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SSA-821: Work Activity Report

The Social Security Administration (SSA) may ask the applicant to complete an SSA-821 Work Activity Report if he/she continued to work after the alleged date of onset. This article provides additional information and tips for assisting applicants with this form. 

Why does SSA ask for this form?

SSA uses the SSA-821 Work Activity Report (PDF) to document any work activity or work incentives that may apply before making a determination about Substantial Gainful Activity (SGA) for initial decisions, appeals, and continuing disability reviews. This form is requested when SSA has information about work activity after the alleged onset date, which is the date provided on the SSA application forms of when the applicant alleges his/her disability became severe enough to prevent him/her from working at an SGA level.

How does SSA use this information?

From information gathered in this form, SSA may determine that work incentives apply, which could reduce the applicant’s countable income below SGA levels.
  • This could have an impact on the applicant’s eligibility for cash benefits and Medicare for SSDI, or in establishing the 12 month durational requirement
  • Remