Ssa 3368 2012 form-2026

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The document is a Disability Report for adults (Form SSA-3368-BK) used by the Social Security Administration to collect information necessary for evaluating disability claims. It provides instructions on how to complete the report accurately, including details about medical conditions, work history, and treatment received. The form emphasizes the importance of providing complete and accurate information to expedite the claim process and outlines what constitutes 'disability' under Social Security guidelines.

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Click ‘Get Form’ to open the SSA 3368 2012 form in the editor.
Begin with Section 1, providing your name, Social Security Number, and mailing address. Ensure all information is clear and complete.
In Section 2, list a contact person who can provide additional information about your medical conditions. Include their relationship to you and contact details.
Move to Section 3 to detail your medical conditions. List each condition separately and provide any relevant symptoms.
In Section 4, indicate your work activity status. Answer questions regarding past employment and how your conditions have affected your ability to work.
Continue through Sections 5 to 10, providing educational background, job history, medications, and any vocational rehabilitation services you may have received.
Finally, use Section 11 for any additional remarks or information that did not fit in previous sections.

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Versions	Form popularity	Fillable & printable
2024	4.3 Satisfied (26 Votes)
2020	4.4 Satisfied (170 Votes)
2020	4.8 Satisfied (120 Votes)
2015	4.3 Satisfied (320 Votes)
2012	4.4 Satisfied (220 Votes)
2010	4 Satisfied (40 Votes)
2008	4 Satisfied (75 Votes)
2004	4 Satisfied (34 Votes)

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What is a SSA-827 form?

SSA and its affiliated State disability determination services use Form SSA-827, "Authorization to Disclose Information to the Social Security Administration (SSA)" to obtain medical and other information needed to determine whether or not a claimant is disabled.

What is a SSA 3373 form?

Social Security Form SSA-3373-BK is a lengthy form that you fill out as a part of the process of applying for Social Security Disability benefits. It also goes by the Adult Disability Report or the Adult Function Report.

What is the SSA 3368 form?

The SSA-3368: Adult Disability Report helps DDS to obtain a complete picture of the applicant's medical history and treatment. Complete information is essential. Be sure to include all information available to you.

ssa3368

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What is SSA 8001 form?

SSA-8001: Application for Supplemental Security Income (SSI) (Deferred or Abbreviated) The SSA-8001 is an abbreviated version of the SSA-8000: Application for Supplemental Security Income.