Section-by-Section Map
| Section | Questions | What it covers |
|---|
| A. General Information | 1 to 4 | Name, Social Security number, daytime phone, where and with whom you live |
| B. Information About Daily Activities | 5 to 18 | Your wake-to-bed day, caring for others and pets, sleep, personal care, meals, house and yard work, getting around, shopping, money, hobbies, social activities |
| C. Information About Abilities | 19 to 20 | The checkbox grid of affected functions, walking distance, attention span, instructions, stress, routine changes, assistive devices |
| D. Remarks | n/a | Open space for anything that did not fit, plus the signature block |
Section B is the longest and carries the most weight. Section C question 19 is where examiners look first.
How to Answer Section A
Straightforward identification. Use your legal name and the Social Security number on the claim, not a spouse's. Question 4 asks where you live (house, apartment, boarding house, nursing home, shelter, group home, or other) and with whom (alone, with family, with friends, other).
Do not skip the living arrangement. If you moved in with your daughter because you can no longer manage stairs or cook safely, that fact belongs here and it supports everything that follows.
How to Answer Section B, Daily Activities
Question 5, describe what you do from the time you wake up until going to bed. This is the single most important answer on the form and the one most people rush. Write it as a timeline with real times, and include the parts that are unpleasant to admit.
Weak: "I get up, watch TV, take naps, go to bed."
Stronger: "I wake around 6:30 but stay in bed until about 8:00 because my back stiffens overnight and I need my morning medication to work before I can stand. I shower sitting on a bench, about every other day, because standing that long makes me dizzy. I eat cereal because I cannot stand at the stove. Most afternoons I walk to the mailbox and back, roughly 100 feet, then rest 20 minutes. I nap from about 2:00 to 4:00. I do not cook dinner. I am in bed by 8:30 but wake three or four times from pain."
Length is not the point. Specific numbers are: how many minutes, how many feet, how many times, how often.
Questions 6 to 8, caring for others and pets. Answer honestly, then qualify. Say what you actually do and what someone else does. "I feed the dog and let him into the fenced yard. My son walks him because I cannot hold the leash if he pulls." Saying "no" when your file shows you are a single parent is the kind of inconsistency that costs claims.
Question 9, what were you able to do before that you cannot do now. This is the before-and-after question. Be concrete and work-flavored. "I framed houses and carried 80-pound bundles of shingles up a ladder. Now I cannot carry a gallon of milk from the car."
Question 10, sleep. Explain the mechanism, not just the fact. Waking six times a night from nerve pain, or sleeping 14 hours and still feeling exhausted, both matter, and both explain why you cannot sustain a workday.
Question 11, personal care. There is a checkbox to mark if you have no problem with personal care. Do not check it reflexively. The form lists dressing, bathing, caring for hair, shaving, feeding yourself, using the toilet, and other. For each one affected, say how: "I wear slip-on shoes because I cannot bend to tie laces or reach my feet." Subparts b and c ask whether you need reminders for grooming or for medication.
Question 12, meals. What you prepare, how often, how long it takes, and what changed. "Frozen dinners and sandwiches, about five minutes, daily. Before my hands started going numb I cooked full meals four nights a week. I burned myself twice in April, so my husband handles the stove now."
Question 13, house and yard work. List what you can still do, how long it takes, how often, whether you need help or encouragement, and if you do none of it, why. An answer like "I can fold laundry sitting down, about 10 minutes at a time, then I have to stop" is far more useful to an examiner than either "I do chores" or "I do nothing."
Question 14, getting around. How often you go outside, how you travel, whether you can go alone, and whether you drive. If you drive rarely, short distances only, or only on good days, say exactly that.
Question 15, shopping. Where, what for, how often, and how long it takes. "Grocery store twice a month, about 20 minutes, leaning on the cart the whole time. My daughter drives and lifts the bags."
Question 16, money. Whether you can pay bills, count change, handle a savings account, and use a checkbook or money orders, plus an explanation for every "no." This matters more than it looks in claims involving depression, anxiety, brain injury, or cognitive decline, because trouble managing money supports a finding of limited concentration and persistence.
Question 17, hobbies and interests. What they are, how often and how well you do them, and what changed. Watching television counts, and so does the honest version: "I put on the TV most of the day but I lose track of the plot and rewind constantly."
Question 18, social activities. Time spent with others, places you go regularly, whether you need reminders to go, whether someone has to come along, problems getting along with family or neighbors, and what changed.
How to Answer Section C, Abilities
Question 19a is a grid of checkboxes covering lifting, squatting, bending, standing, reaching, walking, sitting, kneeling, talking, hearing, stair climbing, seeing, memory, completing tasks, concentration, understanding, following instructions, using hands, and getting along with others. Check everything your condition affects, then use the explanation space to quantify each one. A checked box with no explanation is close to worthless. The form itself gives the model: how many pounds, how far.
The rest of question 19 asks whether you are right or left handed, how far you can walk before stopping and how long you must rest before resuming, how long you can pay attention, whether you finish what you start, how well you follow written and spoken instructions, how well you get along with authority figures, whether you have ever been fired over problems getting along with people, how you handle stress, how you handle changes in routine, and whether you have noticed any unusual behavior or fears.
Answer the walking question in feet or blocks with a rest time attached. "About half a block, then I have to sit for 10 minutes" is usable. "Not far" is not.
