Get Ssa-3373-bk 2004

Completing the SSA-3373-BK form, also known as the Function Report - Adult, is an essential step in the disability determination process. This guide aims to provide clear, step-by-step instructions to help users fill out the form accurately and efficiently, ensuring that all necessary information is submitted.

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

1. Click ‘Get Form’ button to access the SSA-3373-BK form and begin the completion process online.
2. In 'Section A - General Information', fill in the name of the person with the disability, their Social Security number, date, and daytime telephone number where you can be reached.
3. Specify your living situation in question 5a by selecting the appropriate option such as 'House', 'Apartment', or 'Other'. In question 5b, indicate whom you live with.
4. In 'Section B - Information About Daily Activities', detail your daily routine from waking up to going to bed in question 6. Ensure to answer all subsequent questions regarding personal care, meal preparation, household chores, and any assistance required.
5. Continue through the form, addressing each question thoroughly, particularly those about your social activities, hobbies, and any limitations you experience due to your illnesses, injuries, or conditions. Use the 'REMARKS' section on Page 8 if more space is needed.
6. In 'Section C - Information About Abilities', check all applicable items that your conditions affect and provide detailed explanations. Include information on any assistive devices you use in question 21.
7. Finally, on Page 8, ensure you provide your name and address, and confirm the completion date of the form. After reviewing your entries for accuracy, save your changes.
8. You can then download, print, or share the completed form according to your needs before submission.

Get started on completing the SSA-3373-BK online today to help facilitate your disability claim.