SSA-3368 EDCS Screenshots (Revised for PRW FR)

EDCS SSA-3368 Form updates to EDCS screens

SSA-3368 form

R56.0

Contents

Background 3

SSA-3368 Layout and Navigation 3

3368 Left Navigation- used for all EDCS 3368 pages 3

EDCS Frame 4

This screenshot shows the layout of all EDCS pages. 4

SSA-3368 Adult EDCS Screenshots 5

SSA-3368 Section 1 – Information About You: 5

SSA-3368 Section 2 – Contacts 6

Contacts Summary page 6

Contacts Information Page 7

SSA-3368 Section 3 – Medical Information 8

SSA-3368 Section 4 – Work Activity 9

INITIAL PAGE - Title change 9

Claimant has never worked 9

Claimant has stopped working 9

Claimant is still  working 10

SSA-3368 Section 5 – Education, Training, and Literacy 11

SSA-3368 Section 6 – Work History 12

SSA-3368 Section 7 – Medicines 15

SSA-3368 Section 8 – Medical Treatment 16

Summary Page 16

Dr/Therapist Information page 17

Hospital/Clinic Information Page 18

Bottom of both the Dr/Therapist and Hospital/Clinic Information pages - (no changes) 19

Test Summary Page 20

SSA-3368 Section 9 – Other Medical Information Detail Page 21

SSA-3368 Section 9 – Other Medical Information Summary Page 22

SSA-3368 Section 10 – Support Services 22

Support Services Summary Page 22

Support Services Information page 23

SSA-3368 Section 11 – Remarks (no changes) 23

SSA-3368 Section 12 – Who Is Completing this Report 24

Background

The Electronic Disability Case Processing System (EDCS) is a mature software application that has been in production for over 20 years. Due to the age of the application, any updates triggered by the SSA-3368 form will follow the existing design approach in EDCS. This will help ensure easy adoption of new or updated content while limiting the need for separate training on the implemented features.

SSA-3368 Layout and Navigation

3368 Left Navigation- used for all EDCS 3368 pages

EDCS Frame

This screenshot shows the layout of all EDCS pages.

Things to note:

• The left-hand navigation tree displays links to each of the SSA-3368 page screens.

• Individual page screens display in the Page Area

• Next/Previous buttons display at the bottom of the frame.

SSA-3368 Adult EDCS Screenshots

SSA-3368 Section 1 – Information About You:

SSA-3368 Section 2 – Contacts

Contacts Summary page

Contacts Information Page

SSA-3368 Section 3 – Medical Information

SSA-3368 Section 4 – Work Activity

INITIAL PAGE - Title change

Claimant has never worked

Claimant has stopped working

Because of my condition(s)

 

Because of other reasons

and/or

Because of my conditions(s) and other reasons

Claimant is still  working

SSA-3368 Section 5 – Education, Training, and Literacy

SSA-3368 Section 6 – Work History

SSA-3368 Section 7 – Medicines

SSA-3368 Section 8 – Medical Treatment

Summary Page

Dr/Therapist Information page

Hospital/Clinic Information Page

Bottom of both the Dr/Therapist and Hospital/Clinic Information pages - (no changes)

Test Summary Page

SSA-3368 Section 9 – Other Medical Information Detail Page

SSA-3368 Section 9 – Other Medical Information Summary Page

SSA-3368 Section 10 – Support Services

Support Services Summary Page

Support Services Information page

SSA-3368 Section 11 – Remarks (no changes)

SSA-3368 Section 12 – Who Is Completing this Report