OMB control number

Work Activity Report--Employee

OMB 0960-0059 · SSA.

OMB 0960-0059

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.

The latest form for Work Activity Report--Employee expires 2028-07-31 and is listed under ICR 202409-0960-008.

View the official OMB control history on Reginfo.gov.

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202409-0960-008 Revision of a currently approved collection 2024-12-16
202111-0960-004 Revision of a currently approved collection 2021-11-22 Approved without change
202108-0960-003 No material or nonsubstantive change to a currently approved collection 2021-08-10 Approved without change
202106-0960-006 No material or nonsubstantive change to a currently approved collection 2021-06-29 Approved without change
202008-0960-020 No material or nonsubstantive change to a currently approved collection 2020-08-27 Approved without change
201806-0960-004 Revision of a currently approved collection 2018-10-08 Approved without change
201505-0960-008 Reinstatement with change of a previously approved collection 2015-07-31 Approved without change
201204-0960-020 No material or nonsubstantive change to a currently approved collection 2012-06-01 Approved without change
201110-0960-003 Revision of a currently approved collection 2012-01-19 Approved without change
201103-0960-022 No material or nonsubstantive change to a currently approved collection 2011-04-08 Approved without change
200811-0960-005 Revision of a currently approved collection 2009-04-14 Approved without change
200603-0960-010 Extension without change of a currently approved collection 2006-03-22 Approved without change
200302-0960-003 Extension without change of a currently approved collection 2003-02-27 Approved without change
200001-0960-003 Revision of a currently approved collection 2000-01-11 Approved without change
199709-0960-006 Reinstatement without change of a previously approved collection 1997-09-17 Approved without change
199402-0960-003 Revision of a currently approved collection 1994-02-02 Approved without change
199306-0960-002 Revision of a currently approved collection 1993-06-15 Approved without change
199003-0960-003 Extension without change of a currently approved collection 1990-03-19 Approved without change
198906-0960-020 No material or nonsubstantive change to a currently approved collection 1989-06-26 Approved with change
198704-0960-007 Revision of a currently approved collection 1987-04-27 Approved without change
198404-0960-004 Revision of a currently approved collection 1984-04-17 Approved without change
198203-0960-012 Revision of a currently approved collection 1982-03-24 Approved without change
198004-0960-002 Reinstatement without change of a previously approved collection 1980-04-02 Approved without change
197912-0960-007 No material or nonsubstantive change to a currently approved collection 1979-12-31 Approved with change
197907-0960-006 No material or nonsubstantive change to a currently approved collection 1979-07-31 Approved with change
197903-0960-019 No material or nonsubstantive change to a currently approved collection 1979-03-28 Approved with change
197503-0960-002 No material or nonsubstantive change to a currently approved collection 1975-03-18 Approved with change
197411-0960-001 Revision of a currently approved collection 1974-11-14 Approved without change

OMB Details

SSA-821-BK - In Office Responses

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Information collection instruments
FormNameElectronic accessType
Form SSA-821-BKWork Activity Report – Employeewww.ssa.govForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.