To fill out the SSDI function report, form SSA-3373-BK, answer every question with specific, concrete detail about how your condition limits you on a typical bad day, keep your descriptions consistent with what your medical records show, and return the form by the deadline printed on the cover letter. Vague answers and understatement are what sink otherwise strong claims. The examiner is trying to picture what you can do reliably, hour after hour, five days a week, and your job on this form is to give them that picture in your own words.
Why Your Answers Carry Weight
The function report is one of the main pieces of non-medical evidence the disability examiner uses to decide your claim. They read it side by side with your medical records, looking for whether the two tell the same story. If your chart documents severe back pain and your form says you mow the lawn and shop without trouble, the gap weakens you. If your form describes limitations that match what your doctors have found, the two reinforce each other.1Social Security Administration. Assessing Residual Functional Capacity in Initial Claims
The form runs about ten pages and covers nearly every corner of your daily life. It instructs you not to leave any answer blank. If a question doesn’t apply, write “does not apply” rather than skipping it.2Social Security Administration. Function Report – Adult Form SSA-3373-BK
The Rules That Apply to Every Answer
Before you get to the individual sections, a few habits determine whether the form helps you or hurts you.
Be specific. “I have trouble concentrating” tells the examiner almost nothing. “I tried to read my mail last Tuesday and had to re-read the same letter four times before I understood it” tells them everything. Write in numbers when you can: how many minutes you can stand, how many blocks you can walk, how many pounds you can lift, how many times a week the bad days happen.
Describe your worst realistic day, not your best one. Most people instinctively downplay their limitations, either out of pride or because they picture a good day when they answer. The examiner needs to know what you can do reliably, day after day. If you can walk 15 minutes on a good day but only 5 on a bad day, and bad days come three times a week, all of that belongs on the form.
Show the before-and-after contrast. The form asks in several places what you used to do and what has changed. That contrast is some of the most persuasive evidence you can provide. If you used to coach your kid’s soccer team and now can’t sit through a full game, write that down.
Never check a box and leave the explanation blank. The checkboxes are just the setup. The explanation underneath is where the real evidence lives.2Social Security Administration. Function Report – Adult Form SSA-3373-BK
Be honest. Honest descriptions are protected even if you later improve. Deliberate false statements are not, and the penalties are severe (covered at the end).
Section-by-Section Guidance
Daily Routine and Sleep
The form opens by asking you to walk through a typical day from waking to bed. This sets the tone for the rest of the answers, so be concrete. Instead of “I rest most of the day,” write something like: “I wake up around 7, sit on the edge of the bed for 10 minutes because of stiffness, take pain medication, and lie on the couch until it takes effect.” The form also asks whether your condition affects your sleep and how, so describe the pattern: waking from pain, needing to change positions, medication that leaves you groggy.
Personal Care
Questions here cover dressing, bathing, hair care, shaving, feeding yourself, and using the toilet.2Social Security Administration. Function Report – Adult Form SSA-3373-BK If you use a shower chair, grab bars, or need help with buttons or zippers, say so. The form also asks whether you need reminders to take medication or maintain hygiene. That question matters especially for mental health conditions where motivation or memory is impaired. If someone has to prompt you, write that down and describe what happens without the reminder.
Meals
The form asks whether you cook, how often, and what kind of food you make. There is a real difference between preparing a full dinner and microwaving a frozen meal because you can’t stand at the stove for more than a few minutes. If pain, fatigue, or concentration problems limit your cooking, describe exactly what happens when you try. If you have burned pots by forgetting them, say so.
Housework and Getting Around
List what chores you actually do, how long each takes, and whether you need help or encouragement.2Social Security Administration. Function Report – Adult Form SSA-3373-BK If you used to vacuum the whole house in 30 minutes but now can only manage one room before resting, write that. The form then asks how often you leave home, how you get around, whether you drive, and whether you can go out alone. Answer honestly. If you only leave the house for medical appointments, that is a meaningful answer.
Money Management
This section is really a cognitive test. The form asks whether you can pay bills, count change, handle a savings account, and use a checkbook or money orders, and whether any of these have changed since your condition began.2Social Security Administration. Function Report – Adult Form SSA-3373-BK Applicants with traumatic brain injuries, severe depression, or anxiety disorders often struggle here. If someone else has taken over paying your bills because you lose track of due dates or make errors with numbers, that is exactly the kind of detail the examiner needs.
