Disability Report - Child

OMB 0960-0577

OMB 0960-0577

When claimants file a claim for childhood disability benefits under the SSI program, they must furnish medical and other evidence to prove they are disabled. Form SSA–3820 collects various types of information about a child’s condition from treating sources and/or other medical sources of evidence. The DDS evaluators use the information to develop medical and school evidence and to assess the alleged disability. The information, together with medical evidence, forms the evidentiary basis upon which SSA makes its initial disability evaluation. The respondents are claimants seeking SSI childhood disability payments. We are revising language on the SSA-3820 and the i3820 Internet application screens to change Mental Health/Retardation Center to Mental health/Developmental Disabilities Center due to a statuary change in terminology.

The latest form for Disability Report - Child expires 2021-01-31 and can be found here.

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Disability Report - Child (Paper)

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form SSA-3820-BKDisability Report - ChildFillable PrintableForm

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