TN 2 (08-17)
DI 22515.025 Use of Form SSA-3368-BK (Disability Report-Adult) for Vocational Evidence
Review the following sections on the SSA-3368-BK to determine if this form provides sufficient vocational evidence.
A. Work activity
You will find information about the work activity pertinent to onset in Section 4 of the SSA-3368-BK. This information pertains to whether the work is substantial gainful activity (SGA). The work activity information provided in section 4 of the SSA-3368-BK may be vocationally relevant.
For more information on SGA and making a determination of capacity for past work, see:
DI 24001.010 Effect of SGA on Disability Status
DI 25005.015 Determination of Capacity for Past Work-- Relevance Issues
B. Education and training
You will find education and training information in Section 5 of the SSA-3368-BK.
C. Job History
You will find job history information in Section 6 of the SSA-3368-BK.
You will find a list of jobs with basic information in Section 6.A.
If the claimant had only one job in the last 15 years, then you should find all the required vocational information about that job in sections 6.B through 6.I. You may need to develop additional job history if the form lists more than one job during the relevant 15-year period.
D. Considering evidence for the special medical-vocational profiles
Pursue targeted vocational evidence to gather details about the special medical-vocational profiles early in the development process when applicable. For information on special medical-vocational profiles, see DI 25010.001.
Be alert for information that shows:
A long work history in unskilled work with a marginal or less education (6th grade or less)
No relevant work, age 55 or older with a limited or less education (11th grade or less)
A long work history in one job or field of work, age 60 or older with a limited or less education
E. Job information we need to know about past work
1. Information needed about each job
Document each job the claimant held during the relevant 15-year period. See DI 25001.001 (Relevant work period) for details regarding the 15-year period.
We need the following information about each job:
Hours worked per week
Rate of pay
Tools, machinery, and equipment used
Knowledge, skills, and abilities required
Nature and extent of supervision
Description of tasks and responsibilities
Strength, endurance, postural, and physical demands
NOTE: If the job duties described in the SSA-3368-BK do not match up with the claimant’s stated exertional demands, you will need to resolve the issue with the claimant if information about a particular job is material to the determination.
EXAMPLE: The claimant stated he spent all day collecting trash from individual offices and then dumping that trash into a large dumpster at the end of the day. However, he also stated he performed no lifting as part of his job duties. You would need to clarify this information if the claimant’s ability to do that job was material to the determination. If the claimant was required to collect trash by lifting it into the dumpster at the end of the day, lifting was part of his job duties.
IMPORTANT: In Item 6D, we do not require that combined hours spent climbing, stooping, kneeling, crouching, crawling match up to the numbers of hours the claimant worked per day. We also do not require that combined hours handling, writing, typing, handling small objects or reaching match up to the numbers of hours the claimant worked per day. There may be time during the day that the claimant does none of those activities.
2. Information needed when the claimant has a mental impairment or physical impairment with psychiatric manifestations
We need the following additional job information when the claimant has a mental impairment or psychiatric manifestations.