Form SSA-3373-BK - Function Report


(4.6 / 5) 106 votes

Get your Form SSA-3373-BK - Function Report in 3 easy steps

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What is Form SSA-3373-BK?

The form SSA-3373-BK is also known as the Function Report which must be provided by the adults. If the problem occurs with a minor, there is another form. The Social Security Disability applicant needs to provide the template to record the medical changes that happened. Once the changes occur, the applicant has to fill out the document. You can’t delay filling SSA-3373-BK form and sending it to the Social Security Administration. If you want to make a claim on the changed situation in your life, mostly your medical condition, you have to use this specific template. In return, you may receive benefits for the disability. However, to do this, you also need to fill an SSA-827 form with your medical records. If you don’t have enough information, you will need an SSA 3373 BK function report as well.
The form contains details on your current state. They are all simple to fill in if you have information about it. It is important to gather data on your injury in advance.

Form SSA-3373-BK on PDFLiner

What I need the Form SSA-3373-BK for?

  • As a claimant, you need SSA 3373 BK fillable PDF form to prove that you have enough issues with your health to receive benefits for the disability. You can use it to prove changes that happened with your health;

  • The form SSA 3373 BK fillable by the patient is also required by the SSA to make sure that the person does not fake the health condition to receive benefits. It has to be recorded and kept in archives. The form will be the main proof of the benefits that person receives until the health condition is unchanged;

  • The government requires SSA 3373 BK fillable form from the SSA to calculate the amount of money that must be provided to support of disabled citizens.


How to fill out Form SSA-3373-BK?

You will easily find the SSA-3373-BK fillable version on the official website of the SSA. The form contains all the instructions you need inside of it. It is better to read them and make sure that your case matches basic demands or you will be denied from the list of citizens who can receive benefits for disability. If your medical condition has changed, you need to fill out another template and send it to the SSA. If you want to use the online option, you can try the PDFLiner editor that works with PDF documents. It also contains detailed instructions on how to fill out form SSA 3373 BK. Once you fill it out, save the original version on your device, send the copy to the department you need using email, or print it and send it via regular mail. Here is what you need to include there:

  1. Provide information about you, including your name, SSN, phone number, and address;

  2. Provide information about your injury, illness, or any other condition you have;

  3. Share information about your daily activities, including a description of your daily schedule;

  4. Provide information on the personal care, and specify whether you have a problem with it or not;

  5. Provide information on your meals, housework, travels, shopping problems, money, and social activities;

  6. Provide information on your abilities;

  7. Share information on the medicine you take and its side effects;

  8. Sign the document, and put a date, and address.

Form SSA-3373-BK on PDFLiner

Organizations that work with Form SSA-3373-BK

  • Social Security Administration;

  • Federal Agencies.

Fillable online Form SSA-3373-BK - Function Report
(4.6 / 5) 106 votes
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