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Form SSA-3373

Function Report - Adult

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Form reference

Before you begin.

Use these notes as a starting point. Check the issuing agency’s current form and instructions for your client’s situation.

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Gather Necessary Personal and Medical Information

Before starting Form SSA-3373, ensure you have your personal details such as full name, Social Security number, and contact information. Collect information about your medical conditions, healthcare providers, and medication. This preparation ensures that you have all the needed data for a smooth form completion process.

Details worth checking

Ensure No Blank Sections

Leaving sections blank on Form SSA-3373 can lead to delays in processing, as it may be unclear if the omission was intentional. Instead, use 'does not apply' to indicate non-relevant sections. Complete responses ensure efficient processing without unnecessary follow-ups.

Provide Detailed Explanations

Failing to provide detailed narratives about how your conditions limit your ability to work can weaken your application. Detailed descriptions are vital for a thorough evaluation of your claim.

Specify Assistance for Activities

Not indicating if you perform activities with assistance can affect the assessment of your disability. It's important to specify any help you receive for a complete understanding of your limitations.

Correct Social Security Number

An incorrect or incomplete Social Security number can lead to the immediate rejection of your application. Accurate details are crucial for proper identification and processing.

Include Daytime Telephone Number

Omitting your daytime telephone number can hinder communication regarding your application. A reliable contact number ensures you can be reached for essential updates or clarifications.

Utilize 'REMARKS' Section Correctly

Failing to properly utilize the 'REMARKS' section can prevent important additional information from being considered. Proper referencing to question numbers is necessary for clarity.

Complete General Information Section

Incomplete general information, such as missing name or contact details, can impede the processing of your application. Complete and accurate details are essential for identification and communication.

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