Social Activities and Hobbies
The form asks about your hobbies, how often you do them, and how they’ve changed. It also asks how you spend time with other people, what you do together, and whether you have problems getting along with family, friends, or neighbors.2Social Security Administration. Function Report – Adult Form SSA-3373-BK If you used to attend church weekly and now go once a month because of pain, or you’ve withdrawn from friends because of depression, describe the change. These questions carry more weight than they look like they do, because the examiner is trying to gauge how you would interact with supervisors and coworkers in a job.
Physical and Mental Abilities
Section D is a checklist of abilities your condition may affect: lifting, standing, walking, sitting, climbing stairs, kneeling, reaching, using your hands, seeing, hearing, remembering, completing tasks, concentrating, understanding, following instructions, getting along with others, and handling stress and changes in routine. Each yes or no needs an explanation.2Social Security Administration. Function Report – Adult Form SSA-3373-BK Write in measurements: “I can walk about two blocks before my right knee locks up,” or “I can lift a gallon of milk but not a bag of groceries.” The form also asks how far you can walk before resting, how long you can pay attention, whether you finish what you start, and how well you follow spoken versus written instructions.
The Third-Party Report
The agency may also send form SSA-3380-BK to someone who knows you well and observes your limitations regularly, such as a spouse, adult child, close friend, or neighbor. It asks them to state their relationship to you and how much time they spend with you.3Social Security Administration. Function Report – Adult – Third Party Form SSA-3380-BK
The third party’s job is not to diagnose or use medical language. It is to report what they see: you limping to the bathroom, forgetting what you were saying mid-conversation, canceling plans because you couldn’t get out of bed. Concrete incidents beat general statements like “she’s in a lot of pain.”
Consistency between the two reports matters. The examiner will compare them. The answers don’t need to be identical, but they shouldn’t contradict each other. If you tell the third party what you wrote, or share a copy of your completed form with them, you help make sure you’re both describing the same reality.
Returning the Form on Time
You can submit the completed form online through SSA’s document upload portal, by mail to the office listed in the cover letter, or by fax to the number on the barcode cover sheet the agency sent you.4Social Security Administration. Social Security Forms2Social Security Administration. Function Report – Adult Form SSA-3373-BK If you mail it, certified mail with a return receipt gives you proof of delivery. Keep a copy of everything you send. If your claim is denied, that copy is the foundation of your appeal, and an administrative law judge will read your function report closely when weighing your credibility.
The cover letter typically gives you 10 calendar days from its date to return the form. Mail transit eats into that, so you often have less time than it looks. If you need more, call the examiner handling your claim. Agency procedures direct examiners to allow additional time when a claimant gives a reasonable explanation.5Social Security Administration. Requesting Evidence or Action from the Claimant or Third Party Don’t let the deadline pass silently.
If you miss it, the examiner must follow up once, by phone or letter, giving you another 10 calendar days. If you still don’t respond, they can decide your claim on the medical evidence alone, and the agency’s own procedures warn that this may result in a finding that you are not disabled.5Social Security Administration. Requesting Evidence or Action from the Claimant or Third Party The agency does recognize “good reasons” for non-compliance, including physical or mental limitations, serious family illness, and obstacles beyond your control, and it must make a reasonable effort to involve a third party before giving up on cooperation in claims involving mental impairments.6Social Security Administration. Failure to Cooperate and Insufficient Evidence Definitions
Honesty and the Penalties for Lying
Describing your limitations as clearly and forcefully as you can is not the same as exaggerating them. Honest descriptions are protected. Deliberate false statements are not. Federal law makes it a crime to knowingly provide false information on a disability application, and a conviction can carry up to five years in prison.7Office of the Law Revision Counsel. 42 USC 408 Penalties The agency can also impose civil penalties of up to $5,000 for each false statement, plus an assessment of up to twice the benefits improperly paid. Representatives, translators, and healthcare providers who submit false evidence face a per-statement penalty of up to $7,500.8Office of the Law Revision Counsel. 42 US Code 1320a-8 Civil Monetary Penalties and Assessments
These penalties target intentional fraud, not innocent mistakes or honest differences in how you describe your symptoms. If you genuinely believe you can’t walk more than a block but your doctor thinks you can manage two, that disagreement is not fraud. Claiming you can’t leave the house while posting vacation photos on social media is a different story. Write what is true, in as much detail as you can, and you have nothing to worry about.