Question 20 lists assistive devices: crutches, cane, walker, wheelchair, brace or splint, artificial limb, artificial voice box, hearing aid, glasses or contact lenses, and other. It also asks which were prescribed, by whom, when, and when you need to use them. A cane your neighbor gave you still counts, but note that it was not prescribed. If a doctor prescribed it, say so, because a prescribed device is medical evidence.
Section D, Remarks
Use it. Almost nobody does. This is where the things the checkboxes cannot hold go:
- Good days and bad days. "Two or three days a week I can do most of what I described. The other four I do not get dressed."
- Medication side effects. Drowsiness, nausea, and brain fog limit function just as the underlying condition does.
- Context for a "yes." If you checked that you shop in stores, say that it takes three times as long as it used to and you lie down for the rest of the day afterward.
- Why someone else completed the form, if you could not.
If you run out of room anywhere, attach a blank sheet, write the question number, and put your name and Social Security number at the top so it stays with your file.
The Deadline, and What Happens If You Miss It
The DDS cover letter typically asks for the form back within 10 days. That date is an administrative request, not a statutory cutoff. Social Security's own policy (POMS DI 11018.005) requires giving claimants at least 15 calendar days to respond to an initial evidence request, requires a follow-up notice if nothing arrives, and bars a denial for insufficient evidence earlier than 30 days from the date of the original request.
| What | Timing |
|---|
| Date requested on the DDS cover letter | Usually 10 days |
| Minimum response time SSA policy requires | At least 15 calendar days |
| Earliest an insufficient-evidence denial is allowed | 30 days from the original request date |
None of that is a reason to be late. A claim denied for insufficient evidence or failure to cooperate gets no medical review at all, and rebuilding it costs months. If you need more time, call the number on the cover letter before the date passes and ask for an extension. Examiners grant them routinely.
Return it the way the letter says to. The form directs you to send it to the office that requested it, which is DDS, not your local Social Security field office. Many offices accept fax or electronic upload, and SSA's Upload Documents service handles dozens of forms and evidence types. Check the cover letter first, and keep a copy of everything you send.
Mistakes That Sink Claims
Describing your best day. Examiners read "I walk my dog daily" as evidence you can be on your feet daily. Write the typical day, and use Remarks to describe the bad ones and how often they happen.
Leaving answers blank. The form's own instructions say not to. If an item does not apply, write "none," "does not apply," or "don't know." A blank looks like avoidance, or like a missing answer the examiner has to guess at.
One-word answers. "No," "some," "not much," and "a little" give an examiner nothing to translate into a functional limit. Numbers and durations do.
Overstating. Writing that you never leave the house when your file shows monthly physical therapy visits does more damage than an accurate answer would. Since 2016, under SSR 16-3p, Social Security no longer judges "credibility" as a character question. It asks whether your statements are consistent with the rest of the record. One contradiction can taint the whole form.
Letting someone else write it in their voice. A relative can hold the pen, but the answers have to be yours, and the form has a block for whoever completed it. Do not ask a doctor or hospital to fill it out. The instructions specifically say not to.
Forgetting mental symptoms in a physical claim. Chronic pain that wrecks your concentration, or depression that grew out of two years of disability, belongs here. Questions 16 through 19 are built for it, and limits on concentration, persistence, and pace often matter more than lifting limits do.
Copying the old one. When the second Function Report arrives at reconsideration, answer it fresh for where you are now, and say plainly if things have gotten worse.
How the Answers Get Used
The examiner combines your form, any third-party form, and your medical records into a residual functional capacity assessment: how much you can lift, how long you can stand, sit, and walk, and what mental tasks you can sustain. That assessment is compared against the work you did in the past five years, then against other work in the national economy, factoring in your age, education, and skills.
Earnings are measured separately. In 2026, wages above $1,690 a month ($2,830 if you are blind) generally count as substantial gainful activity and block approval no matter what the Function Report says. The Function Report answers the other question: not what you earn, but what you can still do.
Frequently Asked Questions
How long do I have to return Form SSA-3373?
The cover letter from Disability Determination Services usually asks for it within 10 days. SSA policy requires at least 15 calendar days to respond and prohibits an insufficient-evidence denial earlier than 30 days after the original request. Call the number on the letter and ask for an extension rather than sending it late.
What happens if I do not send it back?
Social Security can decide your claim on whatever is already in the file, and can deny it for insufficient evidence or failure to cooperate. That kind of denial happens without a full medical review. If you submit the information during the appeal period afterward, SSA generally treats it as an implied request for reconsideration.
Can someone else fill out the SSA-3373 for me?
Yes. Someone can help you write or complete it, and the form asks for the name, address, and date of the person who completed it. The answers still have to describe you and your limitations. A separate observer's version exists as Form SSA-3380-BK, the Third-Party Function Report.
Does the Function Report decide my case by itself?
No. It is weighed together with medical records, treatment history, work history, and sometimes a consultative examination. It is influential because it is the main record of how your condition plays out day to day, and because examiners check it against everything else for consistency.
Should I say I have good days and bad days?
Yes, and say how many of each. Social Security is deciding whether you can sustain work on a regular and continuing basis. A person who can function two days out of seven cannot hold a full-time job, but only if the record says so plainly. Section D is the place to say it.
Where do I get a blank SSA-3373-BK?
Social Security posts it at ssa.gov/forms. Use the current version rather than an old saved copy, and if DDS mailed you a form with a barcode or claim number printed on it, return that one so it routes to your file.
Does answering "yes" to driving or shopping hurt my claim?
Not on its own. Limited activity is not the same as the ability to work full time. What hurts is an unqualified "yes." Say how often, how long, how far, who helps, and what it costs you afterward.
