Library & Tools

To be appointed as the applicant’s representative, the case manager must complete the SSA-1696: Appointment of Representative form. Here are a few tips for filling out the SSA-1696.

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.

Completing the SSA-827 allows SOAR case managers to obtain the applicant’s medical records, in order to verify that they meet the medical eligibility criteria for SSI/SSDI.

The Function Report (SSA-3373) helps DDS to obtain information about how an applicant’s illness(es) and condition(s) affect their ability to function and perform everyday tasks.

The Work History Report (SSA-3369) helps Disability Determination Services (DDS) to obtain detailed vocational information about the jobs the applicant held in the 15 years prior to becoming unable to work due to his or her illnesses, injuries, or conditions.

Here are examples of completed SSA and SOAR Forms using information from a fictitious SSI/SSDI applicant.

The SSA-8000 is the form used by the Social Security Administration (SSA) to gather all the non-medical information for the SSI application.

SSDI is an insurance program. Therefore, no information about living arrangement or resources is required. Instead, the SSDI application will ask questions about past earnings and entitlement to other benefits. People over 18 years of age who have worked and contributed to the Social Security Trust or others who became disabled before the age of 22 whose parent is deceased or receiving retirement or disability benefits may be eligible.

Here are examples of completed SSA and SOAR Forms using information from a fictitious SSI child applicant.

The Social Security Administration (SSA) may ask the applicant to complete an SSA-821 Work Activity Report if he/she continued to work after the alleged date of onset. This article provides additional information and tips for assisting applicants with this form.