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FUNCTION REPORT - ADULT - Form SSA-3373-BK READ ALL OF THIS INFORMATION BEFORE YOU BEGIN COMPLETING THIS FORM IF YOU NEED HELP If you need help with this form, complete as much of it as you can and.

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How to fill out the SSA-3373-BK online

Filling out the SSA-3373-BK form, also known as the function report for adults, is a crucial step in the Social Security disability evaluation process. This guide will help you navigate each section of the form online, ensuring you provide clear and complete information about your limitations and daily activities.

Follow the steps to effectively complete the SSA-3373-BK online.

  1. Click 'Get Form' button to access the SSA-3373-BK form and open it in your online editor.
  2. Begin with Section A, which requests general information. Fill in the name of the person with a disability, their Social Security number, and your daytime telephone number. Make sure to check the appropriate boxes regarding your living situation and who you live with.
  3. Move to Section B and describe how your illnesses, injuries, or conditions limit your ability to work. Provide detailed responses as this information is vital to your claim.
  4. Proceed to Section C, which focuses on daily activities. Answer every question about your routines, including personal care, meal preparation, household chores, and social interactions.
  5. In Section D, you will discuss your abilities. Check all items that your conditions affect, explain your limitations in detail, and specify any aids you use, such as glasses or a cane.
  6. If needed, use the ‘REMARKS’ section on Page 8 for any additional information that could support your responses. Ensure that you completely fill out this section to provide a comprehensive view of your situation.
  7. Finally, provide your name, address, and the date at the end of the form. After completing the form, save any changes, and download, print, or share the completed document as required.

Start filling out your SSA-3373-BK online today to ensure a thorough submission for your disability claim.

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Individuals use Form SSA-795 to make signed statements relating to claims for Social Security benefits or Supplemental Security Income (SSI) payments under 20 CFR 404.702 and 416.570 of the Code of Federal Regulations.

Social Security Form SSA-3373-BK is a lengthy form that you fill out as a part of the process of applying for Social Security Disability benefits. ... If those medical records don't provide enough information to make a decision, then the SSA will typically ask you to fill out Form SSA-3373-BK.

Generally, it takes about 3 to 5 months to get a decision. However, the exact time depends on how long it takes to get your medical records and any other evidence needed to make a decision. * How does Social Security make the decision? We send your application to a state agency that makes disability decisions.

If you are applying for disability (or already on disability) at some point, you may receive a form called Activities of Daily Living Questionnaire or Adult Function Report. This form is usually sent shortly after you first apply. ... It is also sent during Continuing Disability Reviews for people already approved.

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SSA-3373-BK
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2020 SSA-3373 (Formerly SSA-3373-BK)
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  • 2020 SSA-3373 (Formerly SSA-3373-BK)
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  • Function Report- Adult. Function Report- Adult- Form SSA-3373-BK
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