How to Answer “How Well Do You Handle Changes in Routine?” on SSA Form 3373 (Question 20(k))
Introduction
Life has a way of throwing curveballs at our schedules – a canceled ride, a last‑minute appointment, a change in who is helping you that day. For many people living with serious medical conditions, those curveballs are not just annoying; they can knock the whole day off track.
On SSA Form SSA‑3373‑BK (Function Report – Adult), Question 20(k) asks:
“How well do you handle changes in routine?”
This question is about function, not personality. You only get one line to answer this question on the form, but this small question quietly carries a lot of weight. It helps Social Security understand how your symptoms affect a very important skill: your ability to adapt when plans change.
This guide from Start Disability is educational only. It is not legal advice. Its goal is to help you think through your own experience so you can give an honest, clear, and consistent answer in your own words.
Where Question 20(k) Fits in the Function Report
Question 20(k) appears in Section D of Form 3373 – the section about concentration, understanding, memory, following instructions, stress, and getting along with others. It sits right next to:
20(j) – “How well do you handle stress?” and,
20(l) – “Have you noticed any unusual behavior or fears?”
Other Start Disability guides in this series explain how to think about questions on written and spoken instructions (20(f) and 20(g)), attention, and finishing tasks. Together, these answers help Disability Determination Services (DDS) see the overall pattern of how you function from day to day – not just what you can do, but how reliably you can do it.
If you are also working through the other parts of Section D, you may find it helpful to read our separate guides on the instruction questions. Our article on Question 20(f), “How well do you follow written instructions?” explains how to think through reading and following written directions in daily life, and our article on Question 20(g), “How well do you follow spoken instructions?” walks through how changes, distractions, and memory issues can affect listening and responding. You can use those guides together with this one as you complete the full Form 3373.
Question 20(k) is especially tied to your ability to adapt and manage yourself when life doesn’t go as planned. That is a specific mental‑function area Social Security looks at when it evaluates disability.
Why SSA Cares About “Changes in Routine”
Under Social Security’s rules for mental impairments and Residual Functional Capacity (RFC), examiners must look at how well a person can:
Adapt or manage oneself – handling changes, regulating emotions, and responding appropriately to demands.
Concentrate, persist, or maintain pace – staying on task and recovering when something interrupts you.
RFC is Social Security’s term for what you can still do on a regular and continuing basis despite your medical impairments. Your answer to 20(k) is one small piece of the RFC puzzle, but it can help show:
how often unexpected changes cause symptoms to spike
whether you can return to tasks after an interruption
how much supervision, structure, or reminders you usually need
whether you can keep up with ordinary changes in a workplace
National data from the Social Security Administration show that mental disorders are a major reason people receive SSDI, representing a large share of disabled‑worker beneficiaries. Because of this, examiners pay close attention to questions that reveal how mood, anxiety, trauma, neurocognitive, or developmental conditions affect a person’s ability to adjust when life shifts.
What DDS Examiners Are Really Looking For in Question 20(k) Section D
When a DDS examiner or decision maker reads your answer to Question 20(k) about routine, they are not grading your personality or whether you “like” surprises. They are trying to understand functional limits that may show up in work‑type situations.
Common things they pay attention to include:
Your usual routine
Do you depend on predictable patterns (same waking time, same route, same helpers)?
What happens when those patterns change?
Size and type of changes that cause problems
Small changes: a phone call moves your appointment by 30 minutes.
Medium changes: someone else drives you, or your home‑health aide cancels.
Big changes: new doctor, new medication schedule, sudden childcare responsibilities, or a move.
Symptom response to change
Do you become anxious, panicked, confused, angry, withdrawn, or tearful?
Does pain, fatigue, shortness of breath, brain fog, or migraines get worse?
Do you shut down, pace, isolate, or have trouble making decisions?
Recovery time and follow‑through
Can you settle within a few minutes and continue what you were doing?
Does the rest of the day fall apart after one change?
Do you leave tasks half‑done when the plan changes?
Support, reminders, and structure
Do you need someone to talk you through the change?
Do you need checklists, calendars, alarms, or written schedules?
Do you avoid situations that might involve sudden changes?
Your one‑line answer cannot cover all of this, but thinking about these points beforehand can help you choose a short description that fits your real experience.
