SSA-3373 Function Report: What Should You Write?

Form SSA-3373-BK, the Function Report for adults, asks how your conditions limit your daily life: your day from waking to bed, personal care, cooking, chores, getting around, money, hobbies, social life, and abilities like lifting, walking, memory and concentration. The state agency deciding your disability claim, Disability Determination Services (DDS), sends it when it needs evidence about how you function. Social Security estimates it takes about 61 minutes to complete.

You’re usually asked to return it within about 10 days. If you don’t, the agency follows up once and gives you 10 more days, and after that it can decide your claim on the evidence it has. Your answers are compared with your medical records, so the goal isn’t to sound as limited as possible. It’s to describe your real limits in enough detail that someone who has never met you can picture them.

Why you got the form, and what it means

The form isn’t sent in every case. The state agency uses it when it decides it needs information about your daily functioning, and it can collect the same information by phone instead. It’s a normal part of building the file, so getting it says nothing about whether you’ll be approved.

You may see it again at reconsideration. If your appeal says your functioning has changed, the agency asks for an updated report or records the change in your file.

If filling it out is hard for you, ask for help. Your local Social Security office will complete the form with you if you ask, if you’re worried about doing it yourself, or if the interviewer thinks you can’t manage it. The form itself says to complete what you can and call the number on the letter that came with it.

What Social Security does with your answers

Your symptoms alone can’t prove disability. Social Security first needs medical evidence of a condition that could cause them. Once that’s established, it looks at the intensity and effects of your symptoms, and the factors it weighs by regulation are exactly what this form collects:

• your daily activities,
• where your pain or other symptoms are, how long they last, how often they come and how bad they get,
• what brings them on or makes them worse,
• your medications, how well they work and their side effects,
• other treatment you get,
• anything else you do for relief, such as lying flat on your back, standing for 15 to 20 minutes every hour or sleeping on a board, the examples Social Security’s own rules give.

Then it compares your statements with the medical records and everything else in the file. Social Security’s ruling on symptoms, SSR 16-3p, says statements that are consistent with the rest of the evidence are more likely to be found to limit your ability to work, and inconsistent ones less likely. It also says this isn’t a judgment of your character. In practice, the descriptions you give your doctors at visits are compared with what you write here, so the two should tell the same story.

The rules printed on the form

The current edition, dated October 2026, gives these instructions:

• Print or type.
• Don’t leave any answer blank. Write “none,” “don’t know” or “does not apply” when that’s the answer.
• Don’t ask a doctor or hospital to fill it out. It’s your description, not a medical opinion; your doctor’s view belongs in your medical evidence.
• Explain any answer that needs explaining, even if the question doesn’t ask.
• If someone helps you with an activity, say so.
• Use the Remarks section on page 10 for anything that doesn’t fit, with the question number.
• Give the name and address of whoever filled out the form on page 10.

Question by question

Question 5: how your conditions limit your ability to work

This is the summary answer. Don’t just list diagnoses or symptoms. Say what they stop you from doing: how long you can sit or stand, how much you can lift, how often you have to stop, what happens to your concentration, how often bad days happen. If your conditions affected the jobs you held, say which tasks you could no longer do.

Questions 6 to 11: your day and what has changed

Question 6 asks what you do from waking up to going to bed. Walk through a typical day in order, including rests and naps and what you need help with. If your days vary a lot, say so and describe both a typical day and a bad day, with roughly how often each happens.

Questions 7 to 9 ask whether you care for other people or pets and whether anyone helps you. Be specific about what you actually do. “I take care of my kids” reads very differently from “my mother drives them to school; I make them sandwiches and lie down until they get home.”

Question 10 asks what you could do before that you can’t do now, and Question 11 asks about sleep. Describe how often you wake, why, and how you feel the next day.

Question 12: personal care

You check a box if you have no problems with personal care. Otherwise explain how your conditions affect dressing, bathing, hair care, shaving, eating and using the toilet, and whether you need reminders to take care of yourself or to take your medicine.

