Form SSA-3368-BK Instructions
Find the instructions for filling out the SSA Disability Report on the first two pages of the form. Read them attentively, detach, and keep for your reference. Although the form is very lengthy, do not leave any box unfilled, unless indicated otherwise. If you do not know the answer or the suggested answer does not apply, write, "don't know", or "does not apply". In case you feel any difficulties with the form, fill as much as you can. You can ask a Social Security representative to help you with the rest.
Do not ask your doctor or medical facility to complete this disability report. If you have your medical reports, submit them with the completed form. If your medical records are kept by your health-care provider, the SSA will request them on your behalf with your permission. The information this form contains will tell the agency where to request your records.
How to Fill out SSA-3368-BK and Receive Disability Approval?
The SSA Form 3368-BK consists of 14 pages, 12 of which are the form you need to fill out. Any mistake on the form may lead to delay or denial of your benefits.
- Section 1. Information about the Disabled Person. This section is self-explanatory and requires your personal information. If you cannot speak and understand English, indicate it in this section and specify the language you prefer. The SSA will provide you with a translator/interpreter at no costs to you;
- Section 2. Contacts. Provide information about a person who knows about your medical condition and can help you with your application. It can be anyone except for doctors that treat or have treated you;
- Section 3. Medical Conditions. Make sure you list every disability, illness, or other medical condition you have. A person with several medical conditions gets an approval more often even if none of these conditions qualifies separately taken;
- Section 4. Work Activity. Accurately describe how your medical condition affects your ability to work and the restrictions it places on you. Do not exaggerate your condition, but do not downplay it, either;
- Section 5. Education and Training. This part is self-explanatory;
- Section 6. Job History. Make sure you list all the jobs you have had over the last 15 years. Provide all the required details. If you conceal any part of the information required for this section, it may result in denial of your claim and legal troubles;
- Section 7. Medicines. List all the medications you take including pain relievers;
- Section 8. Medical Treatment. List all health care professionals you have visited, are visiting, or are going to visit and provide all the requested information as accurately, as possible. If you are not sure about any point, specify it to the appropriate health care provider;
- Section 9. Other Medical Information. If anyone else has information about your physical and mental condition, indicate contact information of this person;
- Section 10. Vocational Rehabilitation, Employment, or Other Support Services. Fill out this part only if you receive Social Security Income;
- Section 11. Remarks. Provide any sufficient additional information or explanations in this part;
Where Should I Mail Completed SSA-3368-BK?
Mail the completed SSA Disability Report to the specific office that requested it. Find the address of all the SSA offices on their official website. The full list of offices is also provided in your phone directory under U.S. Government Agencies. One more way to specify the address you need is to call the SSA at the phone number provided on the second page of the form.
Form SSA-3368-BK Related Publications
- Form SSA-3820-BK, Disability Report - Child is a form you need to complete when you request Social Security benefits on the behalf of a disabled child. This document requires a lot of details about the disabled child, including basic information and a thorough medical history;
- Form SSA-16, Application for Disability Insurance Benefits informs the recipient of the SSA disability benefits about the necessity to report specific changes. The list of changes you need to report and the ways to report are provided on the form;
- Form SSA-3441-BK, Disability Report - Appeal is a form you need to fill out if your Social Security disability claim was denied. The document is used to update the information you have provided.