SSA-3378-BK 2014 free printable template

Function Report Child Age 6 to 12th Birthday Filling Out The Function Report IF YOU NEED HELP COMPLETING ANY PART OF THIS FORM, CONTACT YOUR SOCIAL SECURITY OFFICE. WE WILL HELP YOU. The information

How to fill out SSA-3378-BK

How to fill out SSA-3378-BK

1. Obtain the SSA-3378-BK form from the Social Security Administration's website or local office.
2. Read the instructions carefully before starting the form.
3. Fill out the personal information section, including name, Social Security number, and address.
4. Provide detailed descriptions of your daily activities and how your impairment affects them in the relevant sections.
5. Answer all questions honestly and thoroughly, using additional sheets if necessary.
6. Review the completed form for any errors or omissions.
7. Sign and date the form at the end.
8. Submit the form to the appropriate SSA office either by mail or in person.

Who needs SSA-3378-BK?

1. Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) who have mental impairments need to fill out the SSA-3378-BK form.

Instructions and Help about SSA-3378-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 the pain questionnaire for Social Security disability?

The pain questionnaire is asking how pain limits the individual and how often they are experiencing the pain. This form will also ask about any medications they are taking and any side effects the medication is causing. Side effects from medications can also help you show how else your client is limited.

How do you answer a disability questionnaire?

How to Answer Disability Questionnaires Write clearly and legibly. Avoid erasures as much as possible. Do not leave any section of the form blank (unless otherwise specified). Give consistent answers. Answer the questions truthfully. Follow the instructions on the form.

What is the SSA activity of daily living questionnaire?

The Activities of Daily Living Questionnaire is more formally known as Function Report – Adult – Form SSA-3373-BK. This form asks about your abilities and limitations in performing tasks such as caring for yourself and your household.

How long can you pay attention to SSA 3373?

You only have a limited time to comply (10 days from the date of the letter) with Social Security's request so don't delay. But, don't rush through your answers either. Your Adult Function Report, also known as SSA 3373, stays on the record through your entire case and cannot be modified.

When is pain considered a disability?

If you have a chronic pain condition that renders you incapable of working, you may qualify for Social Security disability (SSD) benefits. However, qualifying can be a challenge because the Social Security Administration has a strict definition of what it means to be disabled.

How to fill out Social Security disability questionnaire?

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.

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What is SSA-3378-BK?

SSA-3378-BK is a form used by the Social Security Administration to collect information about an individual's disabilities and limitations for the purpose of determining eligibility for Social Security benefits.

Who is required to file SSA-3378-BK?

Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits and who are seeking to establish their disability status are required to file SSA-3378-BK.

How to fill out SSA-3378-BK?

To fill out SSA-3378-BK, one should follow the instructions provided on the form, ensuring that all sections are completed accurately and thoroughly. It is important to provide detailed information about the individual's medical conditions, daily activities, and how the disability affects their ability to work.

What is the purpose of SSA-3378-BK?

The purpose of SSA-3378-BK is to gather essential information that helps the Social Security Administration evaluate the nature and extent of an individual’s disabilities, which aids in the decision-making process for benefit eligibility.

What information must be reported on SSA-3378-BK?

The form requires information about the individual's medical conditions, treatments, daily living activities, limitations caused by the disability, and how these factors impact their ability to work.