Get Poms: Di 22515.030 - Use Of Work History Report Form ...

Completing the POMS: DI 22515.030 - Use of Work History Report Form online is an essential step for those seeking disability benefits. This guide provides clear and supportive instructions to help you navigate each section of the form effectively.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to access the work history report form online.
2. Begin by providing your personal information in Section 1. Fill in your name, social security number, and daytime phone number.
3. In Section 2, list all jobs you held in the five years prior to your inability to work. Start with your most recent job and include all job titles, ensuring to detail your responsibilities.
4. For each job, estimate your rate of pay, hours worked per day, and type of business. Be thorough in describing your tasks, including any supervisory roles and equipment used.
5. Detail any interactions with coworkers or the public and how much time you spent on these activities. Use the provided space to describe each aspect of your previous roles.
6. In Sections 2 and 3, explain your physical activities and describe any exposure to hazardous environments. This information will help in understanding how your medical conditions could impact your ability to perform past job tasks.
7. If additional space is required for your answers, utilize Section 3 for remarks, ensuring to reference the corresponding job number.
8. Finally, in Section 4, indicate who is completing the report. If someone else is helping, fill out their information, including their relationship to you.
9. After completing the form, you can choose to save your progress, download a copy, print it, or share it as needed.

Complete your documents online today to ensure your disability benefits application is processed smoothly.