Application
Revised on June 24, 2016
- The initial SSI application packet includes the following:
- SSA Cover Letter;
- DSHS form 18-235 Interim Assistance Reimbursement Authorization (signed original);
- SSA-8001 (Title 16 application);
- Internet iClaim (Title 2 application);
- Internet Adult Disability Report i3368;
- SSA-3369 Work History Report;
- SSA-3373 Function Report;
- SSA-827 Authorization to Disclose Information to SSA (signed original, copy, or electronic signature);
- Personal Observation Statement;
- SSA-3288 Consent for Release of Information (signed original or copy); and
- A return envelope.
- Refer to SSI Forms for a description of documents used.
- Send the completed SSI application packet to the local SSA District Office (SSADO) within 60 calendar days of ABD cash approval.
- Send the completed SSI application packet to the local SSADO within 60 calendar days of the referral of a TANF client.
- Verify that the SSADO has received the application packet.