SSA-3373 (Formerly SSA-3373-BK) 2009 free printable template

FUNCTION REPORT ADULT — Form SSA-3373-BK READ ALL OF THIS INFORMATION BEFORE YOU BEGIN COMPLETING THIS FORM IF YOU NEED HELP If you need help with this form, complete as much of it as you can and

How to fill out SSA-3373 Formerly SSA-3373-BK

How to fill out SSA-3373 (Formerly SSA-3373-BK)

1. Begin by downloading the SSA-3373 form from the Social Security Administration's website or obtaining a physical copy from a local office.
2. Fill in your personal information at the top of the form, including name, Social Security number, and contact information.
3. In section 1, describe your daily activities and how your condition affects them. Be specific about any limitations you face.
4. In section 2, list your medical conditions and the healthcare providers you have consulted. Include dates and any treatment you have received.
5. In section 3, detail any medications you are currently taking, including dosage and purpose.
6. In section 4, provide information about your work history, including the types of jobs you have held and the dates of employment.
7. Review your answers for accuracy and completeness before submitting the form.
8. Sign and date the form at the end, and keep a copy for your records.
9. Submit the completed form via mail or in-person at your local Social Security office.

Who needs SSA-3373 (Formerly SSA-3373-BK)?

1. Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.
2. People who have a medical condition that significantly impairs their ability to work.
3. Applicants who need to provide detailed information about their daily functioning and limitations due to their disability.

Who needs an SSA-3373-BK Form?

An SSA 3373-BK also called a Function Report, is required by disabled individuals when it is time to file a claim for disability benefits. This form is of extreme importance when applying for Social Security Disability.

What is SSA-3373-BK for?

The Form is designed to help the Social Security Administration analyze disability cases and make decisions about whether the SDI should be paid to persons who are unable to work. The questions of the form cover the following issues:

how the claimant’s physical condition limits his/her work

the claimant’s regular daily and specific activities

basic abilities

medication and side effects, etc.

Is the SSA-3373-BK accompanied by other forms?

To make a decision, the SSA usually requires the following information about the claimant and the case:

Social Security Number (provided by the claimant),

birth certificate (provided by the claimant),

medical information and diagnosis (confirmed by the medical institution the claimant addressed)

work information (provided by the employer).

When is the SSA-3373-BK due?

It is necessary to apply to the SDI in case the claimant’s impairment is expected to last for at least 12 months or to result in death.

How do I fill out SSA-3373-BK?

If there is a chance that the SSA won’t understand the handwriting due to its illegibility, it is advisable to ask a trusted person for help.

None of the questions must be left unanswered, and they all should provide relevant and detailed information.

Where do I send SSA-3373-BK?

The completed SSA Form 3373 must be submitted to the Social Security Administration for consideration.

Instructions and Help about SSA-3373 Formerly SSA-3373-BK

Hi there this is Jonathan Ginsberg I'm a social security disability attorney, and today I'd like to talk to you about Social Security disability forms all those forms you have to fill out when you apply for disability you file appeals and if you've been in this at all you know that there is well over 100 pages of forms, and they just seem to be endless asking the same questions over and over, and I actually wrote a book about these forms called the disability answer guide which you can see at WWDC ability forms calm, so I do look at these forms a good bit when I update the book, so I see what Social Security is doing what they're asking, and I think that you may found my perspective a little helpful here so first just to give you some perspectives understand that Social Security the people who make these forms up these nameless people up in Washington who do this they don't ever consolidate what they're asking they basically asked the same questions over and over, and they keep adding questions to these forms so three or four years ago we might have a form that was say three pages now it's five pages three or four years ago a five-page form has turned into now a seven-page form, and they just asked the same questions over and over and over, so it's not really your imagination when you look at these forms, and you see that Social Security seems to be asking you the same thing over and over and over what part of your body hurts how does it impact you and so forth, so that's one of the things you need to realize and just deal with that there's nothing we can do about that the forms are really asking the same questions over and over and over I think it's very important that when you complete the forms you keep in mind the definition of disability because everything you say in these forms really needs to be focused on proving one thing and that is that you meet Social Security's definition of disability which of course is that you do not have the capacity to perform the duties of a simple entry-level job, so this is not about what you can or cannot do around your house, or it's not about what you can or cannot do in a past job this is basically saying if there was a simple entry-level job, or basically you had to show up and be breathing what I call a warm body job could you perform the duties of the job and that's really what these forms are to get at so when you answer the questions in the forms don't say things like I can't lift very much, or I can't walk very far you want to be very, very specific and talk about those things that you can or cannot do that would have relevance in a work setting for example if you have limitations on lifting talk about how you can only lift five to seven pounds maybe once or twice a day if you're talking about walking that your capacity to walk has been reduced so that you're going back and forth to the mailbox which was maybe 15 or 20 yards you became become fatigued after doing that if the problem is more mental...

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What is SSA-3373 (Formerly SSA-3373-BK)?

SSA-3373 is a form used by the Social Security Administration to gather information regarding an individual's medical condition and functioning when applying for disability benefits. It is designed to collect evidence of the claimant's mental and physical capabilities.

Who is required to file SSA-3373 (Formerly SSA-3373-BK)?

Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits may be required to file SSA-3373 to provide detailed information about their disabilities and how these conditions affect their daily lives.

How to fill out SSA-3373 (Formerly SSA-3373-BK)?

To fill out SSA-3373, applicants should carefully read the instructions provided with the form, complete all sections truthfully and accurately, and provide detailed responses regarding their medical conditions and limitations. It is important to include any supporting documentation from healthcare providers.

What is the purpose of SSA-3373 (Formerly SSA-3373-BK)?

The purpose of SSA-3373 is to collect detailed information about an applicant's impairments, limitations, and how these conditions affect their ability to work and perform daily activities. This information is critical for the Social Security Administration to make informed decisions regarding disability claims.

What information must be reported on SSA-3373 (Formerly SSA-3373-BK)?

The form requires information about the claimant's medical diagnosis, treatment history, limitations in daily activities, work history, and any other relevant details that describe how their condition impacts their ability to function.