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Navigating the Form SSA 3373 BK for Social Security Disability in Connecticut

Posted by James Aspell | Mar 12, 2024 | 0 Comments

SSA Adult Function Report and Your Disability Appeal

Social security disability form

The completion of Form SSA 3373 BK, the Adult Disability Function Report, is pivotal for individuals applying for Social Security Disability Benefits in Connecticut. This document serves as a crucial piece of evidence in your case, providing the Social Security Administration (SSA) with essential details about your medical condition and its impact on your ability to work and perform daily activities.

Understanding the Significance of Form SSA 3373 BK

Similar to other legal proceedings, the success of Social Security Disability claims heavily relies on documentation. While the format of pre-hearing discovery for Social Security may differ from other cases, the information sought remains similar. Your responses to the SSA's inquiries about your employment history, medical impairments, and functional limitations play a significant role in determining the outcome of your claim.

Form SSA 3373 BK: Key Considerations

Form SSA 3373 BK is one of the crucial forms the SSA requires disability applicants to complete. Your responses on this form provide insights into how your medical conditions affect your daily functioning and capacity to work. Failing to provide detailed and accurate information on this form can negatively impact your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) claim.

Tips for Completing Form SSA 3373 BK

Completing Form SSA 3373 BK can be daunting, but here are some tips to help you navigate the process effectively:

  1. Keep a Detailed Activity Diary: Before completing the form, maintain a diary documenting your daily activities for three consecutive days. Include details such as tasks performed, duration, and any challenges faced.

  2. Avoid Exaggeration: While describing your limitations, refrain from exaggerating. Provide honest and specific details about your abilities and restrictions.

  3. Provide Specific Details: Be specific when describing your limitations and how they impact your daily life. Provide concrete examples to support your answers.

  4. Maintain Consistency: Ensure consistency in your responses across all sections of the form and align them with information provided by your medical providers.

  5. Take Your Time: Carefully read each question, take time to consider your response, and write it down accurately. Seek assistance if needed to ensure clarity.

  6. Document Good and Bad Days: Describe both your good and bad days, including how your symptoms fluctuate over time.

Handling Specific Sections of Form SSA 3373 BK

The form consists of several sections, including:

  • General Information
  • Information About Your Medical Conditions
  • Information About Daily Activities
  • Information About Abilities
  • Remarks

Each section requires thoughtful responses tailored to your unique situation. Provide detailed information about your medical conditions, daily activities, and functional limitations to ensure a comprehensive assessment by the SSA.

Next Steps After Completing Form SSA 3373 BK

After completing and submitting Form SSA 3373 BK, the SSA will review your claim along with other supporting documentation. Be prepared for a waiting period as the SSA evaluates your case. Consider seeking legal assistance to navigate the complex disability claims process effectively.

Completing Form SSA 3373 BK is a crucial step in the Social Security Disability application process. By providing detailed and accurate information on this form, you enhance your chances of securing disability benefits. Remember to seek assistance from experienced professionals if needed to ensure a successful claim outcome.

If you're considering applying for Social Security Disability benefits in Connecticut, it's crucial to understand the significance of Form SSA 3373 BK and how to navigate its completion effectively. Here are some additional insights to help you through the process:

Understanding the Importance of Form SSA 3373 BK

Form SSA 3373 BK serves as a critical tool for the Social Security Administration to evaluate your disability claim. Your responses provide essential details about how your medical conditions impact your daily life and ability to work. Therefore, thorough and accurate completion of this form is vital to the success of your claim.

Tips for Successful Completion

To ensure your Form SSA 3373 BK accurately reflects your situation, consider the following tips:

  • Be Detailed: Provide specific details about your limitations, symptoms, and how they affect your daily activities. The more information you provide, the better the SSA can assess your disability claim.

  • Be Honest: While it's essential to highlight your challenges, avoid exaggeration. Provide truthful and realistic descriptions of your abilities and limitations.

  • Seek Assistance if Needed: If you find any questions confusing or challenging to answer, don't hesitate to seek assistance from a trusted source, such as a legal representative or healthcare provider.

  • Use Attachments: If the space provided on the form is insufficient to fully explain your situation, attach additional pages with detailed explanations. Clearly indicate on the form that supplementary information is attached.

Navigating Specific Sections

Each section of Form SSA 3373 BK requires careful attention. Here are some tips for navigating specific sections:

  • General Information: Provide accurate details about your personal information and living situation. Include any relevant information about dependents or caregivers.

  • Information About Your Medical Conditions: Describe your medical conditions and how they affect your ability to work. Use specific examples and provide information about treatments and medications.

  • Information About Daily Activities: Detail your daily routine, including tasks you can and cannot perform independently. Be honest about any assistance you require for daily activities.

  • Information About Abilities: Provide detailed information about your physical and mental abilities, including any limitations or challenges you face. Be specific about tasks you struggle with and how they impact your daily life.

  • Remarks: Use this section to provide any additional information that may support your disability claim. Be concise but thorough in your explanations.

Seeking Legal Assistance

Navigating the Social Security Disability application process can be complex, especially when completing forms like SSA 3373 BK. Consider seeking guidance from a qualified attorney experienced in disability law. An attorney can provide valuable assistance in completing forms, gathering supporting documentation, and advocating for your rights throughout the claims process.


Completing Form SSA 3373 BK is a crucial step in the Social Security Disability application process. By following these tips and seeking assistance if needed, you can ensure that your responses accurately reflect your situation and enhance your chances of a successful disability claim. Remember, you don't have to navigate this process alone—legal assistance is available to help you every step of the way.


About the Author

James Aspell

Principal since August 1, 2006 James F. Aspell is the principal and managing attorney of the firm which he started in 2006 following 20 years of litigation practice in a mid -size firm in Hartford, Connecticut. Jim focuses his practice in the areas of worker's compensation and personal injury l...


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