If you are filing for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you will almost certainly receive Form SSA-3373-BK, also known as the Function Report – Adult. This deceptively simple-looking form carries enormous weight in your disability case.
The Social Security Administration (SSA) uses this form to understand how your medical condition affects your ability to perform everyday activities — things like cooking, bathing, driving, and concentrating. Your answers shape how a claims examiner views your functional limitations, which directly determines whether you are approved or denied.
Yet most applicants rush through the form or minimize their symptoms out of habit or pride. That single mistake leads to thousands of preventable denials every year. This guide walks you through every section of the SSA-3373-BK Function Report, explains what SSA is really looking for, and shows you exactly how to document your limitations effectively and honestly. If you are also exploring other financial support options while your claim is pending, you may want to review how unemployment benefits work alongside disability filings.
What is Form SSA-3373-BK? The SSA-3373-BK is the Function Report – Adult used by the Social Security Administration to evaluate how a claimant's physical or mental disability limits their daily activities. You should describe your worst days honestly, provide detailed examples, and never minimize your limitations. Vague or overly positive answers can result in a denied disability claim.
What Is Form SSA-3373-BK and Why Does It Matter?
The SSA Function Report – Adult (Form 3373-BK) is a multi-page questionnaire that the Social Security Administration sends to SSDI and SSI applicants during the initial claims review. It asks about your ability to:
- Take care of yourself (bathing, dressing, grooming)
- Prepare meals and manage a household
- Drive or use public transportation
- Handle money and bills
- Socialize and maintain relationships
- Concentrate, follow instructions, and complete tasks
- Handle stress and changes in routine
SSA uses the responses to assess your Residual Functional Capacity (RFC) — essentially, what work-related tasks you can still perform despite your impairments. Your RFC score influences every stage of the five-step disability evaluation process.
This form is not just administrative paperwork. It is one of the most significant documents in your file, often reviewed alongside your medical records and consultative examination results.
- The Function Report directly informs your Residual Functional Capacity (RFC) rating.
- Claims examiners compare it against medical records — inconsistencies trigger denials.
- Describe your worst days, not your best days.
- Be specific and use real examples rather than vague answers.
Step-by-Step Guide to Completing Form SSA-3373-BK
Below is a detailed walkthrough of each section of the Social Security Function Report – Adult form, with guidance on how to answer each part honestly and effectively.
Section 1 — Describe Your Illness, Injuries, or Conditions
This opening section asks you to list the conditions that limit your ability to work. Be thorough. List every diagnosed condition — physical and mental. If you have chronic back pain and depression, list both. Many applicants forget secondary conditions that, when combined, significantly strengthen a claim. Refer to your medical records for the exact diagnostic terminology your doctors use.
Pro tip: Include how long you have had each condition and whether it is worsening over time.
Section 2 — How Your Conditions Affect You (Daily Activities)
This is the heart of the form. You will be asked about your daily routine from the time you wake up until you go to bed. Describe a typical bad day, not a rare good day. Mention how long activities take, whether you need help, whether you need to rest in between, and whether you ever skip activities because of pain, fatigue, or mental health symptoms.
Example: Instead of writing "I cook meals," write: "On most days, I cannot stand long enough to cook. I microwave simple foods and must sit down every few minutes. On bad days, I skip eating or rely on family to bring me food."
Section 3 — Personal Care
Questions about bathing, dressing, grooming, and toileting may feel embarrassing, but they are critical for claims involving physical or mental impairments. If your condition causes pain when reaching, bending, or standing for more than a few minutes, explain that clearly. If depression or PTSD makes it hard to shower regularly or care for yourself, state that honestly. SSA is not judging you — they are building a functional picture.
Section 4 — Meal Preparation
Describe what you actually cook and how long it takes. If you can only prepare simple meals (sandwiches, frozen foods), say so and explain why. If your condition causes you to forget ingredients, burn food, or lose interest mid-task, this is important — especially for claims involving cognitive impairment, psychiatric disorders, or neurological conditions.
