Get Ssa Ha-1151-bk 2009-2025

The SSA HA-1151-BK is a crucial form used to evaluate an individual's ability to perform work-related activities. Filling out this form accurately is vital for the determination of eligibility for Social Security benefits. This guide provides step-by-step instructions to help users complete the form online with ease.

Follow the steps to fill out the SSA HA-1151-BK online.

1. Press the ‘Get Form’ button to retrieve the SSA HA-1151-BK form and open it in your online editor.
2. Begin with the individual's social security number and name in the designated fields to personalize the document.
3. In section 'I. Lifting/Carrying,' indicate the individual's capabilities regarding lifting and carrying by checking the appropriate boxes for each weight category.
4. Provide medical or clinical findings related to the lifting and carrying limitations, ensuring that specific examples underpin your assessment.
5. In section 'II. Sitting/Standing/Walking,' fill in how many hours or minutes the individual can sit, stand, and walk at a time without interruption.
6. Ensure to note any additional activities the individual engages in during the remaining hours of an 8-hour workday.
7. Indicate whether the individual uses a cane to ambulate and provide details on their ambulation capabilities.
8. In section 'III. Use of Hands,' indicate how frequently the individual can perform reaching, handling, fingering, and other specified activities with both hands.
9. Confirm the dominant hand of the individual and provide supporting medical findings relevant to hand use limitations.
10. Next, in section 'IV. Use of Feet,' record how often the individual can operate foot controls using both right and left feet.
11. Proceed to 'V. Postural Activities' and select how often the individual can perform climbing, balancing, and other postural activities.
12. In section 'VI. Hearing or Vision Impairments,' indicate if the individual has any impairments and answer related questions.
13. Fill out section 'VII. Environmental Limitations' with a check in the appropriate boxes concerning exposure to various environmental conditions.
14. Complete section 'VIII' by checking whether the individual can perform basic activities, or identify any other work-related activities affected in section 'IX'.
15. Record the duration of limitations in section 'X' and confirm whether they will last for 12 consecutive months.
16. Finally, ensure the form is signed and dated, and print the name, title, and medical specialty of the individual completing the form.
17. Save changes to the document, and download or print it for submission or sharing.

Start completing your SSA HA-1151-BK online today!