How to Handle an Adult Function Report Third Party Form (SSA-3380-BK)

Robin Mead

Third Party Adult Function report is a form that Social Security sometimes send to your contact person.

If you spoke to Social Security on the phone, or filled out an Activities of Daily Living Questionnaire, they may have asked you for the name of a person who is familiar with your daily life.

This is the person they will contact. If you listed more than one question, they will contact several.

They may send a form, or they may call this person, or they may do nothing and your contact person may never hear from them.

This form is usually sent out two or three months after you first apply. It is also sometimes used during Continuing Disability Reviews, for people who are already on disability.

What is This Form?

The reason Social Security sends out this form is to see what your contact person writes about your daily activities and to see if this is similar to what you and your doctor write.

When Social Security reads this form, they are looking for consistency. They are looking to see that what your contact person writes is similar to what you write and that is similar to what your doctor writes and to everything else in your file. It does not need to be exactly the same, but they will look to see if anything is significantly different.

In some cases, this form can be a small help to your case, however, at the end of the day, this form is not the most important thing. The most important thing is your medical records.

How to Complete This Form

Social Security does not expect (or want) your contact person to be a doctor or give any kind of medical opinion.

They are simply asking the person to write down anything they have personally seen that might be helpful. It is a good idea to check in with your contact person and talk about this form.

If your contact person does not know your daily life very well, they can simply write “I do not know” for any questions they do not know. For example, your contact person may not be with you in the bathroom when you bathe or brush your hair, so they may not know if you have any problems in that area.

It is always best to tell the truth and it is always better to write “I don’t know” then to guess or make something up.

If your contact person writes down any activities you do, it is helpful if they can also mention one of these things, if it applies to you:

  1. If they help you in any way with this activity
  2. If they have seen someone else help or assists you with this activity
  3. If they have seen that you have any struggles or limits with this activity (any way it is different now than how it used to be before you became disabled)

There are some more suggestions for how to give good, accurate answers to questions about daily living activities on this page: How to Fill Out an Activities of Daily Living Questionnaire

“My Contact Person Does Not Want to Answer Questions”

This form can be useful, but it is not a requirement. Your contact person is not required to complete the form and they are not required to answer every question. If you contact person does not respond, Social Security will make a decision based on the other records in your file.

If the form does not get returned, Social Security may contact you and ask you to remind your contact person about the form, or ask you for the name of another contact person, but they cannot require another person to answer questions about you.

Learn More

How to Greatly, Greatly (Greatly!) Improve Your Disability Application

Everything You Need to Know About Social Security Disability Reviews

1 thought on “How to Handle an Adult Function Report Third Party Form (SSA-3380-BK)”

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s