TIPS IN COMPLETING THE ADULT FUNCTION REPORT (SSA 3373-BK) 

Jun 17

As part of SSA’s disability determination process, SSA will evaluate the severity of an individual’s (Claimant) impairment(s).  One tool that SSA uses to evaluate the severity of a Claimant’s impairment(s) is the Claimant’s ability to complete activities of daily living (ADLs).  In assessing a Claimant’s ADLs, SSA will likely have a Claimant complete a questionnaire known as an “Adult Function Report” (SSA 337-BK).

At several stages during the disability determination process, SSA will review with scrutiny a Claimant’s answers to this questionnaire.  Therefore, the Claimant should take care and time in answering the Adult Function Report questions.

In answering the Adult Function Report questionnaire, the Claimant may wish to consider the following Tips:

Tip 1 Unless a question asks for information concerning how daily activities were performed in the past, the Claimant’s answers should focus on the Claimant’s current situation.

Tip 2 SSA will ask a Claimant to provide information describing what a Claimant does from the time a Claimant wakes up until the time a Claimant goes to bed (Question 6).  A lot of Claimants fail to answer this question which likely causes unnecessary delay in SSA processing the claim.  A Claimant should provide sufficient information that gives SSA a general overview as to how a Claimant spends a typical day.  Because SSA provides limited space to answer this question, the Claimant should provide concise to the point answers.

Tip 3 It is recommend that a Claimant answer each question with complete, concise, accurate and truthful information.  Providing answers that are inaccurate, incomplete, exaggerated or failure to answer a question will likely adversely impact the claim.

Tip 4 If a question pertains to a particular daily activity that now takes longer to complete because of symptoms related to the impairment, such as pain, the need for rest, the need to lie down or the need to take medication, the answer should reflect the Claimant’s difficulty in performing the activity at a reasonable pace.

Tip 5 If a Claimant has good days and bad days, a Claimant should state how a bad day impacts a Claimant performing a specific daily activity as well as how a good day impacts the Claimant performing the activity.

Tip 6 If a Claimant needs help with some daily activities such as shopping, laundry, driving, preparing meals, etc., the Claimant’s answers should reflect that help is needed and the type, frequency and duration of help.

Tip 7 If side effects from medication impact the ability to perform certain daily activities, the Claimant’s answers should reflect how medications impact a particular daily activity.

Tip 8 Don’t use vague answers such as: “I don’t do anything” or “I don’t do a lot”.

Tip 9 Before the Adult Function Report is submitted to SSA, the Claimant should carefully review the answers for accuracy and completeness.

Tip 10 Before the Adult Function Report is submitted to SSA, the Claimant should make a copy for his or her file for reference in the future.

The above Tips are not all encompassing.  It is recommended that an individual applying for social security disability benefits consult with a representative or attorney familiar with representing individuals with social security disability claims.