All benefits applications require an Adult Disability Report. You can complete and submit this form through your MySSA account, and we recommend doing that.

To complete a submit a form through your MySSA account, log in and choose “Upload Documents”

This is a screenshot from the MySSA portal, showing your options to navigate in the portal.

Then, type the name of the form you’re looking for in the search bar.

This screen shot shows the “upload documents” option within the MySSA portal, where you can search for forms to submit.

This report has 11 sections.

Section 1: Demographics.

This section is straightforward. List your personal information.

Section 2: Contacts.

Provide contact information for anyone who is helping you with your application. If you are a family member or friend helping someone complete the application, put your information here.

Section 3: Medical Information

List all conditions you have been diagnosed with, and any conditions in process of being diagnosed.

Section 4: Work Activity

Provide information about your work history, and how your disability has impacted your ability to work.

If you have never worked, provide information about when your disability became severe enough to prevent you from working. For some people, this may be the date of your diagnosis, even if that date was in childhood.

Section 5: Education, Literacy, and Training

Provide information related to education, literacy, and training; if you receive or received Special Education services, note that here.

Section 6: Work History

Provide information about your work history for the past 5 years. Provide information about how your disability impacted your ability to do those jobs, including support needed due to the disability. If you have no work history, skip this section.

Section 7: Medicines

Provide information about the medications you are currently taking, including who prescribed them.

Section 8: Medical Treatment.

Provide information for all sources of medical treatment, even if they are not recent. Go back as far as you can. You will need medical records to complete this section.

Section 9: Other Medical Information

Provide information for other agencies that have provided you medical services. If you receive disability-related services from a state agency, list the agency as a provider in this section.

Section 10: Support Services

This section is only used during an SSI Age 18 Redetermination. If that does not describe your situation, skip this section. Provide information about school and vocational services.

Section 11: Remarks

Provide information you didn’t have room for elsewhere. Some examples might be:

• Medical treatment information you didn’t have room for in section 8
• If you are unhoused, note that here
• Any information you’ve provided that you would like to explain further
• Alternative phone numbers or ways to be contacted

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Tip: Have your medical records on hand to fill out this form. Keep your narrative about the impact of the disability handy to answer questions related to that topic.

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To Do: Complete the Adult Disability Report; do this in your MySSA account, if possible.

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