Questions 13 and 14: meals, housework and yard work

For meals, the form asks what you make, such as sandwiches, frozen dinners or full meals, how often, how long it takes, and what has changed since your conditions began. For chores, list what you do, how long each takes, how often, and whether you need help or encouragement. Rest breaks, help from others and tasks you’ve given up are exactly what the agency needs to know.

Questions 15 to 17: getting around, shopping and money

These ask how often you go out, how you travel, whether you can go out alone and whether you drive, with an explanation for each “no.” Shopping asks how you shop, what for, how often and for how long. The money questions ask whether you can pay bills, count change, handle a savings account and use a checkbook or money orders, and whether that has changed. They’re about whether you can manage money, not whether you have enough of it.

Questions 18 and 19: hobbies and social life

List your hobbies and interests, then say how often and how well you do them now, and what has changed. For social activities, the form asks how you spend time with others, what you do, the places you go regularly, whether you need reminders or someone to go with you, whether you have trouble getting along with people, and how all of this has changed.

Question 20: your abilities

This is where numbers matter. You check each ability your conditions affect, such as lifting, squatting, bending, standing, reaching, walking, sitting, kneeling, stair climbing, using your hands, memory, concentration, completing tasks, understanding, following instructions and getting along with others, and then explain each one. The form’s own examples are how many pounds you can lift and how far you can walk.

It then asks:

• how far you can walk before stopping to rest, and how long you rest,
• how long you can pay attention,
• whether you finish what you start,
• how well you follow written and spoken instructions,
• how you get along with authority figures, and whether you’ve ever been fired for problems getting along with people,
• how you handle stress and changes in routine,
• whether you’ve noticed unusual behavior or fears.

Use real measures: “about half a block, then I rest 10 minutes,” “a gallon of milk, not a laundry basket,” “I lose track after about 15 minutes of a TV show.” Avoid “always” and “never” unless they’re literally true.

Question 21: assistive devices

Check any cane, walker, wheelchair, brace, crutches, hearing aid, glasses or other device you use, then say which were prescribed by a doctor, when, and when you need to use them.

Question 22: medicines

The form asks only for medicines that cause side effects, not your full list. Name each one and describe the side effects you actually have, such as drowsiness, dizziness or nausea, and how they affect your day.

Remarks

Use the Remarks section for anything that didn’t fit, with the question number, and for anything important the form didn’t ask about.

Mistakes to avoid

• Describing only your best days. If good days are rare, say how rare.
• Leaving answers blank or writing only “yes” or “no” where the form asks you to explain.
• Contradicting your medical records. If you tell your doctor you walk a mile a day, don’t write that you can’t walk a block.
• Exaggerating. Inconsistent statements make your symptoms less likely to be accepted.
• Listing every medication in Question 22 instead of those with side effects.
• Leaving out help you get from others.
• Missing the deadline without calling.

Deadline and how to send it

You’re normally given about 10 days. If you haven’t sent it by then, the agency follows up once, by phone or letter, and gives you 10 more days. The follow-up says that if you still don’t respond, it may decide your claim on the evidence in the file, which can mean a finding that you’re not disabled. If you need more time, call the number on the letter before the deadline and explain why. The agency can give more time for a good reason.

You can send the form back by mail or bring it to your local Social Security office, or complete or upload it online from Social Security’s forms page, which requires signing in to your my Social Security account. Keep a copy of what you send, and write down the date and how you sent it.

The third-party Function Report

Form SSA-3380 asks the same kinds of questions of someone who knows your daily life well, such as a spouse, relative, neighbor, friend, clergy member or teacher. The agency sends it when it wants that outside view. It isn’t required in every case either.

The person filling it out should describe what they’ve seen themselves, in their own words, because Social Security weighs everything in your file against everything else. If no one who knows you well can complete it, call the number on the letter that came with the form.