When you apply for Social Security Disability, you must fill out an SSD Function Report. This report is called form SSA-3373, and you can find a copy here.
Social Security attorneys and medical professionals refer to this as an ADL questionnaire (Activities of Daily Living). This is one of the most important parts of your application. Sadly, many people don’t spend the time to fill it out properly. Here are some tips to assist you in filling out your SSA-3373 Function Report form well.
5 Tips To Help You Fill Out the SSD Function Report
1. Be honest!
We can’t stress this enough: your activities of daily living will be compared with your medical records. The people evaluating your disability claim see thousands of these forms and review even more medical records. If you exaggerate the things you can’t do or your symptoms, it will show and you’ll damage your claims credibility. This will negatively affect your claim in the future, even if it goes to a hearing before an Administrative Law Judge. The Function Report is one of the first things an Administrative Law Judge (ALJ) will look at when reviewing your claim. If the ALJ doesn’t think your claim is credible, it will be almost impossible to get a favorable decision.
2. Be thorough and don’t procrastinate.
Keep track of the deadlines Social Security gives you to submit your report. You need to send it back on time and it could take several hours to complete it well. Be sure to plan a specific amount of time to sit down and thoroughly complete SSA-3373.
3. Pay special attention to Question 5.
Question 5 on the SSD Function Report asks, “How do your illnesses, injuries, or conditions limit your ability to work?” Don’t just list symptoms of your conditions here. Specifically describe what tasks you couldn’t do at your former jobs that caused you to stop working or be terminated. Also, remember Social Security will evaluate the work you have done for the past 15 years. Maybe you left one job due to a disability and tried another job but still could not do that job. Make sure you include the issues you had at both jobs.
Be Specific on Question 5
You need to show exactly how your disability impacted you at your specific job. Here are some examples of what you could include in this section of the SSD Function Report:
- I could no longer type on a keyboard or write memos.
- I could not lift and carry (my tools or supplies), and I often dropped (things).
- My job required a lot of walking, which I can no longer do.
- I could no longer climb stairs or a ladder to (work on rooftops).
- I could no longer bend over to (pick up things) on the job.
- My medication made me dizzy and I could no longer (operate a machine).
- I could no longer be around my co-workers or work with the public due to (depression, anger, hallucinations, anxiety).
- I could not complete (tasks) on time because I could not stay focused.
- Side effects of my medications prevent me from (completing work tasks).
- I was no longer able to understand instructions or follow orders from supervisors to complete (work assignments) on time.
- I became tired and had to take more breaks than were allowed.
- My vision even with glasses was too poor to see well enough to (complete work tasks).
- I was missing too many days at work due to my condition and doctor visits.
- I could not stand on my feet long enough to complete (work tasks).
Never include answers such as bad economy, company downsizing, or “boss hired a younger person to do my job.” Even if these things affected you, this is not the place to include this information.
4. Don’t limit any of your answers because the form only has a few lines.
Write or type your answers on a separate piece of paper and title it “QUESTION RESPONSES.” On the form, write in “PLEASE SEE SEPARATE PAGE(S) FOR ANSWERS.”
Take all the space you need to fully and accurately describe your limitations. Remember, you want to paint a full picture of what your life is like. It’s fine if that takes a bit more space.
5. Question 6 can make or break your claim. Be honest but be clear and complete.
Question 6 of the SSD Function Report can be tricky. It asks you to describe what you do from the time you wake up until you go to bed at night. Most people with disabilities have “good days” and “bad days”. Make sure you clearly identify and describe what you do on a good day and on a bad day. You can give an honest estimate of how many good days you have a week. Always be very, very, very complete.
Here is an example of what a COMPLETE good day description may look like:
“If I’m having a good day (about 4 per week), I wake up at 7 a.m. I can get out of bed and go to the bathroom. My (wife, husband, partner, etc.) helps me bathe and gets my medication. This can take about an hour. Around 8 a.m., I have coffee and microwave breakfast. I use mostly paper plates and bowls because doing dishes is too hard.
“My medication affects my concentration, so I open my mail and read it before the medication side effects kick in. Sometimes I make a phone call or two to make a doctor’s appointment or arrange for a ride. If a friend or family member has left a message, I call them back. I rarely can answer the phone before it goes to voicemail. But this is okay since I don’t like to talk to people much anyway.
“Around 10 a.m. I lie down on the couch and turn the TV on. Usually I put on talk shows. I don’t pay too much attention to them. They just make me feel like I have a friend around that I don’t have to talk to. Usually, I fall asleep on the couch because my medication makes me sleepy and I wake up around 1 p.m. If the news is on I turn it off. It’s too depressing and makes me feel like I’m missing out on what’s going on in the world.
“I then eat lunch; usually a sandwich or microwaved leftovers. I usually use the bathroom after lunch and around 2:30 I go outside to get my mail. My driveway is about 25 yards and I feel accomplished when I get my own mail. If the weather is nice, I sit on my porch for a bit and enjoy some fresh air.”
A COMPLETE description of a bad day may be like this:
“If I am having a bad day (about 3 per week), the pain wakes me up around 4 a.m. I have a bell next to my bed so I can alert my (husband, wife, partner, etc.) to help me. They give me my medicine and help me use the bathroom. I lie back in my bed and hope the pain gets better. I don’t even try to get out of bed and I just try to get in a comfortable position. Sometimes listening to music helps to distract me from the pain, and I can go back to sleep.
“Around 12:30 p.m. my (husband, wife, partner, etc.) comes home from work to check on me and bring me something to eat. I try to eat something and then they help me use the bathroom again. If I feel a little better I will go lie on the couch and put the TV on.
“Usually I put on talk shows, but I can’t pay too much attention to them. They just make me feel like I have a friend around that I don’t have to talk to. I take more medicine and take a nap for a few hours. When my (husband, wife, partner, etc.) gets home around 5 p.m., they wake me up and make me dinner. Sometimes they help me take a bath, and then I go back on the couch for another hour or two.”
If you include household chores in your description:
Maybe you do household chores during the day. Be very clear how you do them. Describe how long it takes, if someone helps you, or if you have to take breaks or rest between activities. For example:
“I can put clothes in the front-loading washing machine; I use a basket that has wheels to help me. Then I go lie down and rest. When it’s done washing, I have a chair that I sit on in front of the washing machine. I sit and slowly move the clothes into the front-loading dryer. When my (husband, wife, partner, etc.) gets home, they unload the dryer and we both do the folding. They put away the clean laundry for me.
If you’ve been denied Social Security Disability (SSD) benefits, look to Brooks Law Group. Our team of SSD lawyers will fight for you and help you through the claims process. We can help you with your case no matter where you live. Contact us today or give us a call at 1-800-LAW-3030 to set up a free case review!
This post was originally published on April 14, 2017, and has been updated for accuracy and comprehensiveness on October 26, 2020.