Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.
What is ssa 3373 function report?
The SSA-3373 Function Report is a form used by the Social Security Administration (SSA) to collect information about an individual's ability to perform daily activities and tasks. It is typically used during the evaluation process for disability benefits claims. The form asks detailed questions about an individual's physical and mental capabilities, including their ability to stand, walk, sit, lift, concentrate, remember, and interact with others. The information provided in the report helps the SSA assess the individual's functional limitations and determine their eligibility for disability benefits.
Who is required to file ssa 3373 function report?
The SSA-3373 Function Report is typically completed by individuals who are applying for Social Security Disability benefits or updating their disability status with the Social Security Administration. This report helps the SSA assess an individual's daily activities, abilities, and limitations to determine their eligibility for disability benefits.
How to fill out ssa 3373 function report?
To fill out the SSA 3373 function report, follow these steps:
1. Start with your personal information:
- Provide your full name, Social Security Number, and contact information.
- Include the name and contact information of a person who knows about your condition and can provide additional information if needed.
2. Section 1: Describe your daily activities:
- Explain what activities you can and cannot do due to your physical or mental condition.
- Mention if you need assistance in performing any tasks.
3. Section 2: Ability to complete tasks:
- Check the boxes that best describe your capability to perform certain tasks.
- Provide details on your limitations and difficulties in doing specific activities.
4. Section 3: Physical abilities and limitations:
- Explain how your physical condition affects your ability to perform tasks such as standing, walking, bending, lifting, handling objects, etc.
- Provide details about any assistive devices you require.
5. Section 4: Mental abilities and limitations:
- Describe how your mental condition affects your ability to concentrate, understand, remember, follow instructions, and interact with others.
- Mention any difficulty you face in handling stress, changes in routine, or conflicting instructions.
6. Section 5: Medications and side effects:
- List all the medications, dosages, and frequency you take.
- Describe any side effects or limitations caused by medications.
7. Section 6: Medical treatments:
- Mention any ongoing medical treatment, therapy, or consultations you receive.
- List the names and contact information of your medical providers.
8. Section 7: Other impairments or limitations:
- Describe any additional impairments or limitations that impact your daily activities.
9. Section 8: Information from others:
- Include statements or reports from individuals who are aware of your condition, such as doctors, therapists, employers, or family members.
10. Section 9: Remarks:
- Use this section to provide any additional information not covered in earlier sections.
11. Sign and date the form:
- Review all the information provided and sign the form along with the date.
- Enclose any supporting documents or medical records, if available.
Remember to be honest and thorough while filling out the form. Use additional attachment sheets if necessary to provide more details about your condition and limitations.
What is the purpose of ssa 3373 function report?
The SSA 3373 Function Report, also known as the Adult Function Report, is a form used by the Social Security Administration (SSA) to assess an individual's ability to perform daily activities and work-related tasks. The purpose of this report is to gather information about an individual's physical and mental functioning, limitations, and their ability to carry out activities of daily living (such as personal care, household chores, and social interactions).
The information provided on this form is used by the SSA in the evaluation process for disability claims, specifically for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. The details provided in the report help determine if the individual qualifies for disability benefits based on their impairments and limitations, and how these limitations affect their ability to work and function in daily life.
What information must be reported on ssa 3373 function report?
The SSA 3373 Function Report is a form used by the Social Security Administration to gather information about an individual's daily activities and ability to function in various areas. The information reported on this form includes:
1. Personal information: Name, address, SSN, contact information.
2. Medical conditions: A list of all physical and mental impairments or illnesses that affect the individual's ability to function.
3. Daily activities: A description of the individual's typical daily routine, including activities such as personal care, household chores, cooking, shopping, and recreation.
4. Ability to work: Information about the individual's ability to perform work-related tasks, including physical activities, lifting, standing, sitting, and any limitations or difficulties experienced.
5. Social functioning: Information about the individual's ability to interact with others, maintain relationships, and participate in social activities.
6. Concentration and memory: A description of any difficulties in focusing, paying attention, remembering, or following instructions.
7. Medications and treatments: Details about the medications, treatments, and therapies the individual is receiving for their conditions.
8. Assistance received: Information about any help or support the individual receives from others in performing daily activities or managing their conditions.
9. Changes in abilities: Any changes in the individual's abilities over time, including improvements or worsening of their conditions.
10. Other relevant information: Any other information that the individual feels is important to share regarding their daily activities and functioning.
It is important to provide honest and detailed information on the SSA 3373 Function Report to help the Social Security Administration assess the individual's eligibility for disability benefits.
What is the penalty for the late filing of ssa 3373 function report?
The Social Security Administration (SSA) does not explicitly state a penalty for the late filing of the SSA-3373 Function Report. However, it is generally advisable to file the form as soon as possible to prevent any delays in processing your application or potentially having your benefits denied or delayed. It is important to comply with SSA guidelines and deadlines to ensure a smooth application process.
How can I get function report - adult?
It's simple with pdfFiller, a full online document management tool. Access our huge online form collection (over 25M fillable forms are accessible) and find the function report - adult in seconds. Open it immediately and begin modifying it with powerful editing options.
How do I make changes in function report - adult?
pdfFiller not only allows you to edit the content of your files but fully rearrange them by changing the number and sequence of pages. Upload your function report - adult to the editor and make any required adjustments in a couple of clicks. The editor enables you to blackout, type, and erase text in PDFs, add images, sticky notes and text boxes, and much more.
How do I edit function report - adult straight from my smartphone?
The pdfFiller mobile applications for iOS and Android are the easiest way to edit documents on the go. You may get them from the Apple Store and Google Play. More info about the applications here. Install and log in to edit function report - adult.
