Form SSA-3380: The Third-Party Function Report

Form SSA-3380 is the third party version of the Adult Function Report that the Social Security Administration mails to a friend or relative of the person filing for disability. It asks what you have personally observed about how the claimant's conditions affect daily life, and the examiner's cover letter usually gives you about 10 days to send it back.

SSA publishes the form on its forms page at SSA.gov as Form SSA-3380-BK, Function Report, Adult, Third Party. This guide walks through what it asks, how to answer it honestly, and how to handle the deadline.

What the Form Is and Why You Got It

The companion form, SSA-3373, goes to the claimant and covers the same ground from the inside. SSA-3380 goes to the person the claimant named on the disability application as someone who knows about their conditions. When you fill out that application, SSA asks you to identify such a person, and this form is often the reason why.

Getting this envelope does not mean you are in trouble, and it does not make you legally responsible for the claim. It also does not cost anything to return. The state agency that reviews medical evidence for Social Security, usually called Disability Determination Services or DDS, simply wants an outside observer's picture of the claimant's everyday limits.

Claimants sometimes leave things out because they have lived with the condition for years and stopped noticing it. Doctors write about diagnoses and treatment, not about who does the cooking now. A third party report fills that gap, which is why SSA treats it as a routine part of developing a claim.

How DDS Uses Your Answers

SSA's evidence rules, found at 20 CFR 404.1512 for Social Security Disability Insurance, list the kinds of information used to decide claims. A completed SSA-3380 becomes part of that evidence file.

The examiner compares your description with the medical records and with the claimant's own function report. Consistent details across all three sources tend to support the claim. Wild mismatches slow things down, because the examiner may then ask for more evidence or schedule an exam.

Your report is not a verdict on whether the claimant is disabled. You are not being asked to make that call. You are supplying raw observations about daily functioning, and the DDS staff weigh them along with everything else.

What the Form Asks About

A Typical Day

Form SSA-3380-BK opens by asking you to describe what the claimant does from the time they wake up until they go to bed. It asks whether they care for anyone else, such as children, a spouse, or older relatives, since caregiving suggests a level of functioning too. There is no trick here. The examiner wants an ordinary Tuesday, described plainly.

Personal Care and Household Tasks

A long middle section covers sleep, bathing, dressing, chores, and meals. Expect questions about how long routine tasks take, whether the claimant needs reminders or help, and what specifically has changed from before the impairments. If the claimant still does a task but slower, or with rest breaks, say exactly that.

Getting Around, Money, and Schedules

The form asks about driving, riding with others, using public transit, and shopping alone or with help. It asks whether the claimant handles bills, remembers appointments, follows written or spoken instructions, and finishes what they start. Answer for the claimant's real routine, not for their best day or their worst.

Social Life and Thinking Skills

The last stretch covers friendships, visitors, crowds, phone use, temper, and getting along with people, along with memory, concentration, and following conversations. These questions feed the same overall picture, so do not skip them even when they feel repetitive.

How to Answer Honestly

Report What You Have Seen

Use your own eyes as the source. Concrete examples with rough dates and frequency beat general conclusions every time. A sentence like "she stopped driving after her March 2025 surgery and has not renewed her license since" tells the examiner far more than "she cannot get around."

Separate Observation From Hearsay

If the claimant told you something you have never witnessed, label it as reported rather than observed. Write "he tells me his hands go numb after ten minutes, and I have seen him drop his coffee mug twice this spring." The first half is hearsay, and the second half is evidence, and the examiner can tell the difference. That is the whole reason SSA sends a separate form to you.

Saying You Do Not Know Is Fine

Every question on SSA-3380 that you cannot answer from personal knowledge can be answered with "I don't know" or a brief note explaining why. Guessing does real harm. A guessed answer that conflicts with the medical records looks like exaggeration, even when you meant to help.

Do Not Soften and Do Not Inflate

Leave out both kinds of charity. Downplaying real struggles can make the claimant look more capable than they are, and inflating problems can wreck your credibility against the treatment records. Describe what happens, how often, and what has changed, and let the numbers in the medical file speak for themselves.

Practical Details

Write legibly in ink, attach extra sheets when the boxes are too small, and label each extra sheet with the question number it belongs to. Sign and date the form, make a copy for yourself before sending it, and note that the form carries the standard federal warning that false statements on Social Security paperwork carry penalties. Careful and truthful beats polished and vague.

The Return Deadline

The cover letter that comes with the form, usually from the disability examiner assigned to the claim, asks for it back within about 10 days of the letter's date. That is a working target, not a cliff.

If the date is too tight, call the phone number printed on the letter and ask for more time. Examiners grant extensions routinely, and asking protects both you and the claim. If you cannot reach anyone, return the form as soon as you can, because a late report is still normally added to the file.

If the form never comes back at all, SSA's rules at 20 CFR 404.1512 allow the agency to decide the claim based on the evidence already in the file. A missing third party report leaves the examiner with the claimant's own account and the medical records alone, which is usually thinner evidence. Silence is never protective.

If You Cannot Complete the Form

Serious illness, travel, or simply not knowing the claimant well enough are all fair reasons to struggle with this form. Call the number on the cover letter, explain the situation, and say how much you can honestly speak to. A partially completed form that covers the areas you genuinely observe is more useful to DDS than nothing.

If you truly have no observations to offer, say that in writing and return the cover letter with a short note. The examiner will then stop waiting on you and move the claim forward with other evidence, which is faster than an open request sitting unanswered.

Frequently Asked Questions

Q: Do I have to fill out Form SSA-3380 if I am not the one applying for disability?

A: No law forces you to complete it, and you will not be penalized for declining. Your answers do give the state examiner a firsthand picture of the claimant's daily limits, so returning it usually helps the claim.

Q: Should I ask the claimant what to write?

A: The form is asking for your own observations, not a joint project. Answer from what you have personally seen, and write that you do not know for anything you have not observed.

Q: What happens if I miss the return date on the cover letter?

A: Send the form back anyway, because a late report is normally still added to the file. If the form never arrives, SSA's rules let the agency decide the claim on the evidence it already has, per 20 CFR 404.1512.

Disclaimer

This article is general information, not legal advice. Social Security rules and forms change over time. For advice about a specific claim, contact your local Social Security office or a qualified representative.