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Form SSA3368BK (062024) UFDISABILITY REPORT ADULTPage 3 of 15For SSA Use Only Do not write in this box. Related SSN Number HolderAnyone who makes or causes to be made a false statement or representation

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How to fill out form ssa-3368 disability report

01

Gather necessary personal information: This includes your full name, Social Security number, and contact information.

02

Provide information about your disability: Clearly describe your disabling condition and how it affects your daily activities.

03

List your medical providers: Include the names and contact information of all doctors, hospitals, and clinics that have treated you.

04

Detail your work history: Include dates of employment, job titles, duties, and reasons for leaving each job.

05

Report daily activities: Explain how your disability limits your ability to perform everyday tasks.

06

Include any medications and treatments: List all medications you are taking and other treatments you have received, including therapy.

07

Review and verify: Before submission, double-check all the information for accuracy and completeness.

Who needs form ssa-3368 disability report?

01

Individuals seeking Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) due to a disability.

02

People who have a medical condition that limits their ability to work and perform daily activities.

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What is form ssa-3368 disability report?

Form SSA-3368 is a disability report used by the Social Security Administration to gather information on an individual's medical conditions and limitations to determine eligibility for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Who is required to file form ssa-3368 disability report?

Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) who claim to have a disabling condition are required to file form SSA-3368.

How to fill out form ssa-3368 disability report?

To fill out form SSA-3368, applicants should provide detailed information about their medical conditions, treatment history, work history, daily activities, and any limitations they experience as a result of their disability. The form can be completed online or by using a paper form.

What is the purpose of form ssa-3368 disability report?

The purpose of form SSA-3368 is to collect comprehensive information about an applicant's disability to assist the Social Security Administration in making informed decisions about their eligibility for disability benefits.

What information must be reported on form ssa-3368 disability report?

Information that must be reported includes personal identification details, medical conditions, treatment history, medications, work history, education, daily activities, and the impact of the disability on the individual's ability to function and work.

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