Social Security Forms for Disability Benefits

Even if you plan to file online, it is advisable to write out a rough draft on paper forms so that you don’t forget to include important information when working online or when you are in a Social Security office filing in person. The base application for Social Security Disability (SSDI) is the SSA-16-BK, while the base application form for Supplemental Security Income (SSI) disability is the SSA-8000-BK. Base application forms for disabled widows and adult children are the SSA-10 and SSA-4-BK, respectively. These last two forms can be found in the SSA Retirement/Dependent/Survivor Forms section of this website.

Whether you are applying for Social Security Disability as a disabled worker, a disabled widow, a disabled adult child or for SSI as an adult, in addition to the SSA-16-BK or SSA-8000-BK, you also have to complete an SSA-3368 to provide medical information, an SSA-3369 to provide your work history, and an SSA-827, which allows the Social Security Administration to collect information for the purpose of determining your eligibility. You may also want to use some of the other forms available in this grouping of forms to submit additional information about your limitations or special accommodations.

Please click on the link below to open your desired form in a separate browser window. You can then download the form from DisabilityResources.org directly to your computer.

SSA-3381 Medical and Job Worksheet—Adult Disability Claim

SSA-16-BK Application for Disability Insurance Benefits
(Social Security wage earner only)

SSA-16-BK-SP Solicitud para beneficios de seguro por incapacidad

SSA-8000-BK Supplemental Security Income (SSI) Application

SSA-827 Authorization to Disclose Information to the Social Security Administration

SSA-546 Worker’s Compensation/Public Disability Questionnaire

SSA-3368-BK Disability Report – Adult
To be completed by a worker, widow(er), adult child or SSI adult

SSA-3369-BK Work History Report
To be completed by a worker, widow(er), adult child or SSI adult

SSA-3373-BK Function Report – Adult
To be completed by a worker, widow(er), adult child or SSI adult

SSA-3380-BK Function Report – Adult – Third Party Form
To be completed by a third part for a worker, widow(er), adult child or SSI adult

SSA-3033 Employee Work Activity Questionnaire
Employer statement regarding work accommodations and/or subsidy

Physical Residual Functional Capacity (RFC) Assessment Form
(For physician completion)

Mental Residual Functional Capacity (RFC) Assessment Form
(For physician completion)

SSA-4814 Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection
(For physician completion)

Related Social Security Administration Forms For:
Retirement, Dependent & Survivors Benefits
Supplemental Security Income (SSI) Benefits
SSDI/SSI Disability Appeals 
SSDI Work After Disability Approval
Representative Payee, Earnings Record, Direct Deposit & Overpayment