Disability Report - Child

SSA uses Form SSA-3820-BK to collect information about a child’s condition from treating sources or other medical sources of evidence. The State Disability Determination Services (DDS) evaluators use the information from Form SSA-3820-BK 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. Applicants can complete and print Form SSA-3820-BK and mail to SSA, or take the notification page (generated after completing the i3820) to their local Social Security field office (FO). The notification page serves as a back-up alert to the FOs that an applicant transmitted an internet disability report. When claimants do not complete an i3820, FO employees use the Electronic Disability Collect System (EDCS) internal collection process to key information provided by claimants onto EDCS screens to establish a database for the DDS adjudicators. We are submitting a Change Request to append the Disability Determination Ready Claim (DDRC) Certification Statement to this information collection in anticipation of respondents using it for the DDRC pilot.

The latest form for Disability Report - Child expires 2026-04-30 and can be found here.

Disability Report - Child (Paper) SSA-3820

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.