Function Report - Adult

Individuals receiving or applying for SSDI or SSI must provide medical evidence and other proof SSA requires to prove their disability. SSA staff, and, on our behalf, State Disability Determination Services’ (DDS) employees, collect the information via paper Form SSA-3373, or through an in-person or telephone interview for cases where we need information about a claimant’s activities and abilities to evaluate the claimant’s disability. We use the information to document how claimants’ disabilities affect their ability to function, and to determine eligibility, or continued eligibility, for SSI and SSDI claims. The respondents are adult Title II and Title XVI claimants, or current recipients undergoing redeterminations of benefits.

The latest form for Function Report - Adult expires 2026-09-30 and is listed under ICR 202104-0960-006.