Get Ssa Ha-1152-u3 2009-2025

The SSA HA-1152-U3 is a vital form used to evaluate an individual's ability to perform work-related activities, particularly in the context of mental health. This guide provides clear, step-by-step instructions tailored to users of all experience levels on how to complete this form online.

Follow the steps to fill out the SSA HA-1152-U3 online effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the individual's name and Social Security number at the top of the form.
3. Read the instructions carefully, as they guide you on how to determine the individual's ability to perform work-related activities. Take note of the definitions provided for each rating term (none, mild, moderate, marked, extreme).
4. Answer question (1) regarding the individual's ability to understand, remember, and carry out instructions. If the answer is 'yes,' mark the appropriate box that reflects the level of restriction for each activity listed.
5. For question (2), assess the individual's ability to interact appropriately with supervision, co-workers, and the public. Again, mark the box that best represents the level of restriction.
6. If the impairment affects any other capabilities, answer question (3) affirmatively and provide details.
7. Complete question (4) if applicable, indicating the date when the limitations first became present.
8. If the individual has issues with alcohol or substance abuse, answer question (5) and explain how they impact the individual's limitations.
9. Answer question (6) to determine if the individual can manage their benefits and provide your professional signature and the date.
10. Finally, review the completed form for accuracy, then save your changes, download a copy, print it, or share it as needed.

Complete the SSA HA-1152-U3 form online today to facilitate the evaluation process.