SSA-3380-BK 2003 free printable template

FUNCTION REPORT - ADULT - THIRD PARTY - SSA-3380-BK PLEASE READ ALL OF THIS INFORMATION BEFORE YOU BEGIN COMPLETING THIS FORM HOW TO COMPLETE THIS FORM The information that you give on this form will be used to make a decision on the disabled person s claim. You can help by completing as much of the form as you can. When a question refers to the disabled person it refers to the person who is applying for disability benefits. Describe what the disabled person does from the time he/she wakes up...

How to fill out SSA-3380-BK

How to fill out SSA-3380-BK

1. Begin by collecting necessary information such as personal details, medical history, and any relevant documentation.
2. Fill in your name, Social Security number, and other identifying information on the first page.
3. Provide details about your daily activities and any limitations you may face due to your condition.
4. Include information about your medications, treatments, and healthcare providers.
5. Review the form for completeness and accuracy before signing and dating it.
6. Submit the completed SSA-3380-BK form along with any required attachments to the Social Security Administration.

Who needs SSA-3380-BK?

1. Individuals applying for Social Security disability benefits who have mental impairments or conditions.
2. Those who are required to provide additional detailed information about their limitations due to their mental health issues.

• Who needs an SSA 3380 bk 2009 form?
• What is SSA 3380 bk 2009 form?
• Is SSA 3380 bk 2009 form accompanied by other forms?
• • When is SSA 3380 bk 2009 form due?
  • How do I fill out SSA 3380 bk 2009 form?
  • Where do I send SSA 3380 bk 2009 form?

Who needs an SSA 3380 bk 2009 form?

The “Function Report — Adult — Third Party” form also known as the SSA 3380 bk form is necessary for Social Security disability clients and their families in applying for and appealing their Social Security disability claim. The SSA 3380 bk 2009 form must be completed by third parties, which indicate the limitations of the disabled person.

What is SSA 3380 bk 2009 form?

The SSA 3380 bk 2009 Adult Function Report form gives information to help determine whether physical limitations of a disabled person are a sufficient reason for assistance provided by the state.

Is SSA 3380 bk 2009 form accompanied by other forms?

This SSA 3380 bk 2009 form is not accompanied by any other forms.

When is SSA 3380 bk 2009 form due?

You can fill out form SSA 3380 bk at any time as needed. Just be sure it complies with the latest requirements for documents posted on the Official Social security website.

How do I fill out SSA 3380 bk 2009 form?

SSA 3380 bk 2009 form has several pieces to fill out:

• General information, including the name, contact information, and relationship to the disabled person;
• Information that describes a typical day of the disabled person, their activity, meals, housework, shopping, interests, etc.;
• Information about mental and physical condition of the disabled person;
• Remark section

Where do I send SSA 3380 bk 2009 form?

You need to send this form to the office which requested it. If you don’t have that address, you can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Instructions and Help about SSA-3380-BK

All right everybody greets this again is attorney Anthony Ruiz bringing you your social security legal beat tip and I got a couple of questions that have imposed out to me, I want to thank the individuals who are asking me about the workers comp offset as well as about the pain threshold what we call the pain standard as well as about the medically determinable impairment I'm going to address those and upcoming videos, but I wanted to address this one for Mr. CPU who asked me about the functional report forms third party glad you brought that up because that's something I like to talk to people about when this fullness part popped out when you file your disability application and your case gets transferred to the disability determination services one of the things they do is they will send out forms to you with your functional forms these functional forms are designed for you to describe what's going on in the course of your daily activities was coming in terms of what do you do when you get up in the morning how do you handle getting dressed when you do experience any problems don't you're cleaning the house or anything like that what most people don't also realize is that when they'll also ask you meaning in Social Security Administration is to provide them the name of at least two or three people who can provide them with information about your case or about you and what they do is they send them a form similar to the one that you receive this may sound wild, but I want you to keep in mind this somebody asked me once before why does Social Security send all these forms all over the place I don't understand I'll tell you one word consistency because a lot of times they want to see is what you're saying consistent with what everybody else is seeing as well let me give you a good example let's say for instance you say when you go to the grocery store that every time you go you got to ride in a motorized car, and you always have to go with someone you can never go by yourself, and then they send a form to your friend and your friend and ask them have you ever seen your friend go grocery shopping yeah I see him the other day when they were grocery shopping were there any problems' no they were walking around like we walked up and down the aisles together now see how that's a little different from you saying you're at a corporate cart, and you're the other friend of yours are saying they've seen you walking down the aisle that plays a part with your credibility because if you're not being consistent they're going to look at what you're saying in light of your condition with a little degree of suspect so the first thing they do is they look for consistency, and it's consistency throughout so when you get those functional reports they're trying to see are you embellishing them let me kind of add it a step further in some instances when you're apply in some states you have two appeals before you go before judge well the first appeal they're going to...

People Also Ask about

What is an SSA 3380 form?

The information that you give on this form will be used to make a decision on the disabled person's claim. You can help by completing as much of the form as you can. When a question refers to the "disabled person," it refers to the person who is applying for or receiving disability benefits.

Who fills out SSA 3380?

The Form SSA 3380-BK is known as a Third Party Adult Function Report. This form will need to be filled out by a third party such as a friend or family member. It cannot be a medical professional. This person should be close to you, as this form asks very personal questions.

Who fills out form SSA-3380-BK?

Form SSA-3380-BK is a form used by an individual seeking disability benefits from the Social Security Administration. This is a function report for an adult that is completed by a third-party. The third-party chosen to complete this extensive form cannot be a medical professional treating the applicant.

How to fill out Social Security Disability function report?

9 tips for filling out the function report Keep your answers consistent. Start with question 20. Answer questions directly. Talk about your average or worst days. Be honest and don't exaggerate. Send additional information as quickly as possible. Talk about all conditions that keep you from working.

What is function report third party form SSA-3380-BK?

Form SSA-3380-BK: Function Report – Adult – Third Party. Form SSA-3380-BK is filed with the Social Security Administration (SSA) to claim for social security benefits for a physically challenged person. This form is used when the applicant cannot fill out the form personally and requires the assistance of a third party

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What is SSA-3380-BK?

SSA-3380-BK is a form used by the Social Security Administration (SSA) to collect information about an individual's disability and functional abilities.

Who is required to file SSA-3380-BK?

Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits may be required to file SSA-3380-BK.

How to fill out SSA-3380-BK?

To fill out SSA-3380-BK, individuals must provide detailed information about their disabling condition, daily activities, medical treatment, and work history, ensuring all sections are completed accurately.

What is the purpose of SSA-3380-BK?

The purpose of SSA-3380-BK is to assess an individual's disability status by gathering comprehensive information about their health, limitations, and daily functioning.

What information must be reported on SSA-3380-BK?

The form requires details about the individual's medical conditions, the impact of those conditions on daily activities, treatment history, medications, and any assistance or support received.