How to Fill Out the Third-Party Function Report

Key takeaways

• The Third-Party Function Report (Form SSA-3380-BK) is an SSA form used to gather information about an applicant’s condition and how it affects their daily functioning.

• It's typically completed by someone who can speak to the applicant's condition, such as a family member, caregiver, or former coworker. It's a 10-page form with questions about the applicant’s daily activities, like household chores, personal care, and social functioning.

• Although it's not required for every case, it is sometimes requested by Disability Determination Services for certain cases.

If the Social Security Administration (SSA) or Disability Determination Services (DDS) requests a Third-Party Function Report, and you are completing the form on an applicant’s behalf, it is important to provide clear, honest, and consistent information.

Learn more about how to fill out a Third-Party Function Report step-by-step, plus tips and example answers for each section.

What is the Third-Party Function Report?

The Social Security Administration’s Third-Party Function Report (Form SSA-3380-BK) is a form used to gather information about an applicant’s condition and how it affects their daily functioning. Typically, someone who can speak to the claimant’s condition completes the form, like a family member, caregiver, or former co-worker.

This 10-page form asks about the applicant's daily activities, like household chores, personal care, and social functioning. It isn't a required part of every application, but DDS sometimes sends it for specific cases, and a lawyer may also ask someone close to the applicant to fill one out to help support the claim.

How to fill out the Third-Party Function Report (SSA-3380) section-by-section

The Third-Party Function Report includes checkboxes and space for written-in answers. Before you download the Third-Party Function Report on ssa.gov, read below to understand expectations and examples for each section:

Section A — General information

Questions 1-7

In Section A, you will provide your name, contact information, and relation to the applicant. The SSA needs this basic information to process and monitor the application. 

Section B — Information about illnesses, injuries, or conditions

Question 8 

Give the SSA a brief description of the applicant’s conditions and symptoms. Explain exactly how they manifest, and how that prevents them from working. 

Tips:

• List all conditions that currently limit their ability to work.

• Only list conditions that have been diagnosed, unless the applicant has something serious that is eluding a diagnosis.

Section C — Information about daily activities

Section C is very detailed, and is meant to give the SSA a full, comprehensive picture of how the applicant copes with the physical and mental demands of daily life.

Tips:

• Describe symptoms on their worst or average days.

• Think about how their activities have looked in the last couple of weeks. If they did something several months ago, that’s not what they’re asking about.

• If they’ve had to modify or avoid any activities to make them more achievable, talk about that. 

• Be specific, concise, and very clear about their limitations.

SSA-3380-BK Sample Answers: Activities of daily living

Here are some sample answers, if these apply to the applicant:

• “They take their dog outside for 10 minutes to go to the bathroom,” not “They walk their dog every day”

• “They make a microwave meal for dinner,” not “They make dinner at 5 pm”

• “They can only wear clothing without buttons or laces,” not “They can dress themselves independently”

• “They only shop at the convenience store near their home, because they will get lost if they go more than a few blocks away,” not “They do their own shopping most of the time”

Question 9

For this question, give a brief list of the applicant’s usual daily schedule or activities. The SSA needs to know about things the applicant did to manage their condition. In a normal conversation, these wouldn’t be worth mentioning — but they’re important to proving the applicant’s limitations.

Be sure to include information that relates to their condition. For example, if the applicant has extreme fatigue as a symptom of a medical condition and naps for three hours each afternoon, include that in your response.

Questions 10-12

These questions address the applicant’s caretaking responsibilities for children, dependents, and pets. This section can be difficult — it may mean admitting that the applicant can't care for others the way they'd like to.

The SSA isn't grading anyone's parenting or caregiving. It's trying to understand how the applicant's condition limits what they can do. If they need help getting kids to school, or someone else walks the dog, say so. Honest answers give the SSA a clearer picture of the applicant's limitations.

Be specific about how much caretaking the applicant actually does and where they need help. If the answers make it sound like the applicant handles everything on their own all day, the SSA may assume they're able to work. Include the tasks others take on and the breaks the applicant needs.

Examples:

• They change their toddler’s diaper a few times a day and feed her baby food. They typically spend 5-6 hours a day watching TV while she sits in her playpen.

• They are at home most of the day with their elderly mother. Their husband bathes their mother and prepares her dinner every day when he gets home from work.

Question 13

This question aims to understand the applicant's abilities before their illness, injury, or medical condition. Your answer to this question should reinforce your earlier answers.

Most of the abilities you list here should relate to work, but you can mention any relevant details to the applicant’s personal life.

Example:

• They used to work construction, but can no longer lift and move heavy objects.

• They used to work on a computer, but looking at screens triggers their migraines.

• They used to take their children to the park every day, but can no longer walk comfortably enough to do so.

Question 14

This question is about how the applicant’s illnesses, injuries, or conditions might affect their sleep. It’s important to keep the response disability-specific.

Questions 15-16 

These questions cover the applicant's personal care routine, which can feel very private and even embarrassing. If the applicant struggles with basics like bathing, dressing, or eating, they may not want to talk about it.

Before you answer, it helps to talk with the applicant about this section. Make sure your answers reflect what really happens day to day, not what you assume.

Questions 17-19

These questions help assess the applicant’s physical abilities, like lifting and walking, as well as some cognitive abilities, like paying for purchases and navigating errands and trips.

Focus on limitations caused by the applicant's condition. If they can't drive because of back pain, say so. If they don't run errands because they don't have a car, that isn't a medical limitation, so be clear about the real reason and don't present it as part of their disability.

Examples:

• They can do some shopping with a motorized cart

• They are unable to drive because of severe back pain

• They sometimes mow the lawn with a rideable mower

Question 20

The question about money often confuses both applicants and the people filling out this form. It isn't asking how much money the applicant has. The SSA wants to know whether they can handle their finances, such as paying bills, counting change, or keeping track of a bank account.

