Step 1: Understand the Purpose of the SSA 3373 BK Form

The SSA 3373 BK form is used by the SSA to gather detailed information about your daily activities, the severity of your disability, and how your condition affects your ability to function. The form asks about your ability to do tasks such as:

• Personal care (bathing, dressing, eating)
• Household chores (cooking, cleaning, laundry)
• Social interactions and hobbies
• Ability to get around (traveling, using public transportation)
• Work-related activities

Providing clear and accurate responses to these questions is essential in proving the extent of your disability.

Step 2: Sections of the SSA 3373 BK Form

The SSA 3373 BK form is divided into several sections. Below are the key sections and tips on how to fill them out:

Personal Information

The first part of the form requires basic information, including your name, contact details, and Social Security number. This section is straightforward, but make sure all information is correct.

Section 1: Information About Your Condition

In this section, you’ll need to provide details about your medical condition(s), including:

• The nature of your condition(s) (e.g., arthritis, depression, heart disease).
• How long you have had the condition and its progression.
• Whether you have seen any specialists or received additional treatments.

Be specific about your condition and provide as much detail as possible. The SSA needs to understand the severity of your medical issues.

Section 2: Daily Activities

This section asks about your daily routines and how your condition limits your ability to perform them. You’ll be asked questions such as:

• Can you prepare your own meals? If not, explain why (e.g., pain, fatigue, limited mobility).
• Do you need help with personal care? If yes, describe what tasks you need help with (e.g., dressing, bathing).
• Do you do any household chores? Specify which chores you can or can’t do and the difficulty level.

Provide detailed explanations for each activity. Don’t underestimate the severity of your limitations—be honest and thorough in describing the extent of your struggles.

Section 3: Social Activities

The SSA will want to know how your condition affects your ability to interact with others. In this section, you may be asked:

• How often do you interact with family or friends?
• Do you participate in social activities or hobbies?
• Are you able to leave your home? If so, how often, and for what activities?

Describe your social interactions in detail. If you find it difficult to leave the house, engage in conversations, or enjoy hobbies, make sure to include that information.

Section 4: Work History

This part of the form focuses on your work history and how your disability affects your ability to perform job-related tasks. You’ll need to list your most recent jobs and the physical or mental tasks required. You may be asked:

• What was your job title?
• What specific duties did you perform?
• Can you perform those duties now? If not, explain why (e.g., physical pain, inability to concentrate).

Make sure to include as much detail as possible about your past job requirements and the reasons you can no longer work. Include any difficulties you have with concentrating, standing, lifting, or sitting.

Section 5: Physical Abilities

The SSA will want to understand your ability to perform basic physical tasks, including:

• How long can you walk, stand, or sit?
• Do you have any trouble lifting, carrying, or handling objects?
• How far can you walk without experiencing pain or fatigue?

Be honest and provide specific examples of how your physical limitations impact your daily life. If you can only walk for a few minutes before needing to rest, make sure to mention that.

Section 6: Mental and Emotional Limitations

This section asks about the impact of your condition on your mental and emotional health. You may be asked:

• Do you have trouble concentrating or following instructions?
• Do you experience memory problems or mood swings?
• Does your condition affect your ability to interact with others in a work setting?

Be sure to explain any cognitive, emotional, or psychological difficulties you may have. If your condition impacts your ability to focus, remember things, or get along with others, it’s important to document this.

Section 7: Additional Information

In this section, you can provide any other information that may be relevant to your disability claim. This is your chance to include any details that haven’t been addressed in previous sections, such as:

• Any medications you take and their side effects
• Any additional medical treatments you’re undergoing
• Other ways your condition impacts your life that may not have been covered

Use this section to add any further information that could help the SSA understand the full scope of your disability.

Step 3: Tips for Filling Out the SSA 3373 BK Form

• Be Detailed: The SSA needs to understand how your disability impacts your ability to function on a daily basis. Don’t leave anything out, even if you think it’s minor. Even small limitations can support your claim.
• Be Honest: Always be truthful about your abilities and limitations. Overstating your condition can hurt your credibility, while understating it can lead to a denial.
• Include Medical Evidence: Attach any supporting medical documents or letters from your doctor that explain your condition in more detail.
• Take Your Time: Don’t rush through the form. Carefully consider each question and take your time to provide accurate responses.
• Get Help if Needed: If you find the form difficult to understand or complete, consider asking a trusted friend, family member, or attorney for assistance.