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Click ‘Get Form’ to open the SSA 3373 in the editor.
Begin with Section A, providing your name, Social Security number, and contact information. Ensure all fields are filled; if a question does not apply, write 'none' or 'does not apply'.
Move to Section B and describe how your illnesses or conditions limit your ability to work. Be specific about the impact on daily activities.
In Section C, detail your daily activities from waking up to going to bed. Include any caregiving responsibilities and how they affect you.
Proceed to Section D where you will check items that your conditions affect, such as lifting or memory. Provide explanations for each checked item.
Finally, use the Remarks section for any additional information that may help clarify your situation before submitting the form.

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What is a function report?

What is the Adult Function Report? The Adult Function Report examines how your disability affects your day-to-day life. Also referred to as an ADL (activities of daily living) questionnaire, the Adult Function Report is officially known as Function Report SSA-3373.

What is a third party function report?

Third Party Adult Function Report is a form that Social Security sometimes send to your contact person. This form is usually sent out two or three months after you first apply. It is also sometimes used during Continuing Disability Reviews, for people who are already on disability.

What is Social Security function report?

Social Security's Function Report is designed to provide you with an opportunity to paint a picture of what a day in the life is like for someone living with the impairments you have.

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Can I get disability for headaches?

If you live with migraine or headache that isn't the result of another medical condition but still is severe enough that you can't work, you can qualify for disability benefits with a Medical Vocational Allowance.

Why did I get SSA 3373 form?

This in turn allows the SSA to analyze how your symptoms and limitations affect your ability to complete typical job functions. Form SSA-3373 provides crucial information about your medical condition and whether or not it qualifies you for Social Security Disability (SSD) benefits.

How do you answer Question 6 on a function report?

Question 6: Describe what you do from the time you wake up until going to bed. When I ask many of my clients this question, they'll often answer, \u201cnot much.\u201d However, you are always doing something. When you file a disability claim, you need to provide specific details.

What is a function report?

What is the Adult Function Report? The Adult Function Report examines how your disability affects your day-to-day life. Also referred to as an ADL (activities of daily living) questionnaire, the Adult Function Report is officially known as Function Report SSA-3373.

Why did Social Security send me a function report?

If you are filling out an Adult Function Report, Social Security is trying to get an understanding of the activities that you are still able to do (your Residual Functional Capacity).

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