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Provide all or part of the information may prevent an accurate and timely decision on any claim filed. We will use the information to determine eligibility for benefits. We may also share your information for the following purposes, called routine uses: To contractors and other Federal agencies, as necessary and other Federal agencies, as necessary, for the purpose of assisting the Social Security Administration (SSA) in the efficient administration of its programs; and To applicants, c.

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How to fill out the SSA-3368-BK online

Completing the SSA-3368-BK form is an essential step in filing for disability benefits. Accurate information will help expedite your claim process. This guide offers a user-friendly approach to filling out the form online, ensuring you provide the necessary details effectively.

Follow the steps to complete the SSA-3368-BK form with ease.

  1. Press the ‘Get Form’ button to access the SSA-3368-BK form and open it in your preferred editor.
  2. Begin by providing your personal information in Section 1, which includes your name, Social Security Number, mailing address, email, and daytime phone number. Make sure to include your ZIP code and the area code for your phone number.
  3. In Section 2, indicate a contact person who is familiar with your medical conditions. Include their name, relationship to you, and contact information.
  4. Section 3 focuses on your medical conditions. List all physical and mental conditions that limit your ability to work, including their details.
  5. In Section 4, address your work activity, indicating if you are currently working, when you stopped working, and any changes made due to your condition.
  6. Proceed to Section 5 to document your education and training history, including the highest grade or degree completed and any special education received.
  7. In Section 6, provide details about your job history over the past 15 years, including job titles, types of business, dates worked, and your responsibilities.
  8. Section 7 requests information on any medications you are taking. List the names and reasons for each medication.
  9. In Section 8, detail your medical treatments, including healthcare professionals you have visited and any scheduled appointments.
  10. If applicable, use Section 9 to provide information about other medical organizations or individuals who may have information about your condition.
  11. Complete Section 10 if you have participated in any vocational rehabilitation programs.
  12. Finally, use Section 11 for any additional remarks or information that may not have been covered in previous sections.
  13. Once all sections are completed, you can save your changes, download or print the form, or share it as needed.

Take action now—complete your SSA-3368-BK form online and move forward with your disability claim.

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