Form preview

SSA-3368-BK 2020 free printable template

Get Form
Disability Report- Adult-Form SSA-3368-BK You can get help from other people such as a friend or family member. DISABILITY REPORT - ADULT SSA-3368-BK PLEASE READ THIS INFORMATION BEFORE COMPLETING THIS REPORT The information you give us on this report will be used by the office that makes the disability decision on your disability claim. Completing this report accurately and completely will help us expedite your claim. Please complete as much of the report as you can. IF YOU NEED HELP Note If...
pdfFiller is not affiliated with any government organization

Get, Create, Make and Sign SSA-3368-BK

Edit
Edit your SSA-3368-BK form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your SSA-3368-BK form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit SSA-3368-BK online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Use the instructions below to start using our professional PDF editor:
1
Log in to account. Start Free Trial and sign up a profile if you don't have one yet.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit SSA-3368-BK. Add and change text, add new objects, move pages, add watermarks and page numbers, and more. Then click Done when you're done editing and go to the Documents tab to merge or split the file. If you want to lock or unlock the file, click the lock or unlock button.
4
Save your file. Select it from your records list. Then, click the right toolbar and select one of the various exporting options: save in numerous formats, download as PDF, email, or cloud.
Dealing with documents is always simple with pdfFiller.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

SSA-3368-BK Form Versions

Version
Form Popularity
Fillable & printabley
4.3 Satisfied (26 Votes)
4.8 Satisfied (556 Votes)
4.4 Satisfied (135 Votes)
4.3 Satisfied (320 Votes)
4.4 Satisfied (220 Votes)
4.0 Satisfied (40 Votes)
4.0 Satisfied (75 Votes)
4.0 Satisfied (34 Votes)

How to fill out SSA-3368-BK

Illustration

How to fill out SSA-3368-BK

01
Obtain the SSA-3368-BK form from the Social Security Administration's website or your local Social Security office.
02
Clearly print your name, Social Security number, and other identifying information at the top of the form.
03
Complete the section that outlines your medical conditions, providing detailed descriptions of your disabilities.
04
Fill in information about your treatment history, including the names of your doctors and dates of visits.
05
List all medications you are currently taking, along with dosages and prescribing doctors.
06
Answer questions regarding your daily activities and how your condition affects them.
07
Include any other relevant information or documentation that supports your claim.
08
Review your form for completeness and accuracy before submitting it to the SSA.

Who needs SSA-3368-BK?

01
Individuals seeking Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.
02
Those who have a medically determinable impairment that affects their ability to work.
03
Applicants who need to provide detailed information about their medical conditions and treatment history.

Who needs a Social Security Report adult form?

Persons, whose limited abilities do not allow them to work, must fill out a Social Security Report to get the status of the disabled.

What is the Social Security Report adult form?

The information a person gives to the Social Security office on this report will be used by the office that makes the disability decision on person’s disability claim. Completing this report accurately and comprehensively will help the officials expedite the person’s claim. Persons will be considered disabled if they are unable to do any kind of work for which they suited and if the disability is expected to last (or has lasted) for at least a year or is expected to result in death.

Is Social Security Report adult form accompanied by other forms?

This form may be accompanied by the following few ones (depending on the requirements of the Social Security office): SSA 3368, SSA 827 and SSA 3380 bk. If the claimant has any of their medical records, they should be sent or brought to Social Security office with this completed report.

When is Social Security Report adult form due?

Submission of this form is not regulated by any specific deadlines.

How do I fill out Social Security Report adult form?

You should include a ZIP or postal code with each address. Provide complete phone numbers including area code. You must answer every question, unless the report indicates otherwise. Be sure to explain your answer if the question asks for an explanation, or if you want to give additional information. Questions of this report relate to the following topics: medical conditions, work activity, education and training, job history, medicines and medical treatment.

Where do I send Social Security Report adult form?

You should send or bring the completed form to the office that requested it. You can find your local Social Security office through SSA’s website at www.socialsecurity.gov.

