SSA-3380 Function Report – Adult (Third Party) Fillable PDF

The SSA-3380 is the official Function Report – Adult – Third Party used by the Social Security Administration (SSA) to evaluate an adult’s ability to work when a third party provides information about the claimant’s daily functioning.

Our fillable PDF version lets you complete the form directly in your browser, save your progress, and download a completed, printable copy—all without installing any software.

What Is Form SSA-3380?

This form collects detailed information about the disabled person’s physical, mental, and social abilities. It is required when a family member, caregiver, or other knowledgeable person is asked to describe the claimant’s functional limitations.

How to Complete the SSA-3380 Online

• Click the "Fill out this form" button below.
• The Formize PDF Filler app will load automatically.
• Enter the requested information in each fillable field. Use the tab key to move quickly between sections.
• When you finish, click Save & Download to get a PDF you can print or email to the SSA.

Common Mistakes to Avoid

• Leaving fields blank: Incomplete sections cause processing delays.
• Illegible handwriting: Even though the form is fillable, any handwritten notes should be clear.
• Using the wrong date format: Use MM/DD/YYYY as required by the SSA.
• Providing vague answers: Specific examples (e.g., "needs assistance dressing for 30 minutes each morning") help the SSA assess the claim accurately.

Where to Find Help

If you have questions while filling out the SSA-3380, you can:

• Call the phone number listed on the SSA request letter.
• Ask the person who asked you to complete the form for clarification.
• Review the instructions printed on each page of the PDF.

Ready to start? Click the button below to open the fillable form.