The information that you give us on this report tells us where to request your medical and other records. Disability Report- Adult-Form SSA-3368-BK.
Who can apply for adult disability benefits online? . Benefits and have an “ Application Number;” or; An “Adult Disability Report” and have a “Reentry Number.”.
SSA-3820-BK, Disability Report - Child. IRS W-4V Online, Adult Disability Report SSA-4-INST, Reporting Responsibilities for Child's Insurance Benefits.