Section 5 — House and Yard Work
List any household chores you do and how often. But more importantly, list the chores you cannot do anymore and why. If you used to vacuum but can no longer due to back pain, mention that. If you need someone else to do laundry, mention how much help you require. How long can you perform these tasks before needing to stop?
Section 6 — Getting Out, Transportation, and Shopping
Can you drive? Can you ride public transit alone? Can you shop in stores, and for how long? If you avoid going outside due to PTSD, anxiety, or physical pain, describe that. If someone always accompanies you, say so. Functional limitations in transportation directly relate to the ability to maintain employment — a key SSA concern.
Section 7 — Money Management
SSA asks whether you can handle a savings account, pay bills, count change, and manage finances. Difficulties with money management can signal cognitive impairments, memory problems, or severe mental health conditions. If you rely on someone else to handle your finances, explain this clearly and provide context.
Section 8 — Social Activities and Hobbies
Has your disability caused you to give up hobbies or limit social contact? List activities you once enjoyed that you can no longer do. Describe changes in your social life, such as avoiding crowds, withdrawing from friends and family, or being unable to attend events. This section is especially important for mental health disability claims.
Section 9 — Concentration, Memory, and Following Instructions
This section is critical. Answer honestly about your ability to concentrate, follow spoken or written instructions, and complete tasks. Explain how long you can focus before symptoms interfere. If you frequently lose your train of thought, re-read instructions multiple times, or cannot remember to take medications, describe that in detail. These functional limitations are relevant to a broad range of jobs.
Section 10 — Physical Abilities (Lifting, Walking, Standing)
For physical disability claims, this section is often the most important. Be precise: How far can you walk before stopping due to pain or shortness of breath? How long can you stand? How much can you lift? If your answer varies by day, explain that. Describe what happens after you overexert — increased pain, fatigue, needing to rest in bed. These details help establish your RFC.
Section 11 — Handling Stress and Changes in Routine
This section asks about adaptability. Many disability conditions, especially mental health disorders, neurological conditions, and chronic pain disorders like fibromyalgia, are significantly worsened by stress and unexpected change. Be candid about how stress affects your symptoms and functioning. Avoidance, panic attacks, physical flare-ups, and emotional breakdowns are all relevant.
Section 12 — Medications and Side Effects
List all medications you take, their dosages, and any side effects that affect your functioning. Drowsiness, nausea, difficulty concentrating, or dizziness caused by medications can constitute functional limitations. Check our guide on what SSDI benefits cover to understand how medical costs factor into your claim.
Key Legal Facts and SSA Regulations You Should Know
Understanding the legal framework behind the SSA-3373-BK Function Report helps you answer it more strategically and accurately.
| Legal Concept | What It Means for Your Form |
|---|---|
| Residual Functional Capacity (RFC) | Your answers directly shape your RFC — the maximum work you can still do despite impairments. |
| Activities of Daily Living (ADLs) | SSA evaluates your ADLs across four domains: daily activities, social functioning, concentration, and adaptation. |
| Substantial Gainful Activity (SGA) | In 2026, the SGA limit is $1,620/month for non-blind individuals. Your functional limitations must prevent work above this threshold. |
| Five-Step Sequential Evaluation | SSA uses a five-step process to determine disability — your function report informs Steps 3, 4, and 5. |
| Listing of Impairments (Blue Book) | If your condition meets a Blue Book listing, functional limitations still matter for determining severity. |
For a deeper look at how your work history affects eligibility, review SSA's guidelines at ssa.gov/disability.
It is also worth understanding how work credits affect your SSDI eligibility before completing your application.
Social Security Disability Statistics: What the Numbers Tell Us
Context matters when filing a disability claim. Here are key figures that illustrate how high the stakes are:
- Initial denial rate: Approximately 60–70% of SSDI applications are denied at the initial level.
- Reconsideration denial rate: Around 85% of reconsideration appeals are also denied.
- Hearing approval rate: Applicants who reach the ALJ hearing stage have an approval rate of roughly 50–55%.
- With legal representation: Studies show claimants represented by attorneys are approved at significantly higher rates — sometimes double that of unrepresented claimants.
- Average wait time: The average time from application to hearing decision can exceed 18–24 months.
