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Form SSA-3380-BK: the best help for a physically challenged person

Form SSA-3380-BK: Function Report – Adult – Third Party

Form SSA-3380-BK is filed with the Social Security Administration (SSA) to claim for social security benefits for a physically challenged person. This form is used when the applicant cannot fill out the form personally and requires the assistance of a third party. Depending on the information the filler gives in this form, the SSA will make a decision on the disabled person’s claim, so it is important to complete the form accurately and thoroughly. Let’s take a closer look.

Who needs Form SSA-3380-BK?
The “Function Report – Adult – Third Party” form, also known as the SSA-3380-BK, is necessary for disabled citizens applying for social security and for their families while the applicant applies for, or appeals, their Social Security disability claim. This form must be completed by a third party, which suggests the limitations of the disabled person.

What is Form SSA-3380-BK?
The Form SSA-3380-BK gives information to help determine whether the physical limitations of a disabled person are a sufficient reason for government assistance.

Is Form SSA-3380-BK accompanied by other forms?
There is no need to send other forms together with SSA-3380-BK.

When is Form SSA-3380-BK due?

The third party can fill out this form at any time. It is important to note that it must comply with the latest requirements for documents posted on the official Social Security website.

What information should be provided in Form SSA-3380-BK?
The filler must answer all questions of the form for the applicant. If the filler doesn’t know the answer or the answer is “none,” the filler can write “don’t know” or “none.” The SSA-3380-BK form consists of 5 sections and has 25 questions. While completing the form, the filler must provide the following information:

  • General information about the disabled person and the form’s filler (name, address, relationship to the disabled person, phone number)
  • Information about the applicant’s illnesses (how the illnesses limits the applicant’s ability to work)
  • Information about the applicant’s daily activities (the description of the applicant’s ordinary day, details regarding the applicant’s family members and pets, how the applicant’s disability affects his sleep or creates problems with personal care, cooking or eating, house and yard work, walking, driving, shopping, or his hobbies, interests, and social activities)
  • Information about the applicant’s abilities (both physical and mental, ability to get along with other people, ability to handle the stress and change, any notices of unusual behavior, equipment uses due to disability, medicines the disabled person takes and its side effects)
  • In case there are any additional remarks, the filler can include them in section E

After this, the filler should print his or her name, date the form and add the address.

What should the filler do with the form after its completion?
The filler should send this form to the office which requested it. If the filler doesn’t have that address, he can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).