Your SSDI Disability Claim: How to fill out form SSA-3373 with Confidence Line-by-line
This step-by-step guide will help you fill out SSA Form 3373-BK, also known as the adult disability function report. It follows common Social Security disability claim tips to make things clear and simple. Whether you're working on an SSDI claim or just need help with the SSA 3373 function report, this guide is made to walk you through it—one easy step at a time.
Pages 1–2: Introductory Guidance
Read all information carefully before starting. The SSA uses this form to assess your residual functional capacity (RFC), crucial in determining disability.
Print or type using black ink. You may also be able to type directly into the form using your browser or an offline PDF editor program.
Leave no question blank. Use "N/A," "none," or "don't know" where applicable.
Do not have your doctor complete this form. It must be completed by you or someone assisting you.
SECTION A: GENERAL INFORMATION
Full Legal Name – Must match SSA records exactly.
Social Security Number – Double-check for accuracy.
Daytime Phone Number – Ensure SSA can reach you or a trusted contact.
Residence Information
4a. Residence Type – Check only one. Be honest (e.g., group home, shelter).
4b. With Whom You Live – Reflect your daily support environment.
Expert Tip: If you live with others, specify if they assist with daily tasks. This helps define the level of independence.
SECTION B: YOUR ILLNESSES, INJURIES, OR CONDITIONS
How Conditions Limit Work Ability – Use detailed functional language, not medical jargon.
Example: "Due to severe fibromyalgia, I cannot stand for more than 10 minutes without pain and fatigue. My concentration is impaired by constant discomfort, making office tasks difficult."
Expert Tip: Focus on specific, real-world limitations (e.g., "cannot lift more than 5 lbs," "must nap daily"). Be truthful but very clear. SSA may compare your answers to your medical records, doctor's notes, and your own statements elsewhere. Avoid vague claims like "I can't work"—instead, describe how each symptom or condition impacts your ability to perform specific work tasks such as sitting, concentrating, or interacting with others.
SECTION C: DAILY ACTIVITIES
Daily Routine – Describe your typical day from waking up to going to bed. Include any activities you’ve had to change, avoid, or need help with due to your condition.
Caring for Others – Mention if you care for children, elderly family, or others, and how your condition limits your ability to do so.
Pet Care – Note if taking care of a pet is difficult, such as feeding, walking, or cleaning up after them.
Help from Others – If you need help caring for others or pets, describe who helps you, how often, and what they do. This shows the level of support you require on a regular basis.
Before vs. After Illness – Clearly compare your ability to perform daily tasks before your health issue versus now.
Sleep – Describe how symptoms disrupt your ability to fall or stay asleep.
Personal Care – List grooming or hygiene tasks you struggle with or need assistance to complete.
Meal Preparation – Indicate what kinds of meals you make, how often, and whether you need help or take shortcuts because of symptoms.
House/Yard Work – Specify tasks you no longer do, now do less often, or need help with. Mention if you experience pain, fatigue, or dizziness.
Getting Around – Describe how you get from place to place. If you don’t drive, say why. If you need someone with you, include that.
Shopping – Clarify how you shop (in-store or online), whether you need help, and any difficulties such as confusion or exhaustion.
Money Management – State if someone helps with finances and explain why (e.g., memory, attention, stress).
Hobbies/Interests – List hobbies you’ve reduced or quit and explain why (e.g., can’t focus, lack of energy).
Social Activities – Share if you avoid groups, have trouble keeping up with conversations, or prefer isolation due to your symptoms.
Expert Tip: Don’t downplay limitations. Be honest and detailed, especially about help you need and activities you've changed. This helps SSA compare your daily limits with your medical conditions and supports your claim.
SSA reviewers check if your described daily activities are consistent with your health conditions. Be specific about time, effort, and the effect of doing tasks—such as needing breaks, feeling worse afterward, or needing reminders.
SECTION D: ABILITIES
20a. Physical/Mental Functions – Check all that apply and describe each one carefully. Use clear, measurable language (e.g., “can sit for 20 minutes,” “can lift 5 lbs”). SSA often compares your answers here with your medical records and doctors’ notes. If they see inconsistencies, they may have additional questions about your claim. Describe how your impairments affect each function day to day, even if symptoms vary.
20b-k. Mental Functions – Describe any issues with memory, following directions, handling stress, or completing tasks. Give real-life examples like missing appointments, needing reminders, or feeling overwhelmed. When describing how you handle stress, explain how it affects your ability to work, interact with others, or function daily—such as triggering anxiety, physical symptoms, or emotional outbursts.
Assistive Devices – List any devices you use (e.g., cane, brace, CPAP) and who prescribed them. Mention how often you use them and what they help you do.
Medications & Side Effects – List only medications that cause side effects. Describe the side effects in plain language (e.g., “drowsy in the morning,” “nausea after lunch”).
SECTION E: REMARKS (Page 10)
Use to clarify previous answers or provide extra details.
Sign and date, and include contact details for person completing the form if it's not the claimant.
Be careful not to introduce new conditions, contradict earlier responses, or use vague language. Keep it factual and focused on clarifying points you've already discussed in the form.
Expert Tip: Use this space to explain fluctuating symptoms (e.g., "Some days are better, but most are not").
SUBMITTING YOUR COMPLETED FORM
For a quick final check, review our SSA 3373 Function Report Checklist. It helps you catch missed details, avoid common mistakes, and feel confident before submission.
Then make a copy and submit the original to the Social Security Administration using the return method they provided—either by mail, in person, or electronically if available. Be sure to return it by the deadline on your SSA notice to avoid delays in your disability claim.
If your condition may qualify for expedited review, learn more about the Compassionate Allowances program and whether your diagnosis appears on the SSA's list.
If you haven’t downloaded your official SSA Form-3373 yet for your function report, you can download the form straight from the SSA website.
If you have questions or need help, you can contact us, but we cannot give you legal advice. We can help point you in the right direction to keep you moving forward with your SSDI claim. You’ve got this!
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.
AI Ethical Statement: This article includes information sourced from government health websites, reputable academic journals, non-profit organizations, and generated with help from AI. A human author has substantially edited, arranged, and reviewed all content, exercising creative control over the final output. People and machines make mistakes. Please contact us if you see a correction that needs to be made.
