Over 1.8 million people in the United States applied for disability benefits in 2020, but only 648,121 were approved. That means less than 4 in 10 applicants saying they’re too disabled to work met the Social Security Administration’s guidelines. That’s because having a disability doesn’t automatically qualify you for benefits — the only thing the SSA looks at is functionality.
What Is Functionality — and Why Does It Matter?
Your health diagnosis is important. However, it’s also not the biggest consideration in approving or denying you disability benefits. The #1 reason claims get approved or denied is simple: Has your functionality at work changed due to your disability? You could say that the SSA is obsessed with functionality and the role it plays in evaluating disability claims. In plain English, the SSA wants to see how well you function on a day-to-day basis — that’s your functionality level, both at home and potentially at work.
Your Disability Determination Services (DDS) examiner needs to know whether you can function well enough to perform job duties at work. And if you can’t continue at your current job, how long before you can work full-time again? If your doctor expects you to improve in less than a year, the SSA automatically denies you benefits. But let’s say your disability keeps you from working 12 months in a row at your current job. Then, the SSA wants to see if you can function in a similar job with easier tasks. They’re looking for evidence you can’t function at work for 40 hours a week, specifically due to your disability.
Everyone deals with pain and their health issues differently. Even if two people receive the same diagnosis, some naturally cope better or worse than others. What keeps you from working may not stop others from “gainful employment” (i.e., earning enough wages to support yourself). That’s why it’s essential to properly convey your limitations to the SSA in your application using language they’ll clearly understand. If you’ve been denied benefits before, it may be time to apply again using tips we’ll share below. Only this time, explain clearly how much your disability reduces your day-to-day functionality, both at home and at work.
How to Explain Your Current Functionality Limits Clearly On Your Application
Use Adult Function Form SSA-3373-BK to explain your current functionality level. Always be sure to fill the form out accurately and completely. Important: Do not leave any fields or answers on this form blank when you’re filling it out! If you do, your claim may automatically get turned down for benefits, even when questions don’t apply to your situation. Here is what the SSA will ask you:
- How do your illnesses, injuries, or conditions limit your ability to work?
- Describe what you do from the time you wake up until going to bed.
- Do you take care of anyone else such as a wife/husband, children, grandchildren, parents, friend, other?
- What were you able to do before your illnesses, injuries, or conditions that you can’t do now?
Remember, tasks you do at home may also sound like job descriptions, such as cooking, cleaning, child care, errands, etc. So if you can do those activities at home daily without help, you may also perform similar tasks at work.
Five Functionality Report Tips That May Help You Get Approved for Benefits
Want to improve your disability claim’s chances for approval? Follow these five tips when filling out your functionality form to boost your approval odds:
Tip #1: Be honest about your current functionality limits, both on the form and with yourself
Maybe you can’t pick something up off the floor without help, or stand for long without serious pain. The SSA needs to know what things you used to do for eight hours a day, but now can’t. You need to admit how much your disability actually limits your functionality before writing your answers.
Tip #2: Avoid using words like “never,” “always,” and “definitely”
Instead, tell the SSA how your disability makes you do things differently than you did before your diagnosis. How do your symptoms limit your functionality (pain, flexibility, strength, ability to see, hear, etc.)? If you can do something for an hour without pain, could you keep doing it for 40 hours every week? For example: If you’re a bus driver with whiplash, can you turn your head to look both left and right? If whiplash limits your peripheral vision, then it also limits your job functionality as a bus driver.
Tip #3: Be careful explaining daily activities you do now that sound like they could also describe job tasks/duties
Maybe the pain medication you’re on makes you feel dizzy or upsets your stomach. So, you can’t drive or walk without assistance for a few hours without feeling nauseated or falling down. Just because you can walk to and from the kitchen doesn’t mean you can go back to waiting tables full-time. Not sure what your actual functionality limits are? Put this form aside for one week and keep a symptom diary instead. On day 8, read through your notes and reference them while completing your functionality report.
Tip #4: Make sure your answers are short, consistent and match what your doctor says about your functionality limits
If your doctor says you can’t lift more than five pounds, are you still picking up your three-year-old grandson? Maybe your doctor says your head injury makes it hard for you to concentrate eight hours at work. Telling the SSA you like reading makes it sound like you’re able to pay attention better than your doctor expects. Make sure you don’t tell the SSA you can do more than your doctor says you can, especially without help. You may feel like writing detailed notes explaining how hard your life is now compared to before. But for this functionality form, short, consistent answers are always better. Giving too much information doesn’t help your case and could actually hurt your claim’s chances for approval.
