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Symptoms is a defined term in the Social Security disability regulations, and the definition runs to one line. Under 20 CFR 404.1502(i), symptoms means "your own description of your physical or mental impairment."1 The definition of signs at 404.1502(g) is written by contrast, covering abnormalities "that can be observed, apart from your statements (symptoms)."1 What an applicant writes is a named category of evidence rather than a cover letter. The citations here are to 20 CFR part 404, the regulations for Social Security disability insurance benefits, and parallel provisions for Supplemental Security Income sit in part 416.

What that category can do on its own

Evidence is sorted into five kinds by 20 CFR 404.1513(a). Objective medical evidence is first, medical opinion second, and other medical evidence third.2 Evidence from nonmedical sources is fourth, defined as "any information or statement(s) from a nonmedical source (including you) about any issue in your claim."2 Prior administrative medical finding is fifth.2 The rule on symptoms then bounds the fourth kind: "statements about your pain or other symptoms will not alone establish that you are disabled."3

Seven factors, in the agency's own order

20 CFR 404.1529(c)(3) lists seven factors "relevant to your symptoms, such as pain, which we will consider".3 The first is daily activities, and the second is "the location, duration, frequency, and intensity" of the pain or other symptoms.3 The remaining five cover precipitating and aggravating factors, medication, other treatment, other measures used for relief, and anything else bearing on functional limitations.3 All seven are set out in the appendix below, in the regulation's order.

The form is arranged on a different plan

Form SSA-3373-BK, the Function Report for adults, runs in five lettered sections. Section A takes general information and Section B covers the illnesses, injuries, or conditions. Section C covers daily activities, Section D covers abilities, and Section E is headed Remarks.4 Within Section C the questions run by subject, so that 11 asks about sleep, 14 is headed House and Yard Work, and 18 is headed Hobbies and Interests.4 Seven regulatory factors and the numbered questions of Section C are two arrangements of one subject, and the order of one does not follow the order of the other.

Overflow has an instruction of its own. Where more space is needed, the form directs the writer to the Remarks section on page 10, "and show the number of the question being answered."4 A remark that carries no number leaves the reader to work out which question it answers. The instruction at the head of the form is equally direct: "DO NOT LEAVE ANSWERS BLANK."4 The form adds that where the answer is not known, or is none, or does not apply, the writer should say so rather than leave the box empty.4

A deadline counted in business days

Under 20 CFR 404.935(a), each party "must inform us about or submit any written evidence, as required in § 404.1512, no later than 5 business days before the date of the scheduled hearing."5 Where that is missed, "the administrative law judge may decline to consider or obtain the evidence," unless paragraph (b) applies.5 Paragraph (b) applies only where the judge has not yet issued a decision, and it names three circumstances.5 The first is that the agency's action misled the person, and the second is a physical, mental, educational, or linguistic limitation that prevented earlier submission.5 The third is some other unusual, unexpected, or unavoidable circumstance beyond the person's control.5

20 CFR 404.1512(a)(1) opens "In general, you have to prove to us that you are blind or disabled."6 The next sentence adds a duty to inform the agency about or submit "all evidence known to you that relates to" that question.6 The paragraph then makes the duty continuing, requiring disclosure of "any additional related evidence about which you become aware."6

What the account is read for, and what it is not read for

Social Security Ruling 16-3p, effective March 28, 2016 and republished in 2017, removed the term credibility from the agency's sub-regulatory policy.7 In its place is a two-step evaluation: first whether a medically determinable impairment could reasonably be expected to produce the alleged symptoms, and second how far those symptoms limit the ability to perform work-related activities.7 The ruling adds that "in evaluating an individual's symptoms," adjudicators "will not assess an individual's overall character or truthfulness in the manner typically used during an adversarial court litigation."7

Where our work sits

What a condition prevents, what a medical source should record, and how a file will be weighed are not ours to answer. Those belong to the applicant, to the medical sources, and to the adjudicator. We do not give legal advice and we do not give medical opinions.

What a client sends us goes no further. We compare a date in one answer with the date in another. We set a limitation described in Section C beside the way it is described in Section D, and we check a remark for the question number the form asks for. Where an answer says less than the applicant told us, we ask rather than fill it in.

