The Disability Function Report is issued by the Social Security Administration to obtain a better understanding of your disability and the effect it has on your daily life. The document is used in conjunction with your disability application and medical records to determine if your disability qualifies for benefit payments. The document is not the only determinate, but helps the Disability Determination Specialist complete a full picture of your disability.
Print or type all information on the document making sure that the document is as legible as possible. The form must be completed by you or someone who can assist you, such as a friend or family member. Your doctor or nurse should not complete the form.
Provide answers and explanations for as many questions as possible. If a question does not apply to you or you are unsure of the answer write "does not apply" or "don't know" in the space provided. Try to answer each question if possible, however.
Provide any additional information on page eight of the document if you run out of room at the original question. Mark each explanation on this page with the question number that corresponds to it.
Provide brief but thorough explanations to questions regarding how the disability affects your daily life both at home and in social settings. For example, for question five; "How do your illnesses, injuries or conditions limit your ability to work," your answer should relate to how you are unable to work and not to how your disability causes you to be unable to thrive in other areas of your life.
Provide a list of any medications you take due to your illness, injury or condition(s) that cause any side effects. You must also list the side effect(s) caused. You do not need to list any medicines taken that don't cause side effects or those taken for issues not related to your disability.
Provide the printed name of the individual completing the form and the address and email address (if desired) of the applicant at the end of the form. The individual completing the form does not have to be the applicant. The name and address information must be included otherwise the document will be considered incomplete.