How Question 20(k) Connects to Your RFC and the “Total Picture”
Social Security does not decide disability based on one question. Under the regulations and policy guidance on RFC, examiners must consider all of the evidence together – medical records, your forms, third‑party statements, and sometimes consultative exams.
Question 20(k) often connects to:
Question 20(j) – Stress: Many people find that stress and change go together. If you say you handle stress very poorly but say you handle changes in routine “fine” with no explanation, an examiner may wonder how those two answers fit together.
Question 20(f) and 20(g) – Written and spoken instructions: If you report needing detailed structure to follow instructions, it may make sense that unexpected changes are challenging too.
Question 20(i) – Getting along with others: Some people react to change with anger, withdrawal, or arguments, which may also show up in how they get along with supervisors, co‑workers, or family.
Examiners use this cluster of answers to describe your mental RFC – for example, whether you may be limited to work with few changes, a stable routine, or only occasional simple changes.
If you’d like to see how these ideas can look in a real form, you can review our sample Function Report for someone with esophageal cancer (Esophageal Cancer – Form 3373 Sample Answers) on StartDisability.com.
Step 1: Notice Your Real‑Life Patterns with Change
Because routine is, by definition, automatic, many people have never stopped to ask, “How do I actually react when plans change?” These prompts may help you notice patterns over a week or two.
Consider jotting down a few recent situations:
A ride to an appointment canceled or came late.
A doctor’s office rescheduled you for another day.
A family member called needing help when you were already exhausted.
A repair person was late, early, or didn’t show.
Your usual caregiver, aide, or helper changed the schedule.
For each event, ask yourself:
What did I feel in my body (pain, racing heart, dizziness, fatigue)?
What happened in my mind (couldn’t think, overwhelmed, angry, panicky, distracted)?
What did I actually do (called someone, went back to bed, cried, paced, overate, cancelled everything, or pushed through and crashed later)?
You don’t need to include every detail on the form, but this reflection can help you choose one short statement that honestly reflects your usual response.
Step 2: Separate “Small Changes” from “Big Disruptions”
Many people handle certain kinds of changes better than others. For example:
Minor shifts: The TV show you planned to watch is delayed; you eat lunch 30 minutes later than planned.
Moderate changes: Your child’s school calls; you must change your afternoon plans. A friend cancels a ride and you need to arrange a new one.
Major disruptions: A medical crisis, a sudden move, a new caregiver, or a major schedule overhaul.
Ask yourself:
Are small changes usually okay, but big ones cause panic or shutdown?
Or do even minor changes (like a phone call during your routine) throw off your concentration, sleep, or pain level for hours?
Do you need long lead time to prepare for any change at all?
Your answer to 20(k) can briefly show this difference (for example, noting that simple changes are manageable but major or last‑minute changes are very difficult). The key is to stay true to your usual experience.
Step 3: Connect Changes in Routine to Your Medical Conditions
Social Security does not expect you to use medical terms on the form, but it does look for a link between your symptoms and your reported limits. That means it may help to think about why changes in routine are hard for you.
Here are examples of ways people sometimes describe their own patterns (these are educational only, not instructions on what to write):
When anxiety, PTSD, or mood symptoms are involved
Sudden changes may trigger panic attacks, racing thoughts, or a sense of losing control.
You might pace, cry, shut down, or avoid phone calls after a change.
You may need extra time, a support person, or a quiet space before you can adjust.
When neurocognitive or developmental conditions play a role
Conditions such as autism spectrum disorder, ADHD, traumatic brain injury, or other cognitive disorders can make flexibility difficult. People sometimes notice that:
They rely heavily on routines to stay oriented and calm.
A change in plan makes it hard to switch tasks, remember new steps, or tolerate sensory overload.
They may become overwhelmed, disorganized, or “stuck” when something unexpected happens.
When chronic pain, fatigue, or medical fragility are the problem
Your energy may be carefully rationed for specific tasks (for example, showering, one appointment, and a simple meal).
If something changes, you may not have enough energy left to adjust without severe pain or exhaustion.
A rescheduled appointment, extra errand, or long wait may cause a flare that knocks you out for the rest of the day or several days.
