SSA-3380-BK 2009 free printable template

FUNCTION REPORT ADULT — THIRD PARTY Form SSA-3380-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

How to fill out form ssa 3380 bk

How to fill out form SSA 3380 BK:

1. Access the official Social Security Administration website or visit your local Social Security office to obtain a copy of form SSA 3380 BK.
2. Begin by carefully reading the instructions provided with the form to ensure you understand the purpose and requirements of filling it out.
3. Provide your personal information in the specified sections, such as your name, address, social security number, and contact details.
4. If you are completing the form on behalf of someone else, indicate your relationship to the individual and provide their relevant information.
5. Answer the questions on the form accurately and truthfully. These questions may pertain to your disability, medical conditions, work history, and any other relevant factors.
6. If applicable, provide details about the medical professionals you have consulted regarding your disability or condition.
7. Attach any supporting documents or medical records that are required or recommended for a comprehensive evaluation of your disability claim. Make sure to retain copies of these documents for your own records.
8. Carefully review the completed form to ensure accuracy and completeness before submitting it.
9. Sign and date the form in the designated area.
10. Submit the completed form, either online if available or via mail or in-person delivery to the Social Security Administration.

Who needs form SSA 3380 BK:

1. Individuals who are applying for Social Security disability benefits may need to fill out form SSA 3380 BK.
2. This form is specifically for the Adult Disability Report, which is used to gather information about an individual's disability and how it affects their ability to work.
3. The form may be required for both initial disability benefit applications and for individuals seeking to appeal a decision on their disability claim.

• 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 — Ad—?? Lt — Third Party” form also known as 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 form 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 form ssa 3380 bk

How do you answer question 6 on a function report?

Question 6: Describe what you do from the time you wake up until going to bed. When I ask many of my clients this question, they'll often answer, “not much.” However, you are always doing something. When you file a disability claim, you need to provide specific details.

How do you describe daily activities for disability?

Activities of daily living include any activity you engage in on a daily basis such as showering, brushing your teeth, house cleaning, shopping, etc. The SSA needs to know if your condition causes pain or difficultly when performing any daily activity.

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.

What is form SSA 3380?

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.

Why did I receive a SSA-3380-BK?

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.

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.

For pdfFiller’s FAQs

What is form ssa 3380 bk?

Form SSA-3380 BK, also known as the Disability Report - Adult, is a form used by the Social Security Administration (SSA) in the United States. It is a part of the application process for individuals who are applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. This form collects information about the applicant's medical conditions, work history, and daily activities to help determine their eligibility for disability benefits. It is an important document for providing the SSA with detailed information about the individual's impairments and how they affect their ability to work.

Who is required to file form ssa 3380 bk?

Form SSA-3380-BK, also known as the Disability Report - Appeal, is typically filed by individuals who are appealing the decision of the Social Security Administration (SSA) regarding a disability claim. This form is required to be filed by individuals who have previously applied for disability benefits and have been denied, and now wish to appeal that decision. It is important to note that the form may vary based on the specific circumstances, so it is recommended to consult with the SSA or an attorney for accurate information regarding your particular situation.

How to fill out form ssa 3380 bk?

