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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Please comment below with stories, ideas, questions or suggestions. Include all medical sources that have examined or treated the applicant for physical or mental conditions, even if they are not recent.

Information about this employer accommodation is not available to SSA in an earnings record, so it is important to provide details on the SSA For the application to be considered a SOAR-assisted application, case managers must provide all the materials discussed previously, i. If the applicant has someone other than the SOAR representative helping them ssaa the application, you can enter multiple contacts in this section. Fill in your details below or click an icon to log in: List every medical, mental, emotional, learning and health condition that you have separately.

How to Fill Out an Application for Disability Benefits (SSA 16 BK and SSA BK) – How to Get On

Secondary menu FAQ Blog. Simply provide the required information and double check to make sure that it is accurate. If the applicant has been prescribed medication, but sa inconsistent in taking it due to sssa 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 medicine s.

In section three, you will list all medical conditions which affect your ability to work.

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

Use this section to collect any additional information or explanation the applicant did not give in other parts of this report. Section four contains some simple yes or no questions regarding work activity.


If you are currently collecting SSI, you will need to answer the questions regarding self-support programs like Ticket to Work. If the applicant underwent evaluations or treatment while incarcerated, you can add this information to either section 8 or 9.

Medical treatment sources can include hospitals, clinics, substance use treatment, and evaluation by other health professionals. Provide the name of the medicine, the prescribing physician, and the reason for the medicine i.

How to Fill out Form SSA

View a completed sample SSA here. If the applicant has cancer, include the type and stage, as the applicant may qualify for a Compassionate Allowance. By providing comprehensive information, you can help ensure that DDS accesses all available medical records to support the application.

Sxa matter how you apply, the questions are all the same. If this applies, SSA will ask the applicant when they believe their conditions became severe enough to prevent them from working. In section six, you will need to give your job history for the past fifteen years. This section is only for individuals who are already receiving SSI.

Most claimants would benefit from the help and advice of an experienced Social Security disability lawyer when filling this form out.

SSA-3368: Adult Disability Report

Tips and ideas for answering questions: You are commenting using your Facebook account. List them whether you have been seen by a medical professional or not.

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 forj date provided in the SSA and SSA Otherwise, the claim could experience delays at SSA. Hours per day, days per week, and rate of pay. 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. Document if the applicant is experiencing homelessness and if they had any difficulties completing the form.

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Below are sample forms plus tips for making sure your answers are all complete, accurate and helpful. 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 for SSA to know if an applicant needed to change job duties or hours worked based on their conditions. 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. This can be a friend, relative, coworker, or anyone else who can attest to your disability. It is helpful to document who the phone number belongs to in this question.

Use additional paper if you need to. The more training and education you have had, the harder it can be in some instances to qualify for Social Security disability benefits. Leave a Reply Cancel reply Enter your comment here Please let foem know if any links on this page stop working.

If your claim is denied, the SSA will let you know and provide you with information on the appeal process. However it gives you sample completed copies of every form, plus step-by-step instructions for each form. If you have all the information, it should only take about 20 minutes to complete. You are commenting using sda Twitter account. List all brand name or generic medicines the applicant is taking, including those prescribed by a doctor and any over-the-counter medicines, to treat his or her physical and mental conditions.

For example, an applicant may be able to work 10 hours per week, but his employer allows extra breaks and a flexible schedule when the applicant experiences fom.

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