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  • Ssa-3368-bk 2010

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D by the office that makes the disability decision on your disability claim. Completing this report accurately and completely will help us expedite your claim. Please complete as much of the report as you can. IF YOU NEED HELP Note: If you are assisting someone else with this report, please answer the questions as if that person were completing the report. HOW TO COMPLETE THIS REPORT • • • • • • • Print or write clearly. Include a ZIP or postal code with each address. Provide c.

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How to fill out the SSA-3368-BK online

Filling out the SSA-3368-BK form, also known as the Disability Report - Adult, is a crucial step in the process of applying for disability benefits. This guide provides clear and supportive instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the SSA-3368-BK form online.

  1. Click the ‘Get Form’ button to access the SSA-3368-BK form and open it in the editing interface.
  2. Begin by entering personal information in Section 1, which includes your name, Social Security number, mailing address, email, and phone numbers. Ensure all information is complete and clear.
  3. In Section 2, provide contact details for someone who knows about your medical conditions, along with their relationship to you and their availability to assist.
  4. Fill out Section 3 by listing all physical or mental conditions that limit your ability to work. Include details like height and weight, and indicate if these conditions cause pain.
  5. In Section 4, describe your work activity. Answer questions about your current employment status, past jobs, and the impact of your conditions on your work.
  6. Proceed to Section 5 to report your education and training history, including any specialized job training or classes attended.
  7. Describe your relevant job history in Section 6, providing details about your past five jobs in the last 15 years. Answer additional questions about job duties and responsibilities.
  8. In Section 7, list any medications you are currently taking, specifying their purpose and who prescribed them.
  9. Complete Section 8 by detailing your medical treatment history, including names of healthcare providers, types of treatment received, and any scheduled appointments.
  10. Section 9 is for additional medical information. Mention any other organizations that have information about your conditions.
  11. If applicable, complete Section 10 about vocational rehabilitation and support services you have received or are still participating in.
  12. Finally, use Section 11 for any remarks or additional information needed to clarify your responses. Make sure to date the report and submit it when complete.
  13. After completing the SSA-3368-BK form, remember to save your changes, download, print, or share the form as necessary.

Complete your SSA-3368-BK form online today to expedite your disability claim.

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Get SSA-3368-BK
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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
SSA-3368-BK
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