SSA-3380-BK 2015 free printable template

FUNCTION REPORT ADULT THIRD PARTY Form SSA3380BK READ ALL OF THIS INFORMATION BEFORE YOU BEGIN COMPLETING THIS FORM IF YOU NEED HELP HOW TO COMPLETE THIS FORM The information that you give on this

How to fill out SSA-3380-BK

How to fill out SSA-3380-BK

1. Obtain the SSA-3380-BK form from the Social Security Administration website or your local SSA office.
2. Read through the instructions carefully to understand the purpose of the form.
3. Fill in your personal information at the top of the form, including your name, Social Security number, and contact information.
4. Answer the questions in section 1 regarding your daily activities, focusing on how your impairment affects your ability to perform them.
5. Complete section 2 by describing any help you have received from others for daily activities.
6. In section 3, indicate any changes in your condition or limitations since your last review.
7. Review your answers for accuracy and completeness before submitting the form.
8. Sign and date the form where indicated.

Who needs SSA-3380-BK?

1. Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.
2. People who are undergoing a review of their disability status by the Social Security Administration.
3. Claimants who need to provide information about their ability to engage in daily activities due to medical or psychological impairments.

• 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 a function report form?

A Function Report is a multi-page questionnaire about an applicant's activities and how their disabilities impact their daily lives.

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 to fill out Social Security Disability function Report?

How to Fill Out an Adult Function Report for Disability (7 Tips) Answer Every Question and Be Honest! Answer Only the Questions Being Asked. Give as Much Detail as You Can. Be Consistent (Some Questions Overlap) Be Specific on Question 5 of the Function Report. Don't Limit Your Answers to the Space on the Form.

What is a third party function report?

The third-party function report (Form SSA-3380-BK) allows you to have someone else describe the symptoms they've seen you display and how your medical condition impacts your ability to work.

What is the third party function form for Social Security?

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 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.

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What is SSA-3380-BK?

SSA-3380-BK is a form used by the Social Security Administration (SSA) to gather information about a person's disabling condition for the purpose of determining eligibility for Social Security Disability benefits.

Who is required to file SSA-3380-BK?

Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) due to a disabling condition are required to file SSA-3380-BK.

How to fill out SSA-3380-BK?

To fill out SSA-3380-BK, you need to provide accurate personal information, details about your disability, treatment history, the impact of your disability on daily activities, and any medical sources that can provide additional information.

What is the purpose of SSA-3380-BK?

The purpose of SSA-3380-BK is to collect information that helps the SSA evaluate the severity of the applicant's disability and determine their eligibility for disability benefits.

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

The information that must be reported on SSA-3380-BK includes personal identification details, description of medical conditions, history of treatment, ability to perform daily activities, and any additional relevant health information.