There is a companion form. SSA-3380-BK is completed by someone who knows the applicant, and its instruction is plain: "It is important that you tell us what you know about the disabled person's activities and abilities."8 The applicant does not write the third-party report and does not control what it says. Two accounts of the same weeks are then prepared by two people who are not consulting each other.

Appendix: the seven factors listed in 20 CFR 404.1529(c)(3)

The regulation introduces them as factors "relevant to your symptoms, such as pain, which we will consider".3 The first is daily activities. The second is "the location, duration, frequency, and intensity" of the pain or other symptoms. The third is precipitating and aggravating factors. The fourth is the type, dosage, effectiveness, and side effects of any medication taken to alleviate the pain or other symptoms.3

The fifth is treatment other than medication received for relief. The sixth is any measure used to relieve the pain or other symptoms, for which the regulation gives "standing for 15 to 20 minutes every hour" as one of three examples. The seventh is other factors concerning functional limitations and restrictions due to pain or other symptoms.3

References

  1. Office of the Federal Register, Electronic Code of Federal Regulations, 20 CFR 404.1502, Definitions for this subpart, current as of August 2026. https://www.ecfr.gov/current/title-20/chapter-III/part-404/subpart-P/section-404.1502
  2. Office of the Federal Register, Electronic Code of Federal Regulations, 20 CFR 404.1513, Categories of evidence, current as of August 2026. https://www.ecfr.gov/current/title-20/chapter-III/part-404/subpart-P/section-404.1513
  3. Office of the Federal Register, Electronic Code of Federal Regulations, 20 CFR 404.1529, How we evaluate symptoms, including pain, current as of August 2026. https://www.ecfr.gov/current/title-20/chapter-III/part-404/subpart-P/section-404.1529
  4. Social Security Administration, Form SSA-3373-BK, Function Report, Adult, edition 08-2026. https://www.ssa.gov/forms/ssa-3373-bk.pdf
  5. Office of the Federal Register, Electronic Code of Federal Regulations, 20 CFR 404.935, Submitting written evidence to an administrative law judge, current as of August 2026. https://www.ecfr.gov/current/title-20/chapter-III/part-404/subpart-J/section-404.935
  6. Office of the Federal Register, Electronic Code of Federal Regulations, 20 CFR 404.1512, Responsibility for evidence, current as of August 2026. https://www.ecfr.gov/current/title-20/chapter-III/part-404/subpart-P/section-404.1512
  7. Social Security Administration, Social Security Ruling 16-3p, Titles II and XVI: Evaluation of Symptoms in Disability Claims, effective March 28, 2016, republished at 82 FR 49462. https://www.ssa.gov/OP_Home/rulings/di/01/SSR2016-03-di-01.html
  8. Social Security Administration, Form SSA-3380-BK, Function Report, Adult, Third Party, edition 12-2023. https://www.ssa.gov/forms/ssa-3380.pdf

A worked example: Function Report, Daily Activities and Remarks

Social Security Function Report, Adult, Form SSA-3373-BK

The form carries two instructions that decide how an answer is filed. One is printed at the head of the form: "DO NOT LEAVE ANSWERS BLANK." The form adds that where the answer is not known, or is none, or does not apply, the writer should say so rather than leave the box empty. The second governs overflow, directing the writer to the Remarks section on page 10 "and show the number of the question being answered." Separately, 20 CFR 404.1529(c)(3) lists seven factors an adjudicator considers, among them "the location, duration, frequency, and intensity" of the symptoms. The extract below is reproduced unchanged in both panels. Every date, figure, and question number in the revision comes from the extract or from an instruction printed on the form, and every other phrase is the applicant's own. What a condition prevents is the applicant's to say and the medical sources' to record, and nothing here decides it.

Before

SPECIMEN, PREPARED BY EDITFAST FOR ILLUSTRATION. NOT A REAL RECORD.
Prepared for Dana Merrow (fictitious), Form SSA-3373-BK, Section C and Remarks

EXTRACT FROM THE APPLICANT'S INTAKE SHEET (reproduced unchanged in both panels)
IS-1 The applicant gives March 4, 2025 as the date the back pain began.
IS-2 The applicant's words for the standing limitation: about ten minutes before I have to sit down.
IS-3 The applicant reports sleeping in a recliner since May 2025.
IS-4 Household help: a neighbor shops once a week. No other help is reported.
IS-5 The applicant reports no hobbies at present and asked that this be recorded.
IS-6 Question numbers on this form: 6 asks about the daily routine, 11 asks about sleep, 14 is headed House and Yard Work, 16 is headed Shopping, and 18 is headed Hobbies and Interests.

