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.
- Click the ‘Get Form’ button to access the SSA-3368-BK form and open it in the editing interface.
- 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.
- 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.
- 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.
- 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.
- Proceed to Section 5 to report your education and training history, including any specialized job training or classes attended.
- 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.
- In Section 7, list any medications you are currently taking, specifying their purpose and who prescribed them.
- Complete Section 8 by detailing your medical treatment history, including names of healthcare providers, types of treatment received, and any scheduled appointments.
- Section 9 is for additional medical information. Mention any other organizations that have information about your conditions.
- If applicable, complete Section 10 about vocational rehabilitation and support services you have received or are still participating in.
- 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.
- 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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