What the Disability Function Report Actually Asks

The Disability Function Report (Form SSA-3373-BK) is the Social Security Administration's way of understanding how your condition affects your daily life. It is not a medical form — your doctor fills out a separate report. This form asks you to describe, in your own words, what you cannot do because of your impairment.

The report has six main sections: personal information, daily activities, work-related activities, medical treatment, education and work history, and additional remarks. Most readers get stuck on the daily activities section because it asks open-ended questions like "Tell us about your ability to lift and carry objects" or "Describe how your condition affects your ability to remember things." There is no word limit, but Social Security expects concrete examples, not general statements.

A common mistake is answering too briefly. "I cannot lift heavy things" tells Social Security nothing. "I cannot lift a gallon of milk with my right arm because of pain in my shoulder, and I drop things when I try" tells them something they can evaluate against the medical evidence your doctor submitted.

Key Takeaways

  • The Disability Function Report asks you to describe how your condition limits you in daily life, not to diagnose yourself or explain your medical condition.
  • Each answer should include a specific example of what you tried to do, what happened, and why your condition prevented you from doing it successfully.
  • Social Security compares your written answers to your medical records and your doctor's report, so contradictions between them will delay your case.
  • Overstating your limitations (saying you cannot do anything) is as harmful as understating them, because exaggeration signals unreliability to the examiner.
  • The form is available as a PDF on the Social Security website, and you can print it, fill it by hand, or type your answers and print the completed form.

How to Structure Your Answers with Real Examples

Each answer should follow a three-part structure: what you tried to do, what your condition did to prevent it, and what the result was. Here is how that looks in practice.

Example 1: Lifting and Carrying Weak answer: "I cannot lift things because of my back." Strong answer: "I tried to carry a basket of laundry up the stairs last week. After three steps, I felt sharp pain in my lower back and had to set it down. I had to make five trips instead of one, and by the third trip I was limping. The next day my back was stiff and I could not bend over to pick things up."

Example 2: Memory and Concentration Weak answer: "I have trouble remembering things." Strong answer: "My daughter gave me a grocery list of five items last Tuesday. I read it three times before leaving the house. At the store, I forgot two items and bought things that were not on the list. I had to call her from the store to ask what I was supposed to get. This happens every time I shop without writing things down when ready."

Example 3: Standing and Walking Weak answer: "I cannot stand for long periods." Strong answer: "I stood at the kitchen counter making dinner for 20 minutes last night. My feet started hurting after about 10 minutes, and by 15 minutes my legs felt weak. I had to sit down for 10 minutes before I could finish cooking. I cannot stand longer than 15 minutes without needing to sit."

Sections That Cause the Most Confusion

The "Daily Activities" section asks about personal care, household chores, hobbies, and social activities. Social Security wants to know whether you can bathe yourself, prepare meals, do laundry, shop, manage money, and spend time with others. Do not skip questions because you think they are not relevant — answer every one, even if your answer is "I can do this without problems."

The "Work-Related Activities" section asks about your ability to follow instructions, get along with coworkers, handle stress, and manage a schedule. You do not need to have worked recently to answer these questions. Social Security is asking whether you could do these things if you tried, based on your condition. If you have not worked in five years, describe what would happen if you tried to work now.

The "Medical Treatment" section lists every doctor visit, medication, and treatment you have received. Be thorough here. If you see a physical therapist twice a week, a rheumatologist once a month, and take three medications, list all of it. Social Security uses this section to check whether your medical records match what you reported.

What Not to Do: Common Errors That Delay Cases

Do not write "I am disabled and cannot work" as your answer to every question. Social Security already knows you are explore for disability. They need to understand what specifically prevents you from working, not a restatement of your claim.

Do not contradict your medical records. If your doctor's report says you can walk 30 minutes without pain, do not write that you cannot walk five minutes. If there is a real difference between what your doctor observed and what you experience at home, explain it: "My doctor's exam showed I can walk 30 minutes in the office, but at home I have tried to walk to the mailbox (about 50 feet) and had to stop after 20 feet because of pain. The difference may be that I was not moving around much before the appointment."

