Why does the SSA send Form 821-BK?

The SSA sends Form 821-BK when there’s evidence or suspicion that someone has worked after their alleged onset date of disability. It may be sent during an application, appeal, continuing disability review, or if the IRS reports earnings. The form helps SSA determine whether work rules are being followed and if benefits should start.

How do I fill out SSA Form 821-BK?

SSA Form 821-BK includes eight sections covering personal information, income, work schedule, accommodations, health impacts, expenses, and your certification. You'll need to provide accurate wage records, job duties, any employer accommodations, and out-of-pocket disability-related expenses. Attach pay stubs and double-check for accuracy before submitting.

What information is required in Section 1: Personal Information of Form 821-BK?

Section 1 asks for your name, Beneficiary Notice Control (BNC) number, whether you are blind, and the date from which you are reporting work. You’ll also indicate whether you had employment or income since that date.

What do I include in Section 2: Other Income of Form 821-BK?

In Section 2, report income types like back pay, vacation pay, workers’ compensation, or insurance payments. Include the employer’s name and address, the amount earned, the time period, and your employment dates.

What details are needed in Section 3: Work Schedule and Wages of Form 821-BK?

Section 3 requires employer details, supervisor contact, job title, nature of work, work dates, pay rate, and weekly hours. Attach pay stubs or wage records from the SSA’s requested date onward. If you held more than three jobs, include them in the Additional Employment Information section.

What should I report in Section 4: Other Employer Payments on Form 821-BK?

In Section 4, report non-wage payments like sick pay, vacation pay, tips, bonuses, company car, meals, or housing. Provide the type of payment, employer name, date received, and estimated value for non-cash benefits.

What should I write in Section 5: Special Changes or Accommodations on Form 821-BK?

Section 5 covers any accommodations your employer made due to your disability, such as reduced hours, extra supervision, or modified tasks. These details help SSA assess the actual nature of your work and limitations.

How do I describe the impact of my health condition in Section 6 of Form 821-BK?

In Section 6, explain how your health affected your work—such as stopping work, cutting hours, or switching duties. Include the employer name, date of change, and the reason, like medical condition or loss of accommodations.

What should I include in Section 7: Expenses and Remarks of Form 821-BK?

Use Section 7 to list work-related expenses you paid out-of-pocket to perform your job due to your disability. Also, use the Remarks section to provide details related to other parts of the form—do not use it to argue your case or describe symptoms.

What do I need to complete Section 8: Signature and Certification on Form 821-BK?

Section 8 requires your signature and contact information. If you don’t sign traditionally, two witnesses must sign. Review the form for accuracy, ensure all jobs are listed, and make a copy before sending.

What are common mistakes to avoid when filling out SSA Form 821-BK?

Avoid errors like omitting employers, not reporting gig work, rounding income, under-reporting hours, or submitting late. Be thorough and accurate, as the SSA has access to your earnings records and may deny claims for incomplete or incorrect forms.

Where can I get help filling out SSA Form 821-BK?

You can get help from experienced professionals at Citizens Disability through Disability Advice. They can assist with accurately completing SSA Form 821-BK, avoiding errors, and ensuring timely submission to protect your SSDI eligibility.

SSA Form 821-BK

Q: What is SSA Form 821-BK?

SSA Form 821-BK, officially called the Work Activity Report — Employee, is a form the Social Security Administration (SSA) uses to evaluate whether a person's work activity affects their eligibility for Social Security Disability Insurance (SSDI). It records job duties, hours, and wages after the alleged onset date of disability. This helps the SSA determine if the claimant's work meets the criteria for substantial gainful activity (SGA).

Form 821-BK is a form the Social Security Administration, or SSA, sends to people receiving or applying for disability insurance, or SSDI. It evaluates how and whether someone’s work activity impacts the disability onset date and eligibility. Either the SSA or the DDS will send a claimant the SSA Form 821-BK, if the claimant is working or worked after the alleged onset date (AOD). The AOD is always the date the claimant alleges he or she became unable to work because of his or her medical condition. If you have received SSA Form 821-BK, it doesn’t mean you are “in trouble” with the government. The SSA needs information to determine eligibility and when you believe benefits should start. However, as with any SSDI form, timely and accurate completion is essential, otherwise the SSA will deny your claim.

