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How To Fill Out Form SSA-3368-BK in New Orleans

Disability Report - Adult

View and Download Form SSA-3368-BK

Applying for Social Security Disability benefits means filling out a lot of forms. The form reporting your disability – Form SSA-3368 – is one of the first ones you’ll see.

This Adult Disability Report is where you explain the health problems that are keeping you from work. You can have physical or mental health conditions and qualify for Social Security Disability benefits.


You’ll need the following information for Form SSA-3368:

  • The date when your medical problem began
  • The symptoms you’re experiencing
  • Your medical history
  • The medical treatment you have received
  • The doctors who have treated you
  • The medical facilities where you have received treatment
  • An explanation of how your health condition prevents you from working
  • An explanation of why you cannot perform past jobs or other jobs you otherwise would be qualified to hold


You can file Form SSA-3368 online with the Social Security Administration (SSA) at the same time you file for Social Security Disability or Supplemental Security Income (SSI) benefits.

Or, if you apply in person, you can fill out your Adult Disability Report during your interview with an SSA claims representative.

If you think you’re going to have questions understanding the form, it could be better to apply in person with someone who can answer your questions.

WHAT HAPPENS After You File FORM SSA-3368?

Along with Form SSA-3369, this report starts your Social Security Disability claim.

When you live in Louisiana or Mississippi, an SSA claims representative forwards this form to your state’s Disability Determination Services (DDS) office.

Each state has a DDS agency that makes an initial decision on your case for the SSA.

Then an SSA disability claims examiner evaluates your application.

If you’ve provided enough information, the examiner will get a clear idea of your situation.

And if your information is accurate, your claim will move more quickly through the system. That’s why it’s important to double-check points such as contact information for your doctors and addresses of the medical offices where you’ve received treatment.

Missing some items or getting some information wrong could delay your benefits for months.


Gary Sells and his team can help you with Form SSA-3368. We’ll collect and organize important documents and information for you. Many other disability firms won’t do that.

We guide you and ensure your application is strong. Our mission is to give you the best chance of winning disability benefits.

Contact us if you need help with Form SSA-3369.