Activities of Daily Living (ADL) Questionnaire

Social Security uses the ADL questionaire to determine how your disability affect your daily life.

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Individuals who apply for Social Security Disability (SSD) or SSI will most likely be asked to complete an Activities of Daily Living (ADL) questionnaire. Social Security uses the ADL questionnaire to help evaluate how severely a medical impairment affects a person's life, according to the functional limitations placed on both work activities and daily living activities.

What Is the ADL Questionnaire?

The ADL questionnaire is a form listing common activities that everyone who is self-sufficient may be expected to perform, such as mowing the lawn, grocery shopping, dressing, and yes, going to work. Social Security has an official form for this purpose, Form SSA-3373, Function Report. Social Security will use this form to gauge exactly how an impairment affects an individual’s behavior, and, thus, to determine if that individual is capable of participating in substantial gainful activity (SGA). (Participating in SGA means earning a minimum amount each month. If you work and earn more than the SGA work limit, you are not eligible to receive disability benefits).

Both physical and mental impairments can have an impact on a disability claimant’s ability to cope with daily life. For example, a back impairment, such as stenosis or degenerative disc disease, could prevent someone from mowing the lawn or driving long distances. And a mental condition, such as bipolar disorder or traumatic head injury, could cause someone to behave so erratically they can’t hold on to a job.

What the Examiner Will Do With the ADL Form

If an ADL form indicates to the disability examiner that a claimant can’t perform simple daily living activities, the examiner may conclude that the claimant is unable to perform work-related activities as well. However, SSA often attempts to get additional proof of any information given by a claimant: The SSA may contact a third party, someone whom the claimant names on his or her disability application, to corroborate any information on an ADL.

It is expected that a third party who has routine contact with the claimant will be able to give an “unbiased” view of the impairment and how it has affected or changed the claimant’s daily routine. Many people who apply for SSD/SSI assume that the third party they list on their application will be supportive of their claim for disability, but this is not always the case. Never assume that anyone who is not living with your impairment fully understands how it affects your ability to function. Chances are an outsider is not fully aware of your pain and suffering, or the day-to-day difficulties you now face, unless you tell them.

Ensure Possible Parties to Your Claim Are Aware

It is a good idea to let anyone whom you list as a third-party reference on your disability application know that Social Security will probably be contacting them for more information. Be sure to discuss your claim and your symptoms, as well as the impact your impairment has had on your ability to function. Only then can you be sure that the person you have asked to vouch for you will give Social Security the information needed to (hopefully) approve your application for disability.

For more information about Social Security contacting friends and family, see our article on ADL calls. For more information in general, see our article on the importance of the ADL form.

Updated by: , J.D.

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