SSA collects the information to document an applicant's work history. The Disability Determination Services adjudicators use the information to make a decision about the alleged disability. The respondents are applicants for disability benefits.
The latest form for Work History Report expires 2021-01-31 and can be found here.
Document Name |
---|
Form and Instruction |
Supplementary Document |
Supporting Statement A |
Revision of a currently approved collection | 2020-12-09 | ||
Approved without change |
Revision of a currently approved collection | 2017-05-17 | |
Approved without change |
Revision of a currently approved collection | 2014-03-10 | |
Approved without change |
Revision of a currently approved collection | 2010-12-10 | |
Approved without change |
No material or nonsubstantive change to a currently approved collection | 2008-03-06 | |
Approved with change |
Revision of a currently approved collection | 2007-07-25 | |
Approved with change |
Extension without change of a currently approved collection | 2004-06-10 | |
Approved without change |
Revision of a currently approved collection | 2001-06-14 | |
Approved without change |
Reinstatement with change of a previously approved collection | 1998-06-02 | |
Approved without change |
New collection (Request for a new OMB Control Number) | 1997-07-23 |
Federal Enterprise Architecture: Income Security - General Retirement and Disability
Form SSA-3369 | Work History Report | Paper Only | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.