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SUPPORTING STATEMENT FOR FORM SSA3373BK FUNCTION REPORTADULT20 CFR 404.1512 and 20 CFR 416.912OMB No. 09600681A.×Justification1. Sections 205(a), 223(d), and 1631(e) (1) of the Social Security Act
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Function report-adult is a form used to report on the functioning and capabilities of an adult individual who is receiving disability benefits.
The adult individual receiving disability benefits or their representative payee is required to file the function report-adult.
The function report-adult can be filled out online through the official Social Security Administration website or printed and mailed to the SSA.
The purpose of function report-adult is to assess the adult individual's ability to perform daily activities and determine if they are still eligible for disability benefits.
The function report-adult requires information on the individual's daily activities, ability to work, and any changes in their medical condition.
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