We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • Function Report Third Party

Get Function Report Third Party

FUNCTION REPORT ADULT THIRD PARTY Form SSA3380BK READ ALL OF THIS INFORMATION BEFORE YOU BEGIN COMPLETING THIS FORM IF YOU NEED HELP HOW TO COMPLETE THIS FORM The information that you give on this.

This website is not affiliated with any governmental entity

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Function Report Third Party online

The Function Report Third Party form is essential for providing information about a person's activities and abilities for disability claims. Completing this form accurately can significantly influence the determination of eligibility for disability benefits.

Follow the steps to complete the Function Report Third Party online.

  1. Click the ‘Get Form’ button to access the Function Report Third Party form and open it in your preferred editor.
  2. Begin by filling out Section A - General Information. Enter the name of the disabled person, your name, relationship to the disabled person, the date, and your daytime telephone number.
  3. Answer questions regarding your relationship with the disabled person and the time spent together, as well as their living situation in Section A.
  4. Move on to Section B and provide detailed information about the disabled person's illnesses, injuries, or conditions. Describe how these affect their ability to work.
  5. Proceed to Section C and describe the daily activities of the disabled person. Include their personal care, meal preparation, household chores, and social interactions.
  6. In Section D, check the items that the disabled person's conditions affect, and provide detailed explanations for each.
  7. Finally, use Section E - Remarks for any additional information that was not covered earlier. Ensure to complete the provided fields at the bottom of the page with your details.
  8. Once you have filled out all sections, review the form for accuracy. You can then save changes, download, print, or share the completed form as needed.

Complete your documents online effectively and efficiently.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

ADULT - THIRD PARTY Form SSA-3380-BK - Social...
FUNCTION REPORT - ADULT - THIRD PARTY Form SSA-3380-BK ... number provided on the letter...
Learn more
2 Disability and Function - The National Academies...
This includes functional information from the applicant, relevant health care providers...
Learn more
eSOMS Report Function Vulnerability
Feb 10, 2021 — Hitachi ABB Power Grids and the contents hereof must not be imparted to a...
Learn more

Related links form

Town Topics AGENDA ITEM REQUEST FORM Town Manager Have Expressed ... Conditional Use Permit Application LOAN AGREEMENT

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

List people who know your daily life and functioning well and are willing to answer questions about it. Social Security asks for three people, but if you do not have three people who know about your daily functioning, you can list one person and write that there is no one else who knows your condition well.

How to Fill Out an Adult Function Report for Disability (7 Tips) Answer Every Question and Be Honest! ... Answer Only the Questions Being Asked. ... Give as Much Detail as You Can. ... Be Consistent (Some Questions Overlap) ... Be Specific on Question 5 of the Function Report. ... Don't Limit Your Answers to the Space on the Form.

The Form SSA 3380-BK is known as a Third Party Adult Function Report. This form will need to be filled out by a third party such as a friend or family member. It cannot be a medical professional. This person should be close to you, as this form asks very personal questions.

9 tips for filling out the function report Keep your answers consistent. ... Start with question 20. ... Answer questions directly. ... Talk about your average or worst days. ... Be honest and don't exaggerate. ... Send additional information as quickly as possible. ... Talk about all conditions that keep you from working.

The SSA has an optional form called the Function Report that DDS uses when they are in need of additional information about how an applicant is able to function in everyday life.

A Function Report is a multi-page questionnaire about an applicant's activities and how their disabilities impact their daily lives.

List people who know your daily life and functioning well and are willing to answer questions about it. Social Security asks for three people, but if you do not have three people who know about your daily functioning, you can list one person and write that there is no one else who knows your condition well.

Third Party Adult Function Report is a form that Social Security sometimes send to your contact person. This form is usually sent out two or three months after you first apply. It is also sometimes used during Continuing Disability Reviews, for people who are already on disability.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Function Report Third Party
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Function Report Third Party
This form is available in several versions.
Select the version you need from the drop-down list below.
2020 SSA-3380-BK
Select form
  • 2020 SSA-3380-BK
  • 2017 SSA-3380-BK
  • 2009 SSA-3380-BK
  • 2004 SSA-3380-BK
  • 2003 SSA-3380-BK
  • Function Report Third Party
Select form