When depression or cognitive slowing is present
It may take a long time to mentally shift gears from one plan to another.
You might feel “frozen,” indecisive, or unable to start the new plan at all.
You may cancel or avoid activities when something changes, even if you wanted to go.
You do not have to list every diagnosis. A brief description of what usually happens (“When my routine changes, I…”) can help DDS connect your symptoms to your functioning.
Step 4: An Answer‑Building Worksheet (Educational Only)
Question 20(k) only gives you two lines, but it can still show a lot. Here is a brief worksheet you can use privately to organize your thoughts before you write your own answer.
You might jot down answers to questions like:
On a typical week, how often do my plans change?
(Almost never / a few times a week / almost every day.)What usually happens to me when plans change?
(Feel anxious, confused, angry, shut down, cry, can’t think, pain flares, can’t leave the house, etc.)How long does it usually take before I can get back on track?
(Minutes, an hour or two, the rest of the day, several days.)What helps me adjust, if anything?
(Lists, phone calls, someone else planning, extra time, quiet room, medication, deep breathing.)Are there certain kinds of changes I absolutely cannot manage?
(Last‑minute schedule changes, new places, new people, new tasks, changes in medication, etc.)
You do not need to copy these questions or answers onto the form. Instead, you can use them to create one or two short sentences in your own words.
Educational Style Examples of How People Sometimes Answer
The following example “styles” are for education only. They are not legal advice and are not instructions on what to write on your form. Your answer needs to describe your own experience.
1. Mild difficulty with change
“I handle small changes fairly well, but if plans change at the last minute I need a little time and reminders to adjust. I may feel stressed but can usually reschedule and continue my day.”
This kind of answer shows that changes are noticeable but do not typically shut the person down.
2. Moderate difficulty – needs structure and support
“I rely on a set routine. When plans or appointments change, I get anxious and mixed up about what to do next. I usually need someone to help me rearrange my day and write things down, and I often lose track of other tasks.”
Here, the emphasis is on needing help and having real disruption, but not a total inability.
3. Severe difficulty – changes cause major disruption
“I do poorly with changes in routine. If an appointment or plan changes unexpectedly, I become overwhelmed and may cry or shut down. I often cannot adjust and end up canceling the rest of the day and staying in bed.”
This kind of answer describes a pattern of intense symptoms and significant disruption.
Again, these are illustrations of tone and detail, not model answers to copy. Your description may look different depending on your conditions and life.
Common Pitfalls That Can Create Confusion
DDS examiners know that life is messy, and no answer will be perfect. However, certain types of answers may lead to follow‑up questions because they are hard to interpret in the context of the whole file.
Here are patterns applicants sometimes want to avoid:
One‑word answers with no context
Writing only “fine,” “bad,” or “depends” gives very little information. If you use a short word, you may wish to add a brief explanation (for example, whether you mean small vs big changes).All‑or‑nothing language that doesn’t match the rest of the form
Saying “I never handle any change at all” may raise questions if other parts of your form show you manage errands, appointments, or childcare with some flexibility. If there is an explanation (for example, you can only manage changes when someone else plans everything), it may help to mention that.Describing a best day instead of a usual pattern
It is normal to have occasional good days. Social Security is interested in what you can do most of the time on a regular basis. If changes usually derail you, but you occasionally push through, it may help to describe that pattern rather than just the rare good day.Leaving out the “why”
Simply stating “I don’t like change” does not show how your medical conditions are involved. A short phrase such as “because it triggers panic,” “because I lose track of what to do,” or “because it worsens my pain and fatigue” may make the answer clearer and more grounded in your symptoms.Forgetting about tools and supports
If you only manage changes because someone else plans your day, sets alarms, or talks you through each step, leaving that out may make your functioning look more independent than it really is.Inconsistency with medical records
Examiners compare your Form 3373 answers with treatment notes, medications, and other forms. If your records often describe severe anxiety, frequent crises, or repeated medication adjustments due to stress, but you say you handle changes “very well,” they may look for an explanation.
You do not have to predict every possible question. The aim is simply to keep your answer realistic and consistent with the rest of your form and your medical history.