Video Transcript

If you’re unable to work due to a disability, you may be wondering how long you need to wait before
applying for Social Security Disability benefits. The truth is, you don’t have to
wait at all. But getting approved isn’t always easy. That’s where Disability Advice can help.

Many people assume they need to wait before filing for Social Security Disability Insurance (SSDI),
but the best time to apply is as soon as you are unable to work. Unfortunately,
most first-time applicants are denied due to missing documentation or application mistakes.

At Disability Advice, we help you submit a strong claim the first time so you don’t have to wait
even longer for the benefits you deserve. There is no waiting period to apply for SSDI. If you
have a medical condition expected to last at least 12 months or that may result in death,
you should apply as soon as possible. The sooner you apply, the sooner your claim can be processed.

However, there is a mandatory five-month waiting period before you can start receiving benefits if
you are approved. This makes it critical to submit a strong application upfront,
as denials can add months or even years to the process.

Many SSDI applications are denied not because the applicant doesn’t qualify,
but because of missing medical records, incomplete paperwork, or errors in the
application. This forces people into a lengthy appeals process, delaying the benefits they need.

At Disability Advice, we know what the Social Security Administration is looking for in a
successful claim. Our experts can help gather the necessary medical evidence,
ensure your paperwork is complete, and present your case in the best
possible way to improve your chances of first-time approval.

We specialize in guiding applicants through the SSDI process, reducing errors that lead
to denials and delays. With our expertise, you can avoid common pitfalls and maximize your chances of
approval. Filing for SSDI can be overwhelming, and mistakes can cost you valuable time.

Let Disability Advice help you build a strong case so you can get approved as quickly as possible. If
you need help filing or appealing a disability claim, visit disabilityadvice.org today.

Written by: Linda Cosme – Vice President of Disability Policy & Strategy, Citizens Disability

Key Takeaways

What Is SSA Form 821-BK?

The SSA-821-BK is the Social Security Administration’s Work Activity Report — Employee. Usually, the SSA field offices and processing centers send it any time they need a clear, dated record of the wages, hours, and job duties you performed after the date you said you became disabled (your alleged onset date). They use those details—together with your pay-stubs or payroll printouts—to decide whether your work crosses the “substantial gainful activity” (SGA) line or whether work incentives (trial-work months, subsidies, impairment-related work expenses, etc.) apply. Sometimes, the DDS, Disability Determination Services, will send the form if there is work activity after you apply.

To qualify for disability benefits, a claimant must be medically unable to participate in substantial gainful activity, or SGA. The government defines SGA as income above a monthly benchmark based on wages. If your wages fall below this benchmark, you may be eligible to collect SSDI if you meet the medical requirements.

Why Does the SSA Send This Form?

The SSA routinely sends Form 821-BK in several situations, including when:

You are applying for SSDI benefits or appealing a determination.
You are undergoing a random review or a continuing disability review, also called a CDR.
The SSA has evidence or reasonable suspicion that you have been working.
The IRS has received a report of your earnings, and the SSA needs to investigate.

Regardless of why you received this form, SSA 821-BK, it’s essential to complete it fully and accurately. The SSA will use it to ensure you are following the rules for working on SSDI.

Briefly, what you’ll be asked on the SSA-821:

Employment history since the date SSA shows in the application, often your alleged onset or last CDR date.
Wage details for each employer: start/end dates, job title, hours per week, rate of pay; attach pay-stubs if you have them.
Non-work income (vacation pay, sick pay, workers’ compensation, etc.).
Special conditions or work accommodations (extra breaks, reduced productivity, assistive devices).
Out-of-pocket disability expenses that you pay to be able to work (e.g., mobility aids, specialized transportation).

How To Fill Out SSA Form 821-BK: Step-by-Step Guide

Form 821-BK is straightforward and has seven basic sections. It includes introductory cover pages with requirements for completing the form and contact information in case you have questions.

In the first paragraph, you’ll find the earliest date for which the SSA needs your work information, plus the SSA’s records of your work history. These may be incomplete or incorrect, but you’ll have a chance to correct them.

Section 1: Personal Information

At the top of the report’s first page, you’ll see fields for your name and Beneficiary Notice Control number. Your BNC number is a numerical code the SSA uses to identify you without using sensitive information, such as your Social Security number. You’ll find it on the first page of the notice and any other correspondence you receive from the SSA. Double-check this number to make sure you enter it accurately.

