Get Ssa-5665-bk 2018-2025

The SSA-5665-BK is a vital form used by the Social Security Administration to gather information from teachers about a child’s daily functioning as part of a disability benefits claim. This guide will help you navigate and fill out the form accurately and efficiently.

Follow the steps to complete the SSA-5665-BK online.

1. Press the ‘Get Form’ button to access the SSA-5665-BK form in the online editor.
2. Begin by providing your information as the teacher or educator completing the questionnaire, ensuring you include your relationship to the child, the name of the school, and how long you have known the child.
3. Complete the section on the child's instructional levels, including current grades and services received. Be thorough in describing the child's abilities across different subjects.
4. For each domain of functioning, such as 'Acquiring and using information' and 'Attending and completing tasks', carefully assess the child’s performance relative to peers without impairments and mark your observations accurately.
5. When rating the child’s functioning, use the provided rating scale to indicate whether they have no problem, a slight problem, or more serious issues in specific areas. Provide additional comments wherever necessary to elaborate on each rating.
6. Fill out the medical conditions and medications section by describing any relevant health issues that affect the child’s functioning. Specify if medications are prescribed and their effects.
7. Use the final comments section to note any important insights or updates regarding the child’s situation that may not have been addressed in the previous sections.
8. Once all sections are complete, review your information for accuracy. You can then save your changes, download, print, or share the completed form as needed.

Take the next step and fill out the SSA-5665-BK form online today to support the disability benefits process.