How to Complete the Work Activity Report (Form SSA-821)

If you received a Work Activity Report (Form SSA-821-BK) from the Social Security Administration (SSA), it's because the agency thinks you've earned money since your disability began and needs to know whether that work counts as substantial gainful activity. To determine whether and how much you’ve been earning since your disability onset date, Social Security sends you an SSA-821 that asks you questions about any income you’ve received since you became disabled.

While the form isn’t especially long or complicated (it only contains seven questions), you are required to return it within 15 days of receiving it, and the answers are important in determining your eligibility for benefits. You may wonder why the SSA is asking you about any pay or perks you received on the job and whether you had to buy special equipment in order to work, but once you understand some disability basics, the reasoning behind the questions becomes clearer. With that in mind, below you'll find a question-by-question walkthrough of Form SSA-821, along with a sample completed form and instructions on where to send it once you're finished.

Why Is the Work Activity Report Important?

Because a big part of Social Security’s definition of disability involves your ability to earn substantial gainful activity (SGA), the agency needs to know if you’ve made any money that’s above the SGA threshold. Consistent earnings above SGA can jeopardize your claim for benefits or put a stop to existing payments, since it indicates to Social Security that your medical condition isn’t serious enough to keep you from working full-time (or that your condition has improved to the point where you’re able to return to work).

The work activity report isn’t the same as the work history report, which asks you for extensive details about your past employment and job duties. Social Security sends Form SSA-821-BK when there’s any evidence of earnings during a period that you could be considered disabled. This evidence could be self-reported, such as from you telling the SSA that you worked a seasonal job to make ends meet during the holidays, or the agency can gather it from your tax records in the normal course of reviewing your disability application.

What Do I Need to Fill out Form SSA-821?

You should have records pertaining to any earnings or expenses since your alleged onset date by your side when you sit down to fill out Form SSA-821. These can include:

• pay stubs
• W-2s
• W-9s
• employer contact information (name of supervisor, address of employer, and phone number)
• receipts for any costs associated with working while disabled, such as a walker, and
• documentation of any disability-related accommodations you had at your job.

You may want to include anything else that you think would be helpful to let Social Security know about your financial situation. 

How to Complete Form SSA-821: Question-by-Question Guide and Sample

Once you’ve gathered all your relevant records, you can begin to fill out the Work Activity Report. You can download the form as a PDF and fill it in using your preferred PDF editor, or you can print it out and write your answers on the paper copy. (Click the thumbnail below to see an example of a completed Form SSA-821.) 

The first two pages of the form provide instructions on how to fill it out and contact information for your local Social Security office if you need further assistance. The remaining 10 pages are the questions that you’ll need to answer. Here’s how to go through them, step-by-step.

Employee Identification Section

This part asks for your name, Social Security number, and date you became disabled. (If the date isn’t already completed by the SSA, you’ll have to fill it in yourself with your alleged onset date.)

Question 1: Have You Worked?

This section is a basic checkbox to see whether or not you’ve been working at all since the date your disability began. Check “yes” or “no”. At this point, Social Security isn’t concerned with whether you worked at or above the SGA level, just that you’ve worked at some point after the disability onset date.

Question 2: Did You Receive Income Other Than Wages?

The goal of this section is to differentiate between earnings that you receive from working and other forms of income unrelated to work. It’s common for disabled people to cash out their vacation pay after they’ve left their job, for example, or to receive payments from an employer-provided short-term or long-term disability insurance program. Any income you receive along these lines should be reported here.

Question 3: Who Did You Work For?

This section asks about the employers you’ve had for the past two years. In addition to the name of your employer and your supervisor’s contact information, you’ll need to provide your job title, rate of pay, average hours worked, and how long you worked there for. There’s room for information on three separate employers in this section, but you can add more employers in the space provided at the end of the form if necessary.

Question 4: What Other Work Income Did You Receive?

This question is similar to question 2 in that it asks you about things like vacation or disability payments, but its purpose is different. Here, Social Security needs to know if you received any “perks” in addition to your wages in order to properly calculate your earnings (and determine whether they rise to the level of SGA). Perks like PTO or sick leave won’t count as earnings for SGA purposes, but any income tied to your work activity—such as tips or bonuses—can.

Question 5: Did You Get Extra Help On the Job?

This question is mainly geared towards people who are engaged in one of the SSA’s employment incentive programs, such as Ticket to Work, Plan for Achieving Self-Support (PASS), or other types of “sheltered” employment. If these programs don’t apply to you but you do receive work accommodations (like extra time to complete tasks) for your disability, you should discuss them in this section.

Question 6: Did You Make an Unsuccessful Work Attempt?

An “unsuccessful work attempt” is a short period of time, generally no longer than six months, where you earned above SGA but had to stop due to your disability. When an earning period is considered an unsuccessful work attempt, the SSA will essentially treat it as if it didn’t happen with regards to establishing your disability onset date. This can result in a larger chunk of disability back pay for applicants who are ultimately approved.

Question 7: Did You Have Any Disability-Related Work Expenses?

Money that you spend on impairment-related work expenses (IRWEs) is subtracted from your earnings when calculating whether you meet the SGA limit. IRWEs can include a wide variety of items and services that make it possible for you to work with your medical condition, such as a walker, paratransit (transportation specifically for people with disabilities), or care and feeding for a service dog. List the type, cost, and time frame for any IRWEs you incurred here.

Signature and Certification

At the end of the form, don’t forget to sign, date, and provide your mailing address. If you’re unable to sign your name, you’ll need to have two witnesses who know you attest that you signed with an “X”.

Where Do I Submit the Work Activity Report?

Once you’re done filling out Form SSA-821, you’ll need to send it back to Social Security within the 15-day (starting from when you received it in the mail) timeframe. You can do this in several ways:

• Submit the form online with your mySocialSecurity account.
• Mail the form using the address printed on the first page of the SSA-821.
• Fax it to the number provided on the first page of the SSA-821 (if included).
• Drop it off in person at your local Social Security field office.

Whichever method you prefer, keep a copy of the completed form for your records. That way, if the SSA has any questions, you’ll have documentation that you submitted it in full and on time.

Do I Need a Lawyer?

Form SSA-821 is generally straightforward enough to fill out on your own, but how you answer certain questions can have a real impact on your claim (particularly when it comes to unsuccessful work attempts, IRWEs, or explaining work accommodations in a way that supports rather than undermines your case). If you're unsure how a specific answer might affect your eligibility, consider contacting an experienced disability attorney if you haven't done so already. Many disability lawyers offer free consultations and only get paid if you win your case, so there's little downside to finding a lawyer who can help you submit your report with confidence.