Social Security Form SSA-3373-BK

The SSA-3373-BK form is a record of changes, mostly medical, that a Social Security Disability applicant has made to their application. This document should be filled out whenever a claimant makes a change to their disability claim. The procedure for obtaining disability benefits begins when you submit an initial claim for compensation and a Form SSA-827 to release your medical records. If medical documents are insufficient to establish eligibility, the SSA will usually request that you complete Form SSA-3373-BK.

 What Information Does It Ask For?

The form consists of 10 pages and is divided into 5 sections. Most are straightforward and easy to answer, such as name, address, date of birth, mother’s maiden name, etc. For some questions you might not have the answer to, don’t leave it blank. If you do not have the answer, or you do not have any idea, write “none” or “don’t know.” Section A involves questions about your basic information, such as name, address, date of birth, etc. Section B  asks for information about the injury that caused you to apply, such as what you were doing when it happened, who was with you at the time, how long ago it happened, etc. This is where you’ll describe all of the ways your condition(s) limits your ability to work a full-time job. Be sure to read each question carefully so as not to miss anything. A wrong answer on this form could greatly affect your chances of getting disability benefits. In Section C, you are asked about any other health problems you have had besides the one that caused you to file for disability. Section D asks if your condition(s) has changed since your application was first filed, or when it was last reviewed. The claim should be updated every time there is a change in either medical status or work history. What you report on the form will be compared to your medical records and, if necessary, disability interviews. Do not change anything unless it is for something good (i.e., you were hospitalized and therefore unable to work). What this means is that if you have been approved as disabled or your condition has deteriorated since your application was originally filed, then you should complete and file the SSA-3373-BK form. Lastly, in Section E, this is where you may expand on any remarks that you didn’t include in any other part of the form. If you have more compelling evidence to support your claim that you didn’t express in Section B or in your answers to the questions in Sections C and D, this is the place to list it.

How to Submit The Form

The SSA provides an envelope in which to put your completed form. You should never send the original document; always send a copy in case something happens to the original. It is not necessary for you to get medical records or any other records that you have already submitted for this form unless requested by the Social Security Administration. Once you have completed this form, mail it or take it to your local Social Security office. What happens from there will depend on the response you receive from your disability application. Remember that filling out a SSA-3373-BK is very important as it gives the Social Security Administration the information they need to decide whether you should receive benefits. What you report on the form depends on whether your application has been approved or rejected.

The Bottom Line

Most of this form is simple. If you can’t answer a question, just leave it blank and move on. Only fill out the form if your disability claim has been denied or rejected for any reason whatsoever. If you are not sure whether your application has been approved or rejected, contact the Social Security Administration. You can get in touch with them by phone, mail or email. What happens next will depend on how they respond to you and/or if they still think it is necessary for you to fill out the SSA-3373-BK form. Remember that there are strict guidelines as to what the SSA looks for in this form and it is important that your claim be as complete and accurate as possible. What you report on these forms will directly affect the decision made by the Social Security Administration and could potentially determine whether or not you get disability benefits.

The SSA-3373-BK form is used to report any changes that have occurred in your medical condition or work history since the time of your application. What exactly constitutes a change depends on whether you have been approved as disabled, denied benefits, or are still awaiting a decision. The information you reported in this form will be compared to your initial application or last review. The changes you note may affect whether or not your disability claim is approved again, denied benefits altogether, or if additional information is required.
The SSA-3373-BK asks for general information about your health and disability claim status. What you have to report on this form will depend on whether you have been approved as disabled, denied benefits, or are still awaiting a decision. If you have already been approved as disabled, then the only thing that may require clarification is any changes in your condition since the time of your original application.
Be truthful about what you log. You don't want to make unrealistic claims or understate your skills and limitations. Give as much information as you can so that the individual reading the questionnaire has a clear sense of what your life is like on a daily basis.
There is only one way to find out what may be asked of you when answering these kinds of questions, and that is to read the form carefully. What you report on these forms will directly affect your chance of getting benefits so it is important to be as clear and thorough as possible.
You may not be able to answer every question on this form for a number of different reasons, but that doesn't mean you don't need to fill it out. For some questions you might not have the answer to, don't leave it blank. If you do not have the answer, or you do not have any idea, write "none" or "don't know."

True Tamplin, BSc, CEPF®

About the Author
True Tamplin, BSc, CEPF®

True Tamplin is a published author, public speaker, CEO of UpDigital, and founder of Finance Strategists.

True is a Certified Educator in Personal Finance (CEPF®), a member of the Society for Advancing Business Editing and Writing, contributes to his financial education site, Finance Strategists, and has spoken to various financial communities such as the CFA Institute, as well as university students like his Alma mater, Biola University, where he received a bachelor of science in business and data analytics.

To learn more about True, visit his personal website, view his author profile on Amazon, or check out his speaker profile on the CFA Institute website.