When to Use the Remarks Section for Question 20(k)
Given that you're only given one line to answer the "handle routine" question, you might need to use the Remarks section on Form 3373. If you need to add a key detail that will not fit, some applicants choose to use Section E – Remarks at the end of Form 3373. That section is optional, but it may be useful if:
Your ability to handle change varies a lot by time of day (mornings vs evenings), medication timing, or flare‑ups.
You rely on a structured program (for example, a case manager, day program, or home‑health aide) to manage changes for you.
You need to explain why your answer to 20(k) looks different from earlier records (for example, “I used to handle changes better, but in the last year my panic attacks increased and I avoid leaving home when plans shift”).
If you use the Remarks section, many people keep it to one or two short sentences, and some briefly refer back to the question (for example, “More detail on Question 20(k): …”).
How the "handle routine" Question Fits into the Bigger SSDI Picture
From a systems point of view, several people may read your answer over time:
DDS examiner (initial decision): Reviews how your response lines up with other answers, medical records, and any mental‑health or neurocognitive evaluations.
Quality review or reconsideration staff: May re‑check whether your statements about handling change are consistent with your treatment history and work history.
Administrative Law Judge (ALJ) at a hearing (if your case goes that far): Looks at how your testimony about change, stress, attention, and daily activities fits with the RFC assessed under Social Security’s rules.
Your brief answer to 20(k) will not decide your claim by itself, but it becomes part of the overall narrative about how your conditions affect your life. Clear, factual, and consistent explanations can make it easier for each reviewer to understand that story.
Key Takeaways for Start Disability Readers
This question is about function, not personality. Social Security is asking how your medical conditions affect your ability to adapt when plans change, not whether you are “easy‑going.”
Tie changes in routine to your symptoms. Briefly explain what actually happens when your routine shifts – physically, mentally, and behaviorally.
Think in patterns, not snapshots. Focus on your usual experience over time, not only one very good or very bad day.
Mention tools and support. If you only manage change with help, note that in your own words.
Stay consistent with the rest of your form and records. Social Security looks at the whole picture – including other questions in Section D, your work history, and your medical documentation.
This article is part of a larger Start Disability Form‑3373 series, which explores each question in Section 20 to help you understand what Social Security is asking and how to describe your own experience clearly.
FAQ: Question 20(k) – Changes in Routine
Q. Is Social Security judging my character or personality with this question?
A. Under Social Security’s mental‑impairment regulations, examiners rate functioning in areas like adapting or managing oneself, which includes handling changes in routine, regulating emotions, and responding to demands and stress. Your answer helps them understand how your medical conditions affect that area of functioning.
Q. If I say I struggle with change, will that automatically harm my claim?
A. Under Social Security policy, symptoms and statements are evaluated together with objective medical evidence and the entire case record. Your response to 20(k) is just one piece of information examiners use when they assess your RFC and determine whether you can work on a regular and continuing basis.
Q. My ability to handle change goes up and down. How do I explain that?
Many people have “better” and “worse” days. RFC rules focus on what you can do over time, often described as the ability to function 8 hours a day, 5 days a week, or an equivalent schedule. It may help to describe your typical pattern and briefly mention how often bad days or severe reactions to change occur, rather than trying to capture every possible scenario.
References
Social Security Administration. (2024). Form SSA‑3373‑BK: Function Report – Adult.
https://www.ssa.gov/forms/ssa-3373-bk.pdf
Social Security Administration. (n.d.). 20 C.F.R. § 404.1520a – Evaluation of mental impairments.
https://www.ssa.gov/OP_Home/cfr20/404/404-1520a.htm
Social Security Administration. (n.d.). 11/24/25 Disability Evaluation Under Social Security, Blue Book – Adult Listings, §12.00 (Mental Disorders).
https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm
Social Security Administration. (n.d.). 20 C.F.R. § 404.1545 – Residual functional capacity.
https://www.ssa.gov/OP_Home/cfr20/404/404-1545.htm
Social Security Administration. (2023). Annual Statistical Report on the Social Security Disability Insurance Program.
https://www.ssa.gov/policy/docs/statcomps/di_asr/
Disclaimer & AI Ethical Statement
Disclaimer: This article is for informational purposes only and does not constitute medical or legal advice. Consult with a qualified healthcare provider for any medical concerns or questions. Consult with a licensed attorney for legal advice.
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