Tip #5: Have a friend or relative that knows you well review your functionality answers when you’re done
People who know and love you may notice changes in your functionality levels that you don’t realize yourself. For example: Maybe you walk with a limp now, or stopped reading the paper every morning after your car accident. Things you don’t even notice may prove that your functionality started going down right after your doctor diagnosed your disability. Besides, some states may mail you another form that asks you to list a contact person. Make sure you put down someone who’s familiar with any changes in your functionality level on a daily basis. A partner, caregiver or close neighbor is a better contact person than someone who doesn’t know you well (i.e., landlord).
Understanding the Difference Between Mental and Physical Functionality
Functionality isn’t just about what you physically can or cannot do — and not all symptoms prevent you from gainful employment. Physical functionality explains how well you can walk, sit, stand, get around, lift objects, and perform activities using your body. Many people with physical limitations can still do some basic job tasks, like light office work while sitting down. Mental functionality includes your ability to focus, concentrate, follow directions and interact with others in the workplace. For applicants with a mental impairment, your functionality limits are likely different than someone whose disability involves a physical injury. Questions about your mental functionality can help the SSA figure out how your diagnosis limits your ability to work, including:
- How well do you handle stress? (You may not perform well in customer service-related jobs if you’re diagnosed with PTSD, for example.)
- Have you ever been fired or laid off from a job because of problems getting along with other people? (Again, be honest when answering this question. It’s not about the SSA personally judging your social skills. This is strictly to see if you can work in certain positions based on your background and skill set.)
- How well do you follow written/spoken instructions? For example: If you had a traumatic brain injury, you may have trouble remembering things people tell you to do. But if you’re dyslexic, you may do better in jobs where your supervisor leaves a voicemail explaining your work schedule.
Whatever your condition, the SSA will consider your specific functionality limitations when deciding to approve or deny your claim.
How to Answer Functionality Questions at Your ALJ/Appeal Hearing
The SSA looks at disability applications all day, every day. That makes them excellent at spotting inconsistencies between what you say at your appeal hearing and in your claim paperwork. If you’re asked to attend an appeal hearing, you need to come prepared to answer questions about your current functionality. This is because your administrative law judge (ALJs) will frequently refer to your adult functionality report during this hearing. Your judge will ask, “Are you able to generally take care of yourself?” and “Do you prepare your own food/meals?” If you say “yes” but your functionality report says you can’t dress or feed yourself, the judge will notice this. They may ask you why you reported your inability to do these daily tasks, especially if you’re able to now. You’ll likely lose your case if the ALJ thinks you lied in either your functionality report or at your hearing.
Anytime your daily activities change due to your condition improving or getting worse, be sure to update your functionality report! Your ability to perform everyday tasks can get better or decline over time, especially with a doctor treating your condition. So when you do notice any changes, file a new functionality report with the SSA prior to your ALJ hearing.
Other Documents That Can Prove Functionality Limits Based on Disability
For a rock-solid case, consider submitting other documents along with your functionality report. The best, most convincing evidence for your disability claim will come from an acceptable medical source. Here are a few you can request from your healthcare provider that should help strengthen your disability claim:
- Physical RFC (Residual Functional Capacity) forms
- Mental RFC (Residual Functional Capacity) forms
- Doctor’s letter (specifically explaining any changes in your functionality after diagnosing your disability)
- Medical records (specifically those that discuss changes to your functionality)
- Medical equipment you may require for everyday activities
- Psychiatric evaluations
- Evaluations from a licensed doctor or therapist
- Assessments in functionality changes from case workers, social workers, or vocational experts
You May Qualify for Legal Assistance
If the SSA initially denied your claim, look for any inconsistencies in your functionality report and application paperwork. Anytime the reason isn’t immediately clear, ask a Social Security lawyer to review your claim. An experienced lawyer or disability advocate can check your application for mistakes and ensure it accurately conveys your current limitations. And if you haven’t yet applied, a lawyer can help you complete your application and file it free of charge. Since 38% of applicants get denied benefits for making mistakes on these forms, a lawyer can help you avoid that. And a lawyer can represent you at your appeals hearing, if needed. Our lawyers always work on contingency, so you’ll never pay legal fees unless they help you win benefits.
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