Rt IF YOU NEED HELP COMPLETING ANY PART OF THIS FORM, CONTACT YOUR SOCIAL SECURITY OFFICE. WE WILL HELP YOU. The information that you give us on this form will be used by the office that makes the disability decision on the child's claim. You can help them by completing as much of the form as you can. Print or type. Do not ask a doctor or hospital to complete this form. Be sure to explain your answer if an explanation is requested or needed. If more space is needed to answer any.
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How to fill out the SSA-3379-BK online
Filling out the SSA-3379-BK, also known as the Function Report for children aged 12 to 18, is essential for evaluating a child's eligibility for disability benefits. This guide will navigate you through the process of completing the form online, ensuring clarity and accuracy in your responses.
Follow the steps to complete the SSA-3379-BK effectively.
- Click ‘Get Form’ button to download the SSA-3379-BK and open it in the editor for completion.
- Begin with Section 1, Identifying Information. Complete the details for the child, including their name, Social Security number, date of birth, and information about the person completing the form. Make sure to provide both a relationship to the child and a contact number.
- Move on to Section 2, Function Details. Answer questions regarding the child's various functional abilities including vision, hearing, speech, daily activities, communication skills, understanding, physical abilities, social interactions, personal care, attention, and task engagement.
- For each question in Section 2, mark 'yes,' 'no,' or 'not sure' as applicable. Provide explanations in the provided areas whenever a 'yes' answer is given to clarify the child's specific challenges.
- Use the 'Remarks' section if you require extra space to elaborate on any responses. Be sure to reference the question number when adding additional information.
- Once all sections are completed, review the form for accuracy. Ensure all information is correctly entered before proceeding.
- Save any changes made to the form. You may also download, print, or share the document for submission to the local Social Security office.
Start completing the SSA-3379-BK online to assist with your child's disability claim.
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