Social Security

A. Purpose

This EM is to inform you about updates to form SSA-821-BK (Work Activity Report). You can access the new SSA-821-BK via inForms. The form will be available in UniForms in December 2025.

B. Background

We received feedback from advocates and technicians stating that form SSA-821-BK is too long and complicated and that this prevents applicants and beneficiaries from fully completing and in many cases returning the form. To address these concerns, we updated and streamlined the form. We clarified why we are asking for information and how providing it may help the applicant or beneficiary. We updated certain fields to make it compatible with the Upload Docs workflow.

C. Policy

Technicians use the form SSA-821-BK to document work activity and work incentives prior to making a substantial gainful activity (SGA) determination for initial claims, appeals, expedited reinstatement, and work continuing disability review (CDR) cases.

D. Changes to Form SSA-821-BK

Below is a list of some of the changes to the form along with a brief explanation of the change.

1. Cover letter
· Removed the prefilled “Please tell us about your work since” sentence to be compatible with Upload Docs. Technicians may prefill the date on page 3, when appropriate. If the date is not prefilled, we request the information covering the past two years. Individuals may receive a blank form, for instance, Upload Docs does not support prefilled form information.
· Added the types of information requested, the reasons for requesting it, how the information will be used, and a definition of work incentives.
· Removed the table with prefilled IRS data. More recent earnings information is typically available and can be displayed in the “Employment Information” Section.
2. Employee Identification Section
· Added the option “or SSN” for when the form is completed by the applicant or beneficiary.
3. Income Information Section
· Question 2
Ø Removed the table of income types and added NO, YES check boxes.
Ø Added a rationale for why SSA needs this information.
Ø Added a remarks section and removed the general remarks at the end of the form.
· Question 3
Ø Added “Reason Work Ended (if applicable)” with the choices of “Because of my disability” or “Other reason(s)” to aide in Unsuccessful Work Attempt (UWA) development.
Ø Removed the ‘Pay Stub Table’ from each employment information iteration and added a check box indicator if pay stubs are provided. We now have various earnings data sources to obtain wage data (Payroll Information Exchange etc.). Completing the ‘Pay Stub Table’ with estimates is error prone and many beneficiaries skipped this section or stopped completing the form altogether when they reach this section.
· Question 4
Ø Updated with an example and explanation why we are asking for this information. Many did not understand why we are asking for this information and, therefore, would not complete this section.
4. Work Incentives Information Section
· Question 5 (subsidies and special conditions)
Ø Removed the information gathering table and added Questions 5B and 5C.
Ø Added four check box choices to 5B explaining possible accommodations and space to provide information about the employer providing the accommodation to each choice.
Ø Added “someone other than your employer” (with examples) to 5C to mimic the “knowledgeable source[s]” listed on Form SSA-3033.
· In Question 6 (UWA)
Ø Changed the wording of this question to clarify why we are asking for this information and how providing it may help them.
Ø Added the yes and no format to negate the need for a negative reply later in the question.
· Question 7 (Impairment Related Work Expenses)
Ø Clarified why we are asking for this information and how providing it may help the applicant/beneficiary.
Ø Added language clarifying possible reimbursement choices for the expense will reduce pre-completion contact or the collection of misinformation. We added a ‘Continuing’ cost indicator to tell us about reoccurring expenses.