Examples:

• Do they need to use autopay to pay their bills?

• Does someone else need access to their bank accounts (like a family member) to make sure things get paid on time?

Questions 21-22 

These questions cover the applicant's hobbies and activities. Describe how those activities have changed since the applicant's condition started, including anything they've had to stop or cut back on, and how long they can do an activity before they need a break. Make sure these answers match how you've described their abilities in the rest of the form. If the answers make it sound like they can do more in their free time than they could at a job, the SSA may question the rest of the report.

Section D — Information about abilities

Question 23

In this section, you’ll describe how the applicant’s disability affects them in clear, simple terms.

We recommend starting with this question. Then, you can refer back to it as you complete the rest of the report.

Here, the SSA asks questions about how the applicant’s condition affects their physical and cognitive abilities. You might answer questions about:

• Carrying

• Hearing and vision

• How long they can pay attention

• Lifting

• Memory

• Unusual behaviors and fears (like compulsive behaviors)

• Walking

Carefully assess your answers for accuracy. Then, use it as a guide as you complete the rest of the form. As you write your other answers, you can make sure they line up with the abilities listed here.

Question 24

Ideally, medical devices listed here should be prescribed by a doctor, but list them either way. If it’s a solution they found on their own, it’s better if the aid was at least signed off on or endorsed by a doctor, so that it’s mentioned in their medical record. Be sure to mention when and why the applicant needs these medical aids and devices.

Question 25

Here, the SSA wants to know whether the applicant takes medicine for their conditions and whether it causes side effects. The SSA is less likely to consider side effects part of a disability, but they are important to mention. List the medications the applicant uses for their medical condition and include side effects. If you're not sure, it's okay to check "Don't know," but don’t say “None.” The applicant's doctors will list their medications in other parts of the claim.

Section E — Remarks

Use this section for answers you didn’t have enough space for, like the questions about caretaking or additional symptoms. You might not need to complete Section E at all. In that case, write “no remarks,” or “N/A,” rather than leaving it blank.

You don't always need a Third-Party Function Report, but it can add helpful detail to a disability claim, especially when the applicant has trouble describing their own limitations. It may be especially useful when:

• The applicant has a cognitive or mental health condition that makes it hard for them to see or explain how it affects their daily life

• The applicant's condition makes it hard to read, write, or type, so their own Function Report may be incomplete

• A family member or caregiver sees day-to-day struggles that don't show up in medical records, like an adult child caring for an elderly parent

If the applicant needs help filling out their own forms, a friend or family member can also help them complete their Function Report (Form SSA-3373). For children's claims, the SSA uses a different form, the Function Report – Child.

5 Tips on filling out the Third-Party Function Report

To improve the chances of success, consider the following tips when completing the Third-Party Function Report:

1. Review the claimant’s application materials. Before answering questions on the form, look over the applicant’s entire disability application. The SSA will compare answers from different parts of the application, so it is important the information is consistent throughout and avoids contradictions. 

2. Start with question 23. This is a comprehensive question you can use as a guideline when filling out the rest of the answers.

3. Describe the applicant’s worst or average days. When describing the applicant’s limitations, use examples from their worst days, not the days when they function better. The form should highlight how the applicant’s disability negatively impacts their daily life, not about how they’ve managed to succeed and thrive despite it.

4. Focus on the details. You probably care about the person you’re describing in this form and might want to describe their strength, character, or how deserving they are of help. But hold back from doing that in the Third-Party Function report.

5. Add information to the Remarks section. The Third-Party Function report features a section at the end for any additional information you were unable to fit into earlier sections.

Third-Party Function Report vs. Function Report: what’s the difference?

The Third-Party Function report and the Function Report are both forms to gather information about how the applicant’s condition affects their ability to work and complete daily tasks. A third party, like a caregiver or close friend, completes the Third-Party Function Report and provides information about the applicant’s disability. A Function Report, on the other hand, is a form for the applicant to fill out themselves. 

Who shouldn’t use the Third-Party Function Report?

This form isn't required for every application. If DDS sends one to someone close to you, it's important that they fill it out and send it back. Otherwise, it's usually optional, though a lawyer may sometimes recommend one if it would help show how your condition affects your daily life. In most cases, the strongest evidence for your claim is your medical records, such as doctor's notes, test results, and a medical source statement.

A third-party report can help, but only if it's accurate and consistent with the rest of your claim. Before someone fills one out for you, keep a few things in mind:

• Small differences can raise questions. If you say you can't cook but your friend writes that you make dinner most nights, the SSA may question both reports.

• Answers should be in the other person's own words. It's fine to talk through the form together, but if the two reports read almost the same, the SSA may give the third-party report less weight.

• Choose someone who sees your daily life regularly and is comfortable answering detailed questions from DDS.

If you're not sure whether a third-party report would help your claim, a disability lawyer can help you decide what to include.

Bottom Line

The Third-Party Function Report is a 10-page form completed on behalf of an applicant with questions about the applicant's daily activities, like household chores, personal care, and social functioning.

Get help with your disability benefits application

No matter how carefully you’ve filled out the Third-Party Function Report, there’s one key thing you can do to increase your chances of success — get trustworthy legal representation.

Working with a lawyer means your friend or loved one is three times more likely to get the benefits they need. You won't need to pay anything to a disability lawyer unless you win your case, and even then, they’re only allowed to take a set percentage of your first disability check.

Atticus makes it fast, easy, and accessible to find legal representation. Fill out our 2-minute disability benefits quiz, and we’ll get started with finding a disability lawyer who meets your needs.

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