Instructions and Help about SSA-3368-BK

All right everyone we're going to try something a little different this time around as you probably know a lot of my videos that I prepare are actually fairly prepared in advance, but I wanted to try something a little different usually I use the video camera that I had set up already, but somebody suggested that I use Google hangout because it would give me the ability to do a few other things as well so let's go ahead and get shaken and basin here I want to talk to you a little about the adult function forms I'm going to share my screen with you because I want to be able to go through this with you so that you have an understanding of exactly how important this form is and in terms of what you need to do in terms of your case so why don't you give me a second I'm going to pull it up here, and then we're going to talk about it for a little while okay all right this is going to sound really crazy, but I want you to kind of follow along with me here you're going to get what's called the adult function for what this form ultimately does is that this form is information that social security relies upon in order to determine whether the medical records substantiate or supports what you're saying the reason why I'm showing you this form is because first when you get this bad boy it's about I think about 10 pages long don't freak out when you get okay don't freak out it's a form you are the expert on you, you can tell them about what's going on with you don't have yourself losing them out of having a conniption you are in the best place to tell them about you so please and do that yeah this is important for you to understand so that this way you don't get totally you know bogged down or taken out of context here when you're looking at the form you don't read into what it says answer the questions plain and simple okay you know most of the early part is easy where you lay it all down so forth tell them about your case when it says you know information how do your element injuries or conditions limit your ability to work people remember the primary focus of Social Security is how does it limit your ability to work so when you're answering these questions phrase them in terms of explain them based on how your condition affects your ability to work now it's going to ask you little things describe what you do from the time you wake up until you go to bed now people you'll be surprised a number of times actually people will answer that with like one sentence, and I'm sitting there going you do so much during the course of the day how can you say would you do in one sentence add a separate sheet if you need to be descriptive remember this is something that I've said before there is no way for them to know what goes on in your house when you're like when you're there so explain it to them now do you take care of anyone such as this that's why husband children things yes and what do you do for them if you know you take care of these people be descriptive to...

Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.8
Satisfied
556 Votes

People Also Ask about

Unfortunately, pain is subjective and hard to prove – just stating you have pain is not enough. In order to qualify for Social Security Disability Income, you must show you have a medically determinable mental or physical impairment (MDI) that is established by objective symptoms and laboratory tests.
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.
Guide to the List of Recognised Disabilities Cri du chat syndrome. Rett syndrome. Angelman syndrome. Prader-Willi syndrome. Edwards syndrome (Trisomy 18) Williams syndrome. Patau syndrome (Trisomy 13) Coffin-Lowry syndrome.
Today, you can apply for retirement, disability, and Medicare benefits online, check the status of an application or appeal, request a replacement Social Security card (in most areas), print a benefit verification letter, and more – from anywhere and from any of your devices!
Pain is often hard to describe, but you should do your best to relate your pain as specifically as possible to the judge. This would include telling the judge what type of pain you experience (burning, stabbing, etc.), how often you experience it, and how you would quantify it (for example, on a scale of 1 to 10).

Our user reviews speak for themselves

Read more or give pdfFiller a try to experience the benefits for yourself
5
Comprehensive, efficient and intuitive functionality. The only capability I missed was use of the arrow / scroll keys. A simplistic and refreshing technical experience. Thank you!
Rebecca Hanavan NFC National Family C
4
A little hard to navigate but overall a good experience
s

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Using pdfFiller with Google Docs allows you to create, amend, and sign documents straight from your Google Drive. The add-on turns your SSA-3368-BK into a dynamic fillable form that you can manage and eSign from anywhere.
pdfFiller makes it easy to finish and sign SSA-3368-BK online. It lets you make changes to original PDF content, highlight, black out, erase, and write text anywhere on a page, legally eSign your form, and more, all from one place. Create a free account and use the web to keep track of professional documents.
When you use pdfFiller's add-on for Gmail, you can add or type a signature. You can also draw a signature. pdfFiller lets you eSign your SSA-3368-BK and other documents right from your email. In order to keep signed documents and your own signatures, you need to sign up for an account.
SSA-3368-BK is a form used by the Social Security Administration (SSA) to gather information about an individual's disability claim, including work history and medical conditions.
Individuals who are applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits due to a disability are required to file the SSA-3368-BK form.
To fill out the SSA-3368-BK, individuals need to provide personal information, details about their medical conditions, work history, and education, along with the names of healthcare providers and medications.
The purpose of the SSA-3368-BK is to collect comprehensive information that helps the SSA assess the severity of an individual's disability and eligibility for benefits.
Information that must be reported on SSA-3368-BK includes personal identification details, a list of all medical conditions, treatment history, work history, and functional limitations related to the disability.
Fill out your SSA-3368-BK online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview

Related Forms

If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.