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Daily Activities Questionnaire, Third Party


In the Disability Report (SSA-3368-BK), you were asked for the name of a friend or relative that could be contacted about your condition.

If you submitted a statement or affidavit from a third party, there should be no need for an additional form to be sent. See: Affidavits and Statements from Friends, Families and Co-Workers.

Otherwise, it is likely that the person will be contacted by Social Security and asked to complete a form titled DAILY ACTIVITIES QUESTIONNAIRE, THIRD PARTY. Basically, the form asks for third party observation of your condition and the impairments it causes.

It is advisable to review with the person what you said about your condition and the affect it has on your daily activities to help jog the person's memory. He or she may remind you of affects that you didn't notice or forgot about. At the least, such new information should be included in the person's report. It wouldn't hurt to also mention it to the DDS representative yourself when you provide an update on your medical condition.

TIP: If Social Security does contact any of the people you suggested about your daily activities, consider getting similar statements from other people as well to bolster your case. It may be very helpful to include former co-workers, especially a supervisor who noticed your declining job performance.

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