SSA is the basic form all Social Security disability claimants must fill out to apply for Social Security disability benefits. You may fill it out yourself or, if it. Create a Form Ssa Bk in minutes using a step-by-step template. A Form SSA BK is known as an Adult Disability Report. DISABILITY REPORT – ADULT – Form SSABK. If you need help with this form, do as much of it as you can, and your interviewer will help you finish it.

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If you applied in person, you flrm already done this. Enter the type of job performed, not the name of the employer. Often, a person who would not qualify for disability benefits based on their main disabling condition will qualify based on the total effects of all of their conditions.

Section 8 inquires about your medical treatment. Simply provide the required information and double check to wsa sure that it is accurate. Type of treatment received.

SSA-3368: Adult Disability Report

Complete information is essential. If the applicant is currently working, provide information about any changes in his or her work activity. You may fill it out yourself or, if it makes you feel more comfortable, you may have a Social Security Disability attorney or advocate help you fill it out. Skip to main content. You can apply for Social Security Disability online, on paper, in sda, on the phone or through a lawyer.

Information about special education can be valuable to the disability determination.

Social Security Disability Form Adult Disability Report | DisabilitySecrets

If anyone other than your main health care provider has medical information regarding your condition, fill out Section 9. In section three, you will list all medical conditions which affect your ability to work. If you are currently collecting SSI, you will need to answer the questions regarding self-support programs like Ticket to Work.


If this applies, SSA will ask the applicant when they believe their conditions became severe enough to prevent them from working. If the applicant had only one job in the last 15 years, answer the rest of the questions in Section 6.

33368 Please let us know if any links on this page stop working. For applicants experiencing homelessness, provide an address where they are comfortable receiving mail. The first section of form SSA asks for general information. Use additional paper if you need to.

Applicants only need to answer one of these sections, depending on their situation. Section 7 deals with the medications you are taking. You are commenting using your Facebook account. This can be a friend, relative, coworker, or anyone else who can attest to your disability.

Make use of this space to give the SSA a complete description of your disabling condition. List all medications—prescription or non-prescription, that you take on a regular basis. Expensive, but cheaper than hiring a lawyer.

It is helpful to document who the phone number belongs to in this question. You are commenting using your WordPress. Tips and ideas for answering questions:. Enter the name or type of business. If the applicant did not have enough space in the sections of this report to enter the requested information, use this area for additional information. Include all information including dosages, frequency, and the name of the physician who prescribed you the medication.

If you found this page helpful, please share it with others by pressing one of these magic little buttons: If the applicant has someone other than the SOAR representative helping them with the application, you can enter multiple contacts in this section. You will be sent these forms sometime in the next six months.


Information about this employer accommodation is not available to SSA in an earnings record, so it is important to provide details on the SSA This information is used by the SSA to determine what kinds of jobs you may be qualified to do and whether you are capable of returning to any kind of work with which you have experience.

Provide information in this section about the highest grade the applicant completed and details about special education 33368 specialized training.

If the applicant does not remember their job title, add a generic title that describes the tasks performed. Skip to content Robin Mead You can apply for Social Security Disability online, on paper, in person, on the phone or through a lawyer. For example, if you have copies of all medical records for the applicant, enter in remarks: Tips and ideas for answering questions: The second section requires that you provide contact information for someone who is familiar zsa your disabling condition.

How to Fill Out an Application for Disability Benefits (SSA 16 BK and SSA 3368 BK)

Make sure to answer honestly and to include the applicable dates when they are requested. Most claimants would benefit from the help and advice of an experienced Social Security disability lawyer when filling this form out.

If you have had more than one job, skip the rest of the section and move on to Section 7.