You’ll also need to check a box indicating whether you are blind, because the SSA uses different income benchmarks for this group.

Next, complete the Date box with the calendar date marked on the top of the first page of your notice. This is the earliest date for which you’ll be reporting earnings. Finally, under Question 1, indicate whether you had income or employment from that date forward.

Section 2: Other Income

If you did not receive any income from work but had other income from an employer, you’ll fill out Question 2. This section covers income types such as back pay, vacation pay, workers’ compensation, and insurance payments. You’ll need to include:

The name and address of the company paying you
How much you earned and the period, such as “$100 per week” or “$500 per month
The employment dates when you earned this coverage

Include all non-wage and non-salary income you earned during the indicated period.

Section 3: Work Schedule and Wages

If you worked during the period SSA is reviewing, you’ll complete Section 3. Start with Question 3A and enter the following information in the correct boxes:

Employer’s name and address
Supervisor’s name and phone number
Job title and nature of work
Work start and end date
Pay rate
Average number of weekly hours

You’ll also need to provide earnings statements for each pay period. The preferred method is to include pay stubs or wage printouts from the employer, starting with the SSA’s provided date. If you don’t have access to that information, you may manually enter earnings by pay date.

Provide all of this information, including employer and job details, for each position you’ve held since the provided date. If you have more than three to report, use the section at the end of the form marked Additional Employment Information. Be accurate and thorough in describing your work.

Section 4: Other Employer Payments

The fourth section of the form is for additional payments or benefits from the employers you mentioned in Section 3. These include:

Sick pay
Vacation pay
Tips
Bonuses
Company car
Childcare
Meals
Housing

You’ll include the payment type, employer name, date received, and amount or value estimate. A value estimate is relevant for non-cash benefits, such as housing or transportation.

Section 5: Special Changes or Accommodations

Section 5 allows you to list any alterations your employer may have made to your job responsibilities or working conditions to account for your disability. Options include:

Extra help, such as supervision or coaching
Working fewer or different hours than others
Taking more rest breaks
Having fewer or easier responsibilities

Use the “other” section to describe any accommodations you don’t see described.

Disability determinations are based on what you can do, and you don’t want the SSA to overestimate your abilities. By reporting what changes you need to your work environment, you provide an accurate picture of your abilities.

Section 6: Medical or Health Impact

This section lets you report any changes to your work activity, including stopping work, reducing your hours, reducing your earnings, or switching to more manageable tasks.

You’ll need to fill out the name of the employer that applied the change, the date the change happened, and the reasons for the change. You can select your medical conditions or the removal of accommodations, or else write your own reason.

Section 7: Expenses and Remarks

Use this section to describe any work-related purchases you needed because of your qualifying conditions. You must have used your own money and needed the items or services to perform your job.

The section also includes a Remarks section, which you can use to add supplemental information for any other questions on the form. Do not use this section for anything unrelated to a form section. For example, avoid using it to describe your symptoms or “make a case” for your claim.

Section 8: Signature and Certification

The final section provides space for your signature and contact information. If you do not sign with a traditional signature, you will need two witnesses to provide their information.

Double-check the entire form before signing. Be sure you’ve included all relevant details, including any jobs or gigs you’ve worked during the requested period. Make a copy for your records before sending the original.

Common Mistakes To Avoid on SSA Form 821-BK

SSA forms can be confusing, and many people make errors that can cost them benefits. Make sure you avoid all of the following:

Not including all employers you’ve worked for during the requested period
Neglecting to include gig work or other side jobs
Rounding or estimating earnings instead of using exact figures
Failing to disclose accommodations or limitations
Under-reporting hours, remember SSA has your earnings record
Neglecting to note gaps in work
Submitting the form late

You must return SSA Form 82-BK1 within 15 days. Complete and return it as soon as possible to avoid a technical denial of your claim.

Need Help Filling Out SSA Form 821-BK? We're Here for You

Completing Form 82-BK accurately can make the difference between receiving and not receiving SSDI benefits. At Disability Advice, we partner with experienced professionals at Citizens Disability who can show you how to fill out the SSA 821 form or review your completed form.

We can help you avoid mistakes, submit your form on time, and fight for a fair outcome. Reach out today to get started.

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