# Form SSA-3373

URL: https://pdf.net/pdf-forms/healthcare-forms/form-ssa-3373
Category: Healthcare Forms
Attributes: Trusted by students

Form SSA-3373 is a report submitted to the Social Security Administration (SSA) that details how your physical or mental disability affects your daily life and ability to work.

You’ll find a printable Form SSA-3373 on our website, where you can immediately open it and begin filling it out with a single click. Simply type your information directly using our PDF editor, and your document will be completed in no time.

## Versions

- 2024 — [download PDF](https://cdn.sanity.io/files/i16te7yp/production/9339dd4aeec4c77a10f40bbb73a0b401759752c2.pdf)

## How to Fill Out Form SSA-3373

Step 1: Open Form SSA-3373 in our PDF editor.

Step 2: Complete Section A with your personal information.

Step 3: Write about your illnesses, injuries, or conditions in Section B.

Step 4: Describe your limitations in daily activities, abilities, and social interactions, according to the Form SSA-3373 instructions.

Step 5: If you need more space, add your comments in the Remarks section.

Step 6: Complete your contact information and submit the form.

## Facts

### What Is Form SSA-3373 Used For?

Form SSA-3373, also known as the Function Report, is a document describing exactly how your physical and mental disabilities affect your daily functioning and ability to work. It’s used to determine your eligibility for disability payments and other benefits.

### Who Should Use Form SSA-3373?

Form SSA-3373 should be used by individuals with mental or physical disabilities and injuries that limit their daily activities enough for them to qualify for Social Security benefits.

### When Is the Form SSA-3373 Due?

Form SSA-3373 doesn’t have a universal due date; rather, the deadline is 10 days after you receive the letter from the Social Security Administration requesting it. The exact date will be indicated in the letter, but you can contact the SSA to request an extension if needed.

### What Happens If Form SSA-3373 Is Not Submitted?

If Form SSA-3373 isn’t submitted, your disability benefits claim may be delayed or denied due to a lack of information about your limitations.

### How and Where Do I File Form SSA-3373?

You should file Form SSA-3373 with the Social Security Administration, either by delivering it to your local Social Security office or submitting it electronically.

## Related forms

- [Form SSA-3441](https://pdf.net/pdf-forms/healthcare-forms/ssa-3441-form)
- [Form SSA-561-U2](https://pdf.net/pdf-forms/legal-forms/form-ssa-561-u2)
- [Form SSA-827](https://pdf.net/pdf-forms/legal-forms/ssa-827-form)
- [VA Form 21-526EZ](https://pdf.net/pdf-forms/military-forms/va-form-21-526ez)
- [VA Form 21-0781](https://pdf.net/pdf-forms/military-forms/va-form-21-0781)