Welcome to the Social Security Adult Disability Report

Form Approved: OMB No. 0960-0579 Expires 09/30/2015

Thank you for completing part of your online application for Social Security benefits. If you are applying for disability benefits, we will need additional information about your personal, medical, work, and education history. To protect your privacy, we will ask you to repeat some information you already entered in the form that you already completed.

Before you begin...

Before you start this report, you should read How the Online Disability Report Works in order to understand the information and documents that may be needed.

You may also want to review the following related links:

Information About This Internet Report

Disability Information

Legal and Official Information

To Start The Report...

If you want to start a new Disability Report, first refer to the instructions under How the Online Disability Report Works .

I have read the Privacy Act Statement

We estimate that it will take approximately 90 minutes to read the instructions, gather the facts, and answer the questions, but this will depend on the number of questions you need to answer. For more information about estimates, go to the Paperwork Reduction Act .