Activities of Daily Living (ADL) Questionnaire for Social Security

After you apply for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) disability benefits, you'll likely have to complete an "activities of daily living" (ADL) questionnaire form. Social Security uses this daily activities questionnaire to help evaluate your functional limitations—that is, how severely your impairment affects your everyday life and your ability to work.

The answers you provide on the activities of daily living questionnaire will have an impact on your disability determination. This article will help explain what the ADL questionnaire asks and how Social Security uses the information you provide to help decide your claim.

What Is the ADL Questionnaire?

The ADL questionnaire is a form with a list of activities of daily living—common activities that everyone who is self-sufficient might be expected to perform. Social Security uses the form to try to determine what your limitations are and what you can still do by asking about things like:

• what you do from the time you wake up until you go to bed
• whether you drive
• whether you can do your own shopping
• what household chores you can do
• whether you prepare your own meals
• what your hobbies and interests are
• how your medical condition affects your sleep, and
• how your condition limits your ability to work.

The ADL questionnaire also asks about your limitations and how your impairment affects basic functions, like walking and dressing yourself. The form will also ask things like:

• if there are things you can no longer do
• whether you take part in any social activities, and
• whether you care for children or pets.

Social Security's disability questionnaire is officially called the Adult Function Report (Form SSA-3373-BK).

What Kind of Questions Are on the ADL Questionnaire Form?

The ADL questionnaire focuses on questions aimed at determining how well you function on a basic level and your ability to live independently. The basic activities of daily living questions ask how well you can take care of your personal needs. These questions focus on activities like:

• bathing
• grooming
• dressing
• toileting
• eating,
• getting in and out of bed, and
• other basic functions.

The Social Security disability questionnaire also asks about your ability to do "instrumental" activities of daily living (IADLs)—the kind of activities you'd need to be able to do to live independently. The IADL questions cover your ability to do things like:

• grocery shopping
• using the phone
• cleaning your home
• getting yourself to doctor appointments
• paying your bills, and
• tending you your yard or garden.

The ADL questionnaire also asks how much help you need with basic and instrumental activities of daily living and whether you need reminders to take medications or shower regularly.

If you have a physical disability, you might be able to handle most or all your IADL functions yourself but need help with your basic functions. Whereas someone with a mental or cognitive disability might be able to function on a basic level but need help with the instrumental activities of daily living.

Why Does Social Security Need to Know About Your Daily Activities?

Social Security uses the ADL questionnaire form to find out exactly how an impairment affects your behavior and activities. The agency then uses that information to determine if you're capable of "participating in substantial gainful activity" (SGA).

Social Security defines SGA as being capable of earning a minimum amount each month—$1,620 in 2025 ($2,700 for blind individuals). If you work and earn more than the SGA limit, you're not eligible to receive disability benefits.

Both physical and mental impairments can have an impact on your ability to cope with daily life and go to work. For example, a back impairment, such as spinal stenosis or degenerative disc disease, could prevent you from doing tasks like:

• driving long distances
• sitting or walking for a long time, or
• doing housework.

A mental condition, such as bipolar disorder or traumatic brain injury (TBI), could cause you to have cognitive issues or behave so inconsistently that you can't manage your own finances or hold on to a job.

It's important to add both physical and mental limitations to the disability questionnaire if you have them.

What Does a Claims Examiner Do With the ADL Form?

The disability examiner will review the ADL questionnaire after you submit it. If the examiner finds that the ADL form indicates you can't perform many basic daily living activities, the examiner might conclude that you can't perform work-related activities either.

But before making a decision, the examiner might try to get additional proof of some of the information on the daily activities questionnaire. The examiner might contact a third party (someone you name on your disability application) to corroborate how you handle a particular daily activity.

Social Security expects that someone who has routine contact with you (other than your spouse) can give an "unbiased" view of your impairment and how it's affected or changed your daily routine. And many people who apply for SSDI or SSI assume that the third party they list on their application will be supportive of their claim for disability, but that's not always the case.

Never assume that anyone who isn't living with your impairment fully understands how it affects your ability to function. Chances are that someone who doesn't live with you isn't completely aware of your pain and suffering or the day-to-day difficulties you now face unless you tell them.

Can Social Security's ADL Calls Hurt Your Claim?

In processing SSDI and SSI claims, Social Security claims examiners might call your friends and relatives, or even a past employer, to gather information about your ability to perform the activities of daily living. These phone calls are known as "ADL calls." Claims examiners use these calls to get more information to try to fill in any gaps regarding your physical limitations.

Unfortunately, ADL calls are often used against disability applicants. Claims examiners can sometimes subtly phrase ADL questions in a way that gets just the right responses so they can more easily justify denying your claim.

How Can You Prepare Your Friends and Relatives for an ADL Call?

It's a good idea to let anyone you list as a third-party reference on your disability application know that Social Security might be contacting them for more information.

Be sure to discuss your claim and your recent symptoms with them, as well as the impact your impairment has had on your ability to function. Let them know about the difference between what you can do on a good day versus a bad day. You might only see friends and relatives on good days, which could lead them to believe you aren't that limited in your ability to walk, sit, pay attention, and so on.

Having an in-depth conversation about the extent of your limitations will help make sure that the person you've asked to vouch for you will give Social Security the information needed to (hopefully) approve your application for disability.

How Will Your Answers to the ADL Questionnaire Affect Your Claim?

The activities of daily living questionnaire is an important part of the disability determination process for most disability applicants. It can be essential if you have a condition that can't be easily verified with lab tests or X-rays, like a cognitive or mental disorder.

The information you provide on the ADL questionnaire can help Social Security see how your impairment affects your everyday life. And it can help back up your claim that your medical condition keeps you from working—but only if you provide detailed answers.

ADLs ask about everything from shopping and getting around (by public transportation or driving yourself) to being able to take care of your personal hygiene and video chat with others. Social Security needs to understand which activities you can't do because of your impairment and which you can only do in a limited manner (and how limited).

For these reasons, it's important to give detailed answers on the ADL questionnaire. When answering the questions about what you do in a typical day, don't just put "nothing"—even if it feels that way. Instead, explain what time you get out of bed—or if you don't get out of bed at all. If you sit in one place all day, explain that.

Learn more about why the ADL form is so important and how your answers can affect your disability claim.