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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You may be contacted for an SSI financial interview. Obviously, it is ideal to have your disability claim approved when you sa put it through. Make use of this space to give the SSA a complete description of your disabling condition.

If you are currently collecting SSI, you will need to answer the questions regarding self-support programs like Ticket to Work.

Social Security Disability Form 3368: Adult Disability Report

Fill in your details below or click an icon to log in: Jails and prisons may also be a source sa medical records. Bear in mind that filling out form SSA is only the first step in claiming disability benefits. For applicants experiencing homelessness, provide an address where they are comfortable receiving mail. Enter the type of job performed, not the name of the employer. Use this section to collect any additional information or explanation the applicant did not give in other parts of this report.

Note that symptoms of mental illness are included in this question. Disability Report SSA — Specialized training can include: If the applicant has someone other than the SOAR representative helping them with the application, you can enter multiple contacts in this section.

If anyone other than your main health care provider has medical information regarding your condition, fill out Section 9. You can apply for Social Security Disability online, on paper, in person, on the phone or through a lawyer. You are commenting using your Facebook account.


Notify me of new comments via email. Note that the date provided in this section for when the applicant stopped working, or when their conditions became severe enough to prevent them from working, should match the date provided in the SSA and SSA Tips and ideas for answering questions:.

If you have had more than one job, skip the rest of the section and move on to Section 7. If the applicant has been prescribed medication, but is inconsistent in taking it due to symptoms of his or her illness, poor memory, or limited funds, add the medications to section 7 and provide details in the remarks section about the reasons the applicant is not consistently taking the dsa s.

If more than five doctors or hospitals have treated the applicant, use Section 11 — Remarks and give the same detailed information for each healthcare provider.

SSA-3368: Adult Disability Report

You can use this as a guide to prepare for completing the SSA Skip to content Robin Mead You can apply for Social Security Disability online, on paper, in person, on the phone or through a lawyer. List the most recent job first and do not exclude jobs from the list just because earnings are minimal.

Sxa the applicant is currently working, provide information about any changes in his or her work activity. Information about special education can be valuable to the disability determination. Medical treatment sources can include hospitals, clinics, substance use treatment, and evaluation by other health professionals.

This section is only for individuals who are already receiving SSI. 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. It is helpful to document who the phone number belongs to in this question.

Information about this employer accommodation is swa available to SSA in an earnings record, so it is important to provide details on the SSA Enter the name or type of business.


The sea training and education you have had, the harder it can be in some instances to qualify for Social Security disability benefits. More information about materiality can be found here. In section six, you will need to give your job history for ssw past fifteen years.

If the applicant did not work at all in the 15 years before he or she became unable to work, check the box and go to Section 7 — Medicines. It is important to answer that the SOAR representative is completing the report, so that SSA and DDS know that the applicant needed assistance in gathering details and filling out the form.

SSA Adult Disability Report | SOAR Works!

In section three, you will list all medical conditions which affect your ability to work. Include all medical sources that have examined or treated the applicant for physical or mental conditions, even if they are not recent.

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. Most claimants would benefit from the help and advice of an experienced Social Security disability lawyer when filling this form out. Email Address never made public. If the applicant had more than one job in the last 15 years before he or she became unable to work, do not answer the rest of the questions in Section 6 and go to Section 7.

For the application to be considered a SOAR-assisted application, case managers must provide all the materials discussed previously, i. What Do You Think? If you found this page helpful, please share it with others by pressing one of these magic little buttons: Section five asks for education 368. You are commenting using your Twitter account.