The agency will conduct a non-substantive change to update this information collection after the revised form is issued. In addition, the agency will provide timely update to OMB regarding any concerns raised by claimants, SSA personnel, or advocates regarding how the removal of income information or other supplemental information historically provisioned by SSA has impacted the burden or quality of submissions.
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
07/31/2028
36 Months From Approved
07/31/2025
411,300
0
411,300
445,610
0
205,650
0
0
0
SSA uses Form SSA-821-BK to collect employment information to determine whether individuals have worked after becoming disabled and, if so, whether the work is SGA. We use the information to make a determination of eligibility for disability payments. Specifically, we use Form SSA-821-BK to obtain information from individuals during the initial SSI and SSDI claims process; the Continuing Disability Review (CDR) process; and appeals involving work issues. An SSA employee may fill out the form during an in office or telephone interview, or the applicants or recipients may fill it out themselves. SSA reviews and evaluates the data to determine if the applicant or recipient meets the disability requirements of the law. If respondents work when they apply for benefits, they must complete this collection to obtain SSI or SSDI. The respondents are SSDI applicants or recipients, and SSI applicants.
US Code:
42 USC 423
Name of Law: Social Security Act
US Code:
42 USC 1383b
Name of Law: Social Security Act
When we last cleared this information request in 2021, the burden was 205,650 hours. However, we are currently reporting a burden of 244,145 hours. This change stems from an increase in the average burden per response. We last reported an average burden of 30 minutes, but now are adding categories of response with burdens of 40 and 45 minutes. Although the average burden per response changed, SSA did not take any actions to cause this change. These figures represent current Management Information data.
* Note: The total burden reflected in ROCIS is 445,610, while the burden cited in #12 of the Supporting Statement is 244,145. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + a rough estimate of a 30-minute, one-way, drive burden + learning costs. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Form SSA-821-BK Work Activity Report – Employee
Addendum - 0059 (Final).docx
SSA-821-BK - In Office Responses