Form SSA-3373: The Adult Function Report, Explained

Form SSA-3373-BK, known as the Function Report - Adult, is the questionnaire Social Security uses to examine how your medical conditions restrict your everyday activities, personal care, and physical movements. State Disability Determination Services (DDS) examiners rely on this report to evaluate your residual functional capacity and determine whether your daily routine contradicts your claimed limitations. Completing this multi-page form accurately and consistently is essential to building a credible disability record.

Why DDS Sends You Form SSA-3373

When you file an initial claim for Social Security Disability Insurance (SSDI), your medical records show diagnoses, imaging results, and laboratory data. However, clinical charts often fail to capture the granular details of how pain, fatigue, weakness, or mental distress impact your everyday life. Form SSA-3373-BK fills that informational gap.

Under 20 CFR 404.1545, DDS examiners must evaluate your Residual Functional Capacity (RFC). Your RFC represents the maximum physical and mental work activities you can perform on a sustained, regular basis despite your impairments. To establish this assessment, examiners evaluate the limiting effects of your symptoms under 20 CFR 404.1529 and Social Security Ruling 16-3p.

Form SSA-3373-BK provides examiners with your subjective narrative. They compare your answers against clinical findings from your treating doctors and the work history you submitted. If you report severe physical limitations but describe a daily routine that includes heavy house cleaning, gardening, and long driving trips, examiners may conclude that your self-reported limitations exceed your actual medical impairment.

Section-by-Section Breakdown of Daily Activities

Form SSA-3373-BK contains repetitive questions designed to explore how you manage basic life tasks. Understanding the specific intent behind each section helps you provide concrete, realistic details.

Section B: Condition Description

Section B asks how your illnesses, injuries, or conditions limit your ability to work. Keep your answer focused on concrete functional restrictions rather than merely naming your medical diagnosis. Instead of writing that you have severe osteoarthritis, explain that joint stiffness prevents you from gripping small objects, typing, or standing for more than fifteen minutes without intense pain.

Section C: Daily Activities and Personal Care

This section examines your 24-hour day from the moment you wake up until you go to sleep at night. DDS examiners review this schedule to determine whether you maintain the stamina required for an eight-hour workday.

The questions in Section C explore multiple routine areas:

• Personal grooming: Do you need assistance dressing, bathing, washing your hair, shaving, or feeding yourself? Do you need adaptive equipment like shower chairs or long-handled sponges?
• Meal preparation: Do you cook full meals from scratch, or do you prepare simple sandwiches and microwave frozen dinners because you cannot stand at a stove?
• Housework and yard work: Can you clean, wash dishes, vacuum, or do laundry? How long does each chore take, and do you require help from family members?
• Getting around: Can you leave home alone? Do you drive a car, ride in a vehicle, or use public transportation? If you cannot drive, explain why, such as side effects from pain medications or physical inability to turn your neck.
• Financial management: Can you pay bills, count change, and manage bank accounts? SSA uses this question both to evaluate mental concentration and to determine whether you need a representative payee if benefits are awarded under 20 CFR 404.2001.
• Social activities and hobbies: Do you spend time with others in person, over the telephone, or on computers? How often do you participate, and have you withdrawn from social groups since your condition began?

Physical and Mental Checklist

Question 17 presents an extensive checklist covering physical actions like lifting, squatting, bending, standing, reaching, walking, sitting, kneeling, and stair climbing. It also includes cognitive and social functions such as memory, completing tasks, concentration, understanding, following instructions, and getting along with others.

When checking these boxes, you must explain how your conditions limit each specific ability:

• For lifting: Specify how many pounds you can lift safely without triggering severe pain. Mention whether carrying a half-gallon of milk or a bag of groceries causes strain.
• For walking: Note how far you can walk before needing to stop and rest, such as fifty feet or one block, and state how many minutes you must rest before continuing.
• For sitting and standing: State how many minutes you can sit comfortably in an office chair before you must stand up, shift positions, or lie down.
• For mental focus: Describe how long you can concentrate on a task before pain or mental exhaustion causes your focus to drift.

Concrete measurements help examiners translate your answers into specific RFC restrictions. Vague statements such as "I cannot lift anything" are often disregarded because most individuals can lift very light items. Providing realistic numbers gives your report credibility under POMS DI 22510.005.

The Trap of Describing Good Days

Chronic medical conditions often fluctuate in severity. Claimants frequently make the mistake of answering Form SSA-3373-BK based on their best days, describing activities they can manage only when symptoms temporarily improve.

Answering this way can inadvertently damage your claim. Disability evaluation under Social Security rules assesses what you can perform on a sustained basis: eight hours a day, five days a week, week after week. If you describe your activities on a rare good day without explaining that severe flare-ups follow, examiners assume your reported activity level reflects your daily baseline.

When answering, describe your capabilities on an average day. If you have fluctuating symptoms, make that clear in your responses. You can state that on two good days during the week you can load the dishwasher, but that on bad days severe pain confines you to bed.

Maintaining Consistency Across Your File

DDS examiners read Form SSA-3373-BK in conjunction with the Adult Disability Report (Form SSA-3368-BK) and clinical records from your healthcare providers. Inconsistencies between these documents raise red flags during evaluation.

For example, if you state on your function report that you cannot sit for more than ten minutes, but your treating physician notes that you regularly drive two hours across the state to visit family, the examiner will flag that contradiction. Similarly, if you write that you require a cane or walker, but medical records never mention an assistive device or show that a doctor prescribed one under 20 CFR Part 404, Subpart P, Appendix 1, DDS may request a consultative examination to resolve the discrepancy.

If your physical condition has deteriorated significantly since you submitted your initial application, explain that change clearly in the remarks section. Providing context prevents examiners from viewing natural disease progression as a contradiction.

Completing the Remarks Section

Section E provides space for additional remarks. If the standard boxes do not allow you to explain your daily realities fully, use this section to provide concrete narrative details.

You can describe specific accommodations you need at home, such as having to lie down for an hour every afternoon to relieve lumbar pressure. You can also mention that personal tasks take twice as long to finish as they used to. If another person helped you complete the questionnaire, identify them in Section F as required by SSA rules. Providing honest, measured, and detailed answers ensures your Function Report paints an authentic picture of your daily functional limitations.

Frequently Asked Questions

Is Form SSA-3373 required for every disability claim? DDS sends Form SSA-3373 whenever a claim cannot be approved solely on medical listings, requiring an assessment of your functional capacity under 20 CFR 404.1545.

What should I do if my symptoms change from day to day? Describe your limitations on an average bad day rather than your best day, and explain how frequently your flare-ups occur during a typical week.

Can a family member help me write answers on Form SSA-3373? Yes, someone can assist you or write your answers down, provided you disclose their assistance and identify them in Section F of the form.

This article is general information about SSA filing procedures, not legal advice. Program rules, forms, and processing details change over time, and every situation is different. Consult a qualified representative or contact SSA directly for guidance on your specific claim.