BASIC (09-00)

DI 11005.022 Completing and/or Reviewing Interview Forms

A. Introduction

The disability interview forms have been designed for use in self-help situations and should be completed by the applicant when appropriate (DI 11005.018B.2). The questions are written at the sixth grade reading level, which is the SSA standard, and are self-explanatory. Therefore, no specific instructions are provided for their completion.

The information collected provides the DDS with a detailed explanation of the claimant's medical history, functional abilities, effects of pain, and any work history, which are essential to the disability determination.

B. Policy

It is the responsibility of the FO interviewer or reviewer to see that the information obtained on the forms that are the FO's responsibility (DI 11005.018) is as complete and accurate as possible, including the resolution of any discrepancies in the file before the claim is sent to the DDS (e.g., different dates last worked shown on the SSA-3368 and SSA-3369, or different onset dates on the forms).

C. Procedure

Following are some reminders in connection with completion and/or review of the applicant forms:

  • Every applicable question should be answered as completely and accurately as possible.

  • Enter “NA” when a question does not apply.

  • Addresses, including ZIP codes, and telephone numbers, including area codes, must be complete, but see the EXCEPTION.

EXCEPTION: Continue to comply with any regional or local arrangements with the DDS that permit a partial entry or a coded annotation in the medical source items.

  • In questions requesting a “Yes” or “No” answer, be sure the applicant has checked one block or the other (or explained why neither was appropriate), and provided an explanation when appropriate.

  • When no items are checked in questions requesting the applicant to check items on a list, make sure the applicant has not overlooked the question.

  • There should be an explanation in every place where an explanation is requested or where one would be appropriate in light of the applicant's answer.

  • Use the “REMARKS” section of the form to explain any answers, elaborate on any sources listed, or supply additional sources of evidence.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0411005022
DI 11005.022 - Completing and/or Reviewing Interview Forms - 06/20/2013
Batch run: 06/20/2013
Rev:06/20/2013