5 Tips for completing the Work History Report 1

  1. Accurately list your tasks/responsibilities.
    • Be honest. Do not exaggerate, but also avoid downplaying your responsibilities.
    • Make sure you list all of your responsibilities, even if they were not done frequently. One of the biggest mistakes we see is when clients only describe their typical daily tasks but leave out less frequent, but required, responsibilities.
    • Example: Client A is a receptionist at a small dental office. Once a week, they are required to clean the office, take out the trash, and move files into storage.
    • Only list yourself as a manager or supervisor if that was your job title or you were required to manage as part of your responsibilities.
  2. Keep your answers consistent.
    • SSA and DDS will look for consistency across your answers.
  3. Give specific answers.
    • Do your best to accurately describe the amount of weight you were expected to lift and carry.
    • Example: Would regularly lift 20-pound cleaning supplies or Answered inbound calls and scheduled appointments.
  4. Be “Short and Sweet.”
    • Be thorough but concise. Answer the question that is asked.
  5. Answer all questions.
    • If you leave questions blank or unanswered, it could result in delays in your claim being processed by SSA or DDS.

1This guide is intended to be for informational purposes only and should not be construed as legal advice. Your answers should be honest, in your own words, and based on your own specific circumstances.

Walkthrough

section 1

  1. Name, Social Security Number and Daytime Telephone Number.
    • Ensure that you are using your name as listed on your Social Security Card.
    • Use the number that is most accessible.
  2. Information about your Work
    • Make sure to list your job titles in chronological order.

section 2

  1. Job title:
    • Rate of Pay-Hourly, Salary and number of hours per day/week.
    • Describe your job. This section is important. You will want to make sure that you describe all your job duties that you performed, not just tasks that you would complete on a typical day.
    • In this example, we will be using the Cashier role at a grocery store. The job title was a Cashier, however they would also stock shelves when the store was not busy. So we will include all duties, including ringing up customers, bagging up groceries for the customer, handling money and calculating change, pushing stock carts and stocking shelves with produce and boxed goods.
    • We will mark that this applicant used machines as they used a cash register and scanners.
  2. In this Job, how many hours did you Breakdown:
    • Walk, Stand, Sit, Climb, Stoop, Kneel, Crouch, Crawl will need to add up to the number of hours worked per day.
    • Handle, Reach, Write/Type or Handle Small objects cannot exceed the number of hours worked per day.
  3. Lifting and Carrying:
    • You will want to list all of the items/materials that you would lift and carry, frequent and infrequent.
    • For the heaviest weight lifted, you will want to mark the answer that is the most accurate-this includes items that may have been infrequent. This cashier would have to lift 50 pound bags of dog food, so we will mark the 50 lbs box.” with “lift boxes of produce, bags of dog food, and other merchandise weighing up to 50 pounds while stocking.  Even if this was not done frequently it should be accounted for if it is the heaviest weight they were required to lift.
    • For the frequently lifted, provide the answer  that is the most accurate depiction of what you frequently liftedThe  employee in our example has to frequently lift items that weighed up to 10 pounds when bagging groceries and stocking shelves, we will mark the 10 lbs box.
  4. Did you supervise other people in this job?
    • You will only mark this question as “yes” if you were in a supervisory/management position, meaning you set schedules, handled time cards/payroll, assisted in hiring/firing of employees, ect. If you were simply a veteran employee whose experience lent itself to answering questions for newer staff or showing new employees a process, answer “no” for this question.
  5. All job titles that you listed in Section 2 Information About Your Work must have a Job title Section completed. If you run out of room, you can add jobs under Section 3-Remarks

Questions to Keep in Mind:

  1. If a previous job was administrative in nature (i.e. office work), were you required to carry reams of paper, boxes of files, or customer orders throughout the office?
  2. Were you required to perform miscellaneous tasks such as cleaning the office, taking out the trash, or loading deliveries onto a truck?
  3. If you were in a Supervisory or Management role, did you on occasion or frequently have to conduct the same tasks/duties as your staff. If yes, then you will want to add those tasks to your description including your management tasks as well.

If the answer to any of these questions is “yes,” review the weight selected on the work history form and make sure it matches these responsibilities.

After Completing the Work History Report:
Once you have completed your work history report, it is imperative that you return it to Disability Determination Services (DDS) immediately using the business reply envelope they provide. Any delay in returning this form could result in delay in your claim, or even result in a denial.

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2This guide is intended to be for informational purposes only and should not be construed as legal advice. Your answers should be honest, in your own words, and based on your own specific circumstances.