SSA Form SSA-16

2025 Printable Template

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Form last updated: 03/2024. Please verify this is the current version before use.

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What is a SSA-16 used for?

Form SSA-16 is used by individuals to apply for Social Security Disability Insurance (SSDI) benefits. It collects information about medical conditions, work history, and other relevant details to assess eligibility for SSDI.

Who needs to fill out a SSA-16 form

Individuals applying for Social Security Disability Insurance (SSDI) benefits due to a disability that prevents them from working.

How to fill out a SSA-16 online?

Follow these steps to complete your SSA-16 form online.

Step 1
Step 1
Access the form online or obtain a physical copy from a Social Security office.
Step 2
Step 2
Fill in your personal information accurately.
Step 3
Step 3
Provide detailed employment history.
Step 4
Step 4
Describe your medical conditions and their impact on your work.
Step 5
Step 5
Indicate any related public disability benefits you have applied for.
Step 6
Step 6
Review all information for correctness before submission.
Social Security Administration

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Frequently Asked Questions

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Form SSA-16 is used to apply for disability benefits from the Social Security Administration for those unable to work due to medical conditions.

It is not required for individuals with conditions like ALS or terminal illnesses who may qualify for expedited processing.

You can submit the form online, by mail, or in person at your local Social Security office.

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