These numbers reinforce how important it is to complete every form — including the SSA Function Report — as carefully and thoroughly as possible from the start. Learn more about the SSDI waiting period and why it exists. You can also review the Social Security Disability pay chart to understand what monthly amounts claimants typically receive once approved.
Common Mistakes to Avoid When Filling Out Form SSA-3373-BK
These are the most frequent — and most damaging — errors claimants make on the Function Report – Adult:
SSA is asking about your functional capacity across all days. If you have bad days, those matter. Describe your typical worst days — not the one day a week you feel tolerable.
Answers like "some," "a little," or "sometimes" give SSA nothing to work with. Quantify everything. "I can walk about half a block before my knee gives out and I need to stop for 15 minutes."
Claims examiners will cross-reference your answers with your doctor's notes. If your records show severe limitations but your form suggests you function normally, your credibility is damaged. Be consistent.
Many applicants focus only on physical limitations and neglect to document depression, anxiety, cognitive difficulties, or emotional instability. Mental health conditions are legitimate disabling impairments. If you have been diagnosed with a psychiatric disorder, document its functional impact thoroughly.
Every blank field is a missed opportunity to document your limitations. If a question doesn't seem to apply, explain why rather than leaving it empty. Unanswered questions can suggest to reviewers that the limitation doesn't exist.
Medication side effects — drowsiness, nausea, cognitive fog, balance issues — are functional limitations. They belong on this form. If your medications impair your ability to work, document it.
If a family member, friend, or caregiver helps you with daily tasks, list that help. It demonstrates that you cannot independently perform those activities.
Tips for Completing the Function Report for Mental Health Disability Claims
If your disability claim is based primarily or partially on a mental health condition — such as PTSD, severe depression, bipolar disorder, schizophrenia, or anxiety disorder — the SSA-3373-BK requires extra attention.
Document the "Four Functional Areas" for Mental Health
SSA evaluates mental impairments across four broad functional areas:
- Understanding, remembering, or applying information
- Interacting with others
- Concentrating, persisting, or maintaining pace
- Adapting or managing oneself
Your answers in the Function Report are used to rate your limitations in each of these domains on a scale (none, mild, moderate, marked, or extreme). A rating of "marked" in two areas or "extreme" in one area can qualify you under SSA's mental health listings.
What Happens After You Submit the Function Report?
Once you return your completed SSA-3373-BK form, it enters your disability file. A Disability Determination Services (DDS) examiner reviews it alongside your medical records, physician reports, and any consultative exam results.
You may also receive a separate form — the SSA-787 (Activities of Daily Living Questionnaire) — to be completed by someone who knows you, such as a family member or caregiver. That third-party perspective adds credibility to your account.
If your initial claim is denied, you have the right to appeal. Understand your options by reading about the five-year rule for Social Security Disability and how it may affect your eligibility timeline. You may also qualify for both SSDI and SSI simultaneously. If you are in your 50s, it is also worth understanding how disability rules change for applicants over 50 — SSA applies different vocational guidelines that can work in your favor.
If your doctor is hesitant to support your claim, review our guidance on what to do if your doctor won't support your disability claim.
When Should You Consult a Social Security Disability Lawyer?
The SSA Function Report is often the deciding document in initial claims. A single poorly worded answer can undermine months of medical evidence. This is why consulting a Social Security Disability Lawyer before completing this form — not just after a denial — can make a significant difference.
An experienced disability attorney can:
- Review your form before submission for accuracy and completeness
- Help you articulate limitations in legally meaningful language
- Ensure your answers are consistent with your medical records
- Prepare you for any consultative examination
- Represent you at ALJ hearings if your claim is denied
Most disability attorneys work on a contingency fee basis — meaning you pay nothing upfront. Their fee is capped at 25% of your back pay (maximum $7,200 in 2026). For a full breakdown of what legal representation costs, read our guide on how much a Social Security Disability lawyer costs. You can also explore what other benefits you may qualify for alongside SSDI.
Also learn more about SSI benefits if your income and resources are limited. And if you are approaching retirement age, it helps to understand what happens to your disability benefits when you turn 65 and how your payments may transition.