SECTION C - INFORMATION ABOUT DAILY ACTIVITIES

6. Describe what you do from the time you wake up until going to bed.
I get up and it takes a while. The pain started in early 2025. Some days I manage and some days I do not. I try to move around but I cannot stand for long.

14a. List household chores, both indoors and outdoors, that you are able to do.
Not much anymore.

18a. What are your hobbies and interests?

REMARKS
I have been sleeping in the chair since last spring because lying flat is worse. My neighbor does the shopping.

After

SPECIMEN, PREPARED BY EDITFAST FOR ILLUSTRATION. NOT A REAL RECORD.
Prepared for Dana Merrow (fictitious), Form SSA-3373-BK, Section C and Remarks

EXTRACT FROM THE APPLICANT'S INTAKE SHEET (reproduced unchanged in both panels)
IS-1 The applicant gives March 4, 2025 as the date the back pain began.
IS-2 The applicant's words for the standing limitation: about ten minutes before I have to sit down.
IS-3 The applicant reports sleeping in a recliner since May 2025.
IS-4 Household help: a neighbor shops once a week. No other help is reported.
IS-5 The applicant reports no hobbies at present and asked that this be recorded.
IS-6 Question numbers on this form: 6 asks about the daily routine, 14 is headed House and Yard Work, 16 is headed Shopping, and 18 is headed Hobbies and Interests.

SECTION C - INFORMATION ABOUT DAILY ACTIVITIES

6. Describe what you do from the time you wake up until going to bed.
I get up and it takes a while. The back pain began on March 4, 2025. I try to move around. I can stand about ten minutes before I have to sit down. Some days I manage and some days I do not.

14a. List household chores, both indoors and outdoors, that you are able to do.
[Query to the applicant: IS-4 records that a neighbor shops once a week and no other help. It does not record which chores you still do. Please tell us, so this answer is yours rather than ours.]

18a. What are your hobbies and interests?
None.

REMARKS
Question 11. I have slept in a recliner since May 2025 because lying flat is worse.
Question 16. My neighbor does the shopping once a week.

What changed, and why

WasNowReason
I get up and it takes a while. The pain started in early 2025. Some days I manage and some days I do not. I try to move around but I cannot stand for long.I get up and it takes a while. The back pain began on March 4, 2025. I try to move around. I can stand about ten minutes before I have to sit down. Some days I manage and some days I do not.IS-1 gives a date where the answer gave a season. IS-2 gives the applicant's own words for the standing limitation, and the answer carried a phrase with no duration in it. The other three sentences are the applicant's own, carried over from the answer as written.
Not much anymore.[Query to the applicant: IS-4 records that a neighbor shops once a week and no other help. It does not record which chores you still do. Please tell us, so this answer is yours rather than ours.]The intake sheet records who shops and does not record what the applicant still does indoors or outdoors. Writing an answer from the shopping entry would make the answer ours rather than the applicant's, so the line carries a query.
(question 18a has no answer)None.The answer was blank, and the form says DO NOT LEAVE ANSWERS BLANK. IS-5 records that the applicant asked for none to be recorded.
I have been sleeping in the chair since last spring because lying flat is worse. My neighbor does the shopping.Question 11. I have slept in a recliner since May 2025 because lying flat is worse. / Question 16. My neighbor does the shopping once a week.The form asks that a remark show the number of the question being answered, and neither remark did. IS-6 records that 11 asks about sleep and 16 is headed Shopping. IS-3 gives the month and the word recliner, IS-4 gives the frequency, and the applicant's stated reason is left in place in the applicant's own words.

Final specimen (PDF, 4 KB) Marked-up specimen (PDF, 7 KB)

Specimen prepared by EditFast for illustration only. Not a real document, record or filing. Any resemblance to an actual organization, person or record is unintended. Not legal, regulatory, clinical or professional advice.

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