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How to Fill Out a Work History Report

(Form SSA-3369-BK)

When you apply for benefits, you will have to fill one of these reports out. This does not look like a very important form, but it is. Social Security is not using it to check to see if it matches their payroll information or anything like that. Rather, it will be used to determine what kind of work you have done in the past. That is a critical factor at Steps 4 and 5.

Remember, you can fill it out yourself or have someone else fill it out for you. You can do it by hand as well. If you do not understand a question, get some help.

Social Security only cares about the work you have done in the past 15 years. Nothing before that is relevant at Step 4 and Step 5.

  • For “Job Title,” put down what the employer called you. So if you worked for a store as a “Sales Associate,” put that down instead of limiting yourself to “sales clerk,” “cashier,” or “stock clerk.” If you did not have an official job title, put down what you would say if someone simply asked you, “So, what do you do for a living?”
  • If you worked as a truck driver for 20 years, but with ten different companies, you would only have one “Job Title,” for example.
  • If you worked for a temp agency, we will come back to that in Section 3.
  • For “Type of Business,” try to boil it down to a couple of words. If I worked at Walmart, I would say “retail.” If I worked at Jiffy Lube, I would say “auto maintenance.”
  • For “Dates Worked,” do the best you can. It is hard to go back in time for many people. Reach out to your spouse, family, or friends to help you remember. Try to be as complete as possible. Do not leave any jobs out, even if they only lasted a few days. Let DDSD or the judge determine what is relevant and what is not.
  • For each “Job Title” you put down on Page 1, you have to fill out the details beginning on Page 2. This can be tough for some people because every day was different. If I were a Sales Associate for a retail store, and my hours varied from 4 to 10 hours a day, I would write down, “4-10.”
  • For “Describe this Job,” tell them what you did all day. Some “store managers” never stock shelves. Others do a lot of lifting. Your description of the job carries a great deal of weight with DDSD and the judge.
  • Remember, you need to write down how long you had to stand, walk, reach, and handle. Take the maximum amount; do not try to average it out. It is O.K. if the categories equal more than the hours worked in a day.
  • For “Lifting and Carrying,” include the occasional heavy things you had to lift. If you worked in an office where there was no lifting more than 10 pounds, except for once a month when the 50-pound boxes of copy paper were delivered, check the 50-pound box for the “heaviest weight lifted.” Then check the 10-pound box for the “frequently lifted” category.

Section 3:

  • This is where you explain what you did not get a chance to do earlier because you ran out of space.
  • If you had more than six jobs listed, use Section 3 to finish Section 2.
  • If you worked for one temp agency, but the work you did varied from week to week, Section 3 is the place to explain it.

Final tips:

1. Use scratch paper to help you formulate your answers. Especially for Section 2, try to put your jobs in order.

If your handwriting is poor, you can always type out your responses using this pdf.

2. Think about your answers ahead of time and think about why you cannot do your old jobs. For each job, make sure that requirement is in that description. If you leave it out, DDSD will determine that you can go back to that old job.

Example: A 55 year-old mechanic injures his right knee making it unbearable to kneel, crouch, or crawl. Being a mechanic is all he knows how to do and his knee pain is keeping him from working as a mechanic. Unless the applicant writes down that kneeling, crouching, or crawling was a requirement of the job, DDSD will determine that he can go back to being a mechanic, even though everyone knows how physically hard being a mechanic can be.

DDSD usually sends the Work History Report with several other forms. If at any time, you feel like you are getting in over your head, please reach out and get some help.

If you have any questions, please call me at (310) 443-4117 for a free consultation.

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