Disability Report - Adult, (Internet Version)

Disability Report - Adult

i3368 Screenshots - Revised to Include CAL

Disability Report - Adult, (Internet Version)

OMB: 0960-0579

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Fig. 1: Work/Education Screen for Curtailed SSA-3368

Changes to the Work/Education screen for a curtailed
Internet SSA-3368:
The sub-tab “Education” will not appear on the
Work/Education tab.
The highlighted text informs user that education
information is not necessary.

Fig. 2: Work Activity Screen
Fig. 2-1

Change to the Work Activity screen for a curtailed Internet SSA3368:
This version of the screen appears when the user reported on the
Work/Education Introduction screen that work stopped
The sub-tab “Education” will not appear on the Work/Education tab.
The curtailed Internet SSA-3368 will not present questions associated
with the “Education” sub-tab to the user.

Fig. 2-2

Change to the Work Activity screen for a curtailed Internet SSA3368:
This version of the screen appears when the user reports on the
Work/Education Introduction screen that the disabled person is working.
The sub-tab “Education” will not appear on the Work/Education tab.
The curtailed Internet SSA-3368 will not present questions associated
with the “Education” sub-tab to the user.

Fig. 3: Job History Screen

Change to the Job History screen for a curtailed
Internet SSA-3368:
The sub-tab “Education” will not appear on the
Work/Education tab.
This question will appear only when necessary. When
presented, it will be the only question on the screen.
The curtailed Internet SSA-3368 will not present the job
list and job detail questions that the non-curtailed Internet
SSA-3368 presents.

Fig. 4: Review Screen
Fig. 4-1

Change to the Review screen on the curtailed Internet SSA-3368:
Figure 4 is a series of six screenshots that illustrate the Review screen
(the Review screen is too long to fit into one screenshot).
The only change to the Review screen is in the sixth screenshot, below.

Fig. 4-2

Fig. 4-3

Fig. 4-4

Fig. 4-5

Fig. 4 -6

Change to the Review screen on the curtailed
Internet SSA-3368:
The Work/Education section does not display the
Education subheading because we did not collect
education history from the user.
There are no job details or job listings displayed
because we did not collect that information from the
user.

Fig. 5: Receipt for Your Records screen
Fig.5-1

Change to the Receipt for Your Records screen on the
curtailed Internet SSA-3368:
Figure 5 is a series of six screenshots that illustrate the Receipt
for Your Records screen (the screen is too long to fit into one
screenshot).
The only change to the screen is in the sixth screenshot, below.

Fig. 5-2

Fig. 5-3

Fig. 5-4

Fig. 5-5

Fig. 5-6

Change to the Receipt for Your Records screen on the
curtailed Internet SSA-3368:
The Work/Education section does not display the
Education subheading because we did not collect
education history from the user.
There are no job listings or job details displayed because
we did not collect that information from the user.


File Typeapplication/pdf
AuthorCary Koons
File Modified2011-04-08
File Created2011-04-08

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