Form SSA-3380-BK, also known as the Function Report-Adult, is a document used by the Social Security Administration (SSA) to collect detailed information about an individual's daily activities, abilities, and limitations when applying for disability benefits. Here are the steps to fill out this form: 1. Obtain the form: You can download Form SSA-3380-BK from the official SSA website or request a copy from your local SSA office. 2. Personal information: Fill in your name, Social Security number, and contact information at the top of the form. 3. Representative information: If you have someone helping you with your disability claim, provide their contact information and indicate whether they have legal authority to represent you. 4. Medical information: List all the medical conditions, illnesses, injuries, or disabilities you have been diagnosed with, including their date of onset and the names of the treating physicians. 5. Activities of daily living: Describe your typical daily routine, including how you take care of personal needs like bathing, dressing, eating, and using the restroom. Explain any difficulties you face in performing these tasks and whether you need assistance. 6. Household chores: Indicate which household chores you are able to perform and any limitations or difficulties you experience while doing them. 7. Hobbies and leisure activities: Mention the activities, hobbies, and interests you regularly engage in and any limitations that affect your participation. 8. Physical abilities: Provide details about your physical abilities, including walking, standing, sitting, lifting, reaching, and handling objects. Indicate any pain, weakness, or lack of coordination that affects these activities. 9. Mental and emotional abilities: Describe any limitations you have in terms of memory, concentration, understanding, following instructions, dealing with stress, and relating to others. 10. Social activities: Explain how often you socialize with others, any difficulties you experience in social situations, and whether you need assistance or accommodations to participate. 11. Changes in daily activities: If there have been any changes in your ability to perform daily activities since the onset of your medical conditions, explain them in this section. 12. Additional remarks: Use this space to provide any other information or details that you believe are relevant to your disability claim. 13. Sign and date: Review the completed form carefully, sign and date it. Keep a copy of the filled form for your records. Submit the original form to the SSA office as instructed, either by mail or in person. It is important to provide clear and honest information on the form to support your disability claim.

What is the purpose of form ssa 3380 bk?

Form SSA-3380 BK, also known as the Function Report-Adult, is used by the Social Security Administration (SSA) to collect information about an adult individual's ability to perform daily activities and their experiences with completing tasks at home, in school, or at work. The purpose of Form SSA-3380 BK is to provide the SSA with detailed information about the individual's limitations, impairments, and how these conditions affect their ability to work and carry out daily tasks. The information provided in this form helps the SSA determine an individual's eligibility for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. It also assists the SSA in evaluating the individual's functional capacity and their ability to engage in substantial gainful activity.

What information must be reported on form ssa 3380 bk?

Form SSA-3380-BK, also known as the Function Report-Adult, is used by the Social Security Administration to collect information about an individual's daily activities, ability to work, and any limitations they may have due to a physical or mental condition. The form is typically completed by the applicant or their representative and requires the following information: 1. Basic personal information: Name, Social Security number, contact information, and the date the form is being completed. 2. Information about the individual's impairments: Detailed description of the medical condition(s) or disability(ies) that affect the individual's ability to work or perform daily activities. 3. Daily Activities: The form requests information on the individual's daily routine, including their ability to care for themselves, household tasks they can or cannot do, meal preparation, shopping, hobbies, and recreational activities. 4. Work history: The form asks for a summary of the individual's past work experience, including job titles, duties, physical and mental requirements, and reason for leaving each job. 5. Education and training: The individual is required to provide details about their education, including any special training or vocational programs they have completed. 6. Use of medications and medical treatment: Information about the medications, treatments, therapies, and assistive devices the individual uses to manage their condition. 7. Limitations and difficulties: The form asks the individual to describe any difficulties they face in performing daily activities due to their condition, including any trouble with attention, concentration, memory, social interactions, or following instructions. 8. Symptoms and impact on functioning: The individual is required to describe the symptoms they experience due to their condition and how those symptoms affect their ability to work and perform daily activities. 9. Emotional and behavioral issues: The form asks the individual to report any emotional or behavioral issues they experience, such as depression, anxiety, mood swings, or outbursts. 10. Impact on social functioning: Information about the individual's ability to interact with others, maintain relationships, and participate in social activities is requested. 11. Other relevant information: The form provides space for any additional information or comments the individual or their representative considers important for the review of the disability claim. It's important to note that this is a general description of the information typically requested on Form SSA-3380-BK. The specific questions and format of the form may vary, and individuals should refer to the official version of the form for the most accurate and up-to-date requirements.

What is the penalty for the late filing of form ssa 3380 bk?

The penalty for late filing of Form SSA-3380-BK, also known as the Adult Disability Report, can vary. The Social Security Administration (SSA) does not explicitly specify a monetary penalty for late filing. However, delaying the filing of this form may result in delayed processing of your disability claim or benefits. It is generally advisable to submit the necessary forms and documents in a timely manner to ensure smooth processing.

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