SSDI Application Evidence Organizer
Tip: The SSA generally focuses on evidence from the last 12 months for medical issues, and the last 15 years for work history. Use this tool to ensure you have no gaps.
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Medical Providers
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Past Jobs Listed
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Limitations Documented
The date your disability prevented you from working.
Medical Treatment Sources
List all doctors, hospitals, and clinics that have treated your disabling conditions.
| Provider | Condition | Dates | Type | Action |
|---|---|---|---|---|
| No providers added yet. | ||||
Work History (Last 15 Years)
The SSA needs to know about the physical and mental demands of your past work.
| Job Title | Dates | Exertion | Action |
|---|---|---|---|
| No jobs added yet. | |||
Functional Limitations (ADLs)
Describe how your condition limits your Activities of Daily Living.
| Area | Description | Action |
|---|---|---|
| No limitations added yet. | ||