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Form SSA3373 (102020) Discontinue Prior Editions Social Security Administration Page 1 of 10 OMB No. 09600681FUNCTION REPORT ADULT READ ALL OF THIS INFORMATION BEFORE YOU BEGIN COMPLETING THIS FORM
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How to fill out function report- adult function

01
To fill out a function report for an adult function, follow these steps:
02
Start by providing your personal information, including your name, address, and contact information.
03
Next, provide details about your current employment status, such as your job title and employer's name.
04
Describe any physical or mental health conditions that limit your ability to work or perform certain tasks.
05
Explain how these limitations affect your daily activities, including any difficulties you experience in completing work-related tasks.
06
Provide information about any medical treatments or therapies you are currently undergoing to manage your condition.
07
Describe any assistive devices or accommodations you require to perform your job duties.
08
Include any additional details or supporting documentation that can help evaluate your functional capacity.
09
Review the completed function report, ensuring all sections are properly filled out and accurate.
10
Submit the function report as instructed, either by mail or online, depending on the application process.
11
Remember to be thorough and honest when filling out the function report, as it plays a crucial role in determining eligibility for certain benefits.

Who needs function report- adult function?

01
The function report for adult function is needed by individuals who are applying for disability benefits or seeking accommodations in the workplace due to physical or mental health conditions that impact their ability to work.
02
This report is usually required as part of the application process for government assistance programs, such as Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
03
Additionally, individuals who are seeking workplace accommodations may need to provide a function report to their employer or human resources department as supporting documentation for their request.
04
In essence, anyone who is experiencing functional limitations due to a health condition and wishes to access disability benefits or workplace accommodations may need to fill out a function report.
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The function report - adult function is a form used to assess how an adult's medical condition affects their ability to perform everyday activities and interact in social situations.
Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) may be required to file a function report - adult function as part of their application process.
To fill out the function report - adult function, individuals should provide detailed information about their daily activities, limitations, social interactions, and how their condition affects these areas. It's important to be specific and honest in describing challenges.
The purpose of the function report - adult function is to gather comprehensive information about an adult's functional limitations due to their medical condition to aid in the evaluation of their eligibility for disability benefits.
Information that must be reported includes personal details, an account of daily activities, social interactions, abilities in areas like grooming, household tasks, and any limitations faced due to physical or mental health conditions.
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