Do not leave blank spaces. If a question does not explore to you, write "Not applicable" or "N/A" rather than leaving it empty. A blank space looks like you did not understand the question or did not try to answer it.

Do not use medical jargon you do not understand. Write "I have pain in my lower back" rather than "I suffer from lumbar radiculopathy" unless you are certain that is the correct term and you use it naturally. Social Security wants your description, not a copy of your diagnosis.

Matching Your Answers to Your Medical Records

Before you submit the form, read through your medical records if you have them. Your doctor's notes from the past three months should roughly match what you wrote. If your doctor wrote "patient reports pain with prolonged standing" and you wrote "I cannot stand at all," that contradiction will raise questions.

If there is a mismatch, do not change your answer to match the records. Instead, explain the difference in the "Additional Remarks" section. "My doctor examined me for 15 minutes and I was able to stand for that time, but I was in pain the whole time and could not have stood longer. At home, I usually cannot stand longer than 10 minutes before the pain forces me to sit."

Social Security expects some variation between what you report and what your doctor observed. Doctors see you for short periods in controlled settings. You live with your condition every day. A reasonable explanation of the difference actually makes your case stronger, not weaker.

Where to Find the Form and How to Submit It

The Disability Function Report is available as a PDF on the Social Security Administration website under "Forms." The form number is SSA-3373-BK. You can read it, print it, and fill it by hand, or you can open it in Adobe Reader or another PDF editor and type your answers directly into the form fields.

If you are explore for SSDI or SSI, Social Security will mail you this form after you submit your initial process. You typically have 10 days to return it, though you can request an extension if you need more time. Return it by mail to the address on the cover letter, or bring it to your local Social Security office in person.

Keep a copy for your records before you mail it. If Social Security loses it or says they never received it, you will have proof that you submitted it on time.

How Social Security Uses Your Answers

A disability examiner reads your Disability Function Report alongside your medical records and your doctor's statement. They are looking for consistency: do your descriptions of what you cannot do match the medical evidence? Do your examples sound realistic, or do they sound exaggerated?

The examiner is not trying to catch you in a lie. They are trying to understand whether your condition prevents you from working. If you describe realistic limitations that match your medical records, the examiner can move forward with evaluating your case. If your answers are vague, contradictory, or seem exaggerated, the examiner will ask for more information, which delays your case.

Your answers also help Social Security understand what kind of work you might still be able to do. If you can walk 30 minutes, sit for two hours, and lift 10 pounds, Social Security will look for jobs that fit those limits. If your answers are too vague to understand your actual limits, the examiner cannot make that assessment.

Frequently Asked Questions

Can I type my answers or do I have to write by hand?

You can do either. If you type, print the completed form and sign it by hand. If you write by hand, make sure your handwriting is legible — if the examiner cannot read your answer, they may ask you to resubmit it. Typing is usually faster and easier to read.

What if my condition changes between when I fill out the form and when Social Security reviews it?

Tell your local Social Security office in writing. Send a letter describing what has changed and when it changed. Do not wait for Social Security to ask — volunteering new information shows good faith and prevents delays if they discover the change on their own.

Should I mention treatments I have tried that did not work?

Yes. If you tried physical therapy for three months and it did not improve your condition, mention it in the medical treatment section. Social Security wants to know what you have done to manage your condition, including things that did not help. That information supports your claim that your condition is not easily treated.

What if I do not remember the exact dates of my doctor visits?

Write the month and year if you remember them, or write "approximately" and your best estimate. Social Security will verify the dates against your medical records anyway. Approximate dates are fine as long as you are not deliberately hiding information.

Can I have someone else fill out the form for me?

You can have someone help you, but you must sign the form yourself and the answers must be yours. If Social Security suspects someone else wrote the answers, they may ask you questions to verify that you understand what you submitted. Write your own answers in your own words.