Confused about RFC reports? How SSA-3373, SSA-4734, and the RFC assessment work together
When you apply for SSDI, several key pieces of evidence come together to show what you can and cannot do at work:
Form SSA-3373 (Function Report): You fill this out to share your daily challenges—like walking, lifting, and concentrating—in your own words.
Your medical records: Reports and notes from your doctors serve as important evidence, verifying and adding detail to your Function Report.
Form SSA-4734 (Medical Consultant Report): After reviewing your SSA-3373 and your medical records, SSA medical professionals complete this form to list your physical and mental abilities in clear, detailed statements.
Together, these elements give SSDI examiners a full picture of your disability and help determine your Residual Functional Capacity (RFC).
SSA-3373: Your Function Report‑3373: Your Function Report
What it is: A form you fill out (SSA‑3373‑BK) to explain how your disability affects everyday tasks like walking, lifting, concentrating, and personal care.
Why it matters: It captures your first-person view—highlighting your bad days—so reviewers understand how your condition truly impacts your life.
Who uses it: SSDI examiners at Disability Determination Services (DDS) review your Function Report, medical records, and interview notes to decide if your disability claim meets SSA criteria.
SSA‑5002: Examiner’s Notes
If the SSDI examiner needs to jot down extra comments—like clarifications or notes from your interview—they use Form SSA‑5002. This is not for you to fill out; it’s a tool for examiners to record important details that don’t fit on SSA‑3373.
SSA‑4734: The Medical Consultant Reports
After looking at your SSA‑3373 report, medical records, and doctor statements, SSA’s medical experts create their own detailed reports using two forms:
Physical RFC (SSA‑4734‑BK)
A narrative form where the consultant describes your physical abilities in sentences. For example, they explain how long you can stand or walk, how much you can lift, and how factors like heat or hazards affect you.
Mental RFC (SSA‑4734‑F4‑SUP)
A written summary of your mental and emotional abilities. The consultant discusses your memory, concentration, social interaction, and adaptability, explaining any limitations in everyday work situations.
How it works together: Your SSA‑3373 Function Report gives your personal account. The SSA‑4734 consultant reports use that account plus your medical evidence to write clear, detailed statements about what you can still do at work.
POMS Guidelines for RFC Assessment
The Social Security Administration’s Program Operations Manual System (POMS) provides detailed rules for assessing Residual Functional Capacity under subchapter DI 24510.000 (RFC). It includes:
DI 24510.005: General guidelines on how to consider medical evidence, claimant statements, and other information when evaluating RFC.
DI 24510.006: Instructions for initial claims under SSR 96‑8p, requiring separate consideration of exertional (strength) and non‑exertional (postural, manipulative, visual, communicative, and environmental) functions, and a narrative discussion explaining how each conclusion is supported by evidence.
DI 24510.050: Completion of the Physical RFC Assessment Form (SSA-4734-BK). Provides step-by-step instructions for detailing each physical function—strength limits, postural activities, manipulative tasks, and environmental factors—with accompanying narrative support
These POMS sections ensure that SSDI examiners use a consistent approach when translating your Function Report, medical records, and consultant reports into an official RFC determination.
RFC Assessment: How SSDI Examiners Decide What You Can Do
SSDI examiners take your SSA‑3373 report, medical records, and SSA‑4734 consultant reports and piece them together in the RFC assessment. This is where they decide:
Can you work an eight‑hour day, five days a week?
What kinds of tasks you can handle safely and on a regular basis?
Regulatory Basis: Federal CFR Definition of RFC
According to federal regulations at 20 C.F.R. § 404.1545, Residual Functional Capacity (RFC) is your maximum ability to perform work-related activities on a sustained basis despite your impairments. This regulation explains:
How SSA must consider all your physical and mental limitations, including symptoms like pain and fatigue.
That RFC combines your own reports, medical evidence, and consultant findings into a final determination of what you can still do each day.
Tips for a Strong Claim
Be honest and detailed on SSA‑3373. Include vivid examples of your bad days.
Ask your doctor for clear medical source statements. Those help SSA consultants complete SSA‑4734 accurately.
Keep copies of everything you submit.
FAQs
Q: Can I fill out SSA‑4734 myself?
No. Only SSA medical and psychological consultants complete SSA‑4734.
Q: What if I forget something on SSA‑3373?
You can add notes or ask SSA for a follow‑up interview. Just be sure all details are recorded.
Q: What is Form SSA‑5002?
Form SSA‑5002 is completed by SSDI examiners to note additional comments or clarifications from your interview when they need more space than SSA‑3373 allows.
Q: How do my medical records affect my claim?
Your doctors’ notes and test results provide the evidence behind your Function Report and support the consultant reports, making your RFC assessment stronger.
Q: Can I submit more evidence after filing?
Yes. You can send updated medical records or statements at any time during the review to ensure DDS has the most current information.
References
Social Security Administration. Form SSA-3373-BK: Function Report – Adult. Retrieved July 7, 2025, from https://www.ssa.gov/forms/ssa-3373-bk.pdf
Social Security Administration. (2025). Report of Contact (Form SSA-5002). Retrieved July 7, 2025, from https://secure.ssa.gov/apps10/poms.nsf/lnx/0413015250.
Social Security Administration. POMS DI 24510.000: Residual Functional Capacity (RFC) – Table of Contents. Retrieved July 7, 2025, from https://secure.ssa.gov/poms.nsf/lnx/0424510000
Social Security Administration. (2025). Physical Residual Functional Capacity Assessment Form (Form SSA-4734-BK) (POMS DI 24510.050). Retrieved July 7, 2025, from https://secure.ssa.gov/poms.nsf/lnx/0424510050
Indiana Department of Administration. (2017). Physical Residual Functional Capacity Assessment Exhibit (Form SSA-4734-BK) [Sample form]. Retrieved from https://www.in.gov/idoa/proc/bids/rfp-18-075/075attj.pdf
Disclaimer: This article is for informational purposes only and does not constitute medical or legal advice. Consult with a qualified healthcare provider for medical questions. Consult with a licensed attorney for legal advice. This article does not create an attorney-client or doctor-patient relationship.
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