
Form SSA3373 (062020) Discontinue Prior Editions Social Security AdministrationPage 1 of 10 OMB No. 09600681FUNCTION REPORT ADULT READ ALL OF THIS INFORMATION BEFORE YOU BEGIN COMPLETING THIS FORM.
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How to fill out the Function Report- Adult - Form SSA-3373-BK online
Completing the Function Report- Adult (Form SSA-3373-BK) is an essential step in providing the Social Security Administration with a comprehensive view of your daily activities and limitations. This guide will help you navigate the online process of filling out this important form.
Follow the steps to effectively complete your Function Report- Adult.
- Press the ‘Get Form’ button to access the form online and open it for editing.
- Begin by filling out Section A, which includes your general information. Provide the name of the person with a disability, social security number, and daytime contact information.
- In Section B, describe how your illnesses, injuries, or conditions limit your ability to work. Be as detailed as possible.
- Proceed to Section C, which focuses on your daily activities. Answer questions regarding your routine from waking up to going to bed, including personal care, meals, and household chores.
- Continue to Section D where you will detail how your conditions affect your abilities across various areas such as lifting, walking, and following instructions.
- If necessary, utilize the ‘Remarks’ section on Page 10 to provide any additional information that was not covered in the previous sections.
- Finally, review all your entries for accuracy, then save and download the completed form. You may also print or share it as needed.
Complete your Function Report- Adult online today to ensure your disability claim is processed efficiently.
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