Work Activity Report--Employee

OMB 0960-0059

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. We are making minor revisions the form and the notices.

The latest form for Work Activity Report--Employee expires 2021-12-31 and can be found here.

Latest Forms, Documents, and Supporting Material
All Historical Document Collections
Revision of a currently approved collection 2021-11-22
Approved without change
No material or nonsubstantive change to a currently approved collection 2021-08-10
Approved without change
No material or nonsubstantive change to a currently approved collection 2021-06-29
Approved without change
No material or nonsubstantive change to a currently approved collection 2020-08-27
Approved without change
Revision of a currently approved collection 2018-10-08
Approved without change
Reinstatement with change of a previously approved collection 2015-07-31
Approved without change
No material or nonsubstantive change to a currently approved collection 2012-06-01
Approved without change
Revision of a currently approved collection 2012-01-19
Approved without change
No material or nonsubstantive change to a currently approved collection 2011-04-08
Approved without change
Revision of a currently approved collection 2009-04-14
Approved without change
Extension without change of a currently approved collection 2006-03-22
Approved without change
Extension without change of a currently approved collection 2003-02-27
Approved without change
Revision of a currently approved collection 2000-01-11
Approved without change
Reinstatement without change of a previously approved collection 1997-09-17
Approved without change
Revision of a currently approved collection 1994-02-02
Approved without change
Revision of a currently approved collection 1993-06-15
Approved without change
Extension without change of a currently approved collection 1990-03-19
Approved with change
No material or nonsubstantive change to a currently approved collection 1989-06-26
Approved without change
Revision of a currently approved collection 1987-04-27
Approved without change
Revision of a currently approved collection 1984-04-17
Approved without change
Revision of a currently approved collection 1982-03-24
Approved without change
Reinstatement without change of a previously approved collection 1980-04-02
Approved with change
No material or nonsubstantive change to a currently approved collection 1979-12-31
Approved with change
No material or nonsubstantive change to a currently approved collection 1979-07-31
Approved with change
No material or nonsubstantive change to a currently approved collection 1979-03-28
Approved with change
No material or nonsubstantive change to a currently approved collection 1975-03-18
Approved without change
Revision of a currently approved collection 1974-11-14

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