social Security Act requires claimants to furnish medical and other evidence to prove they are disabled. Applicants for disability benefits will complete form SSA-3368. The information will be used, in conjunction with other evidence, by State DDS's to develop medical evidence, to assess the alleged disability, and to make a disability determination.
Form #: SSA 3368 BK
Agency: Social Security Administration
Type: Both Form and Instructions
Capability: [2] Printable Only
Format: pdf
Pages: 12
What's Needed: Adobe Reader  Download