TN 11 (06-04)
DI 11005.605 Completing the SSA-3368-BK, SSA-3369-BK, SSA-3373-BK, or SSA-3820-BK
The speed with which a disability determination will be made may depend on the completeness and accuracy of these forms. Review the forms for completeness, particularly for medical sources' names and addresses.
See DI 11005.020 - DI 11005.040 for completion of disability interview forms.
CAUTION: Do not use the words terminal or terminal illness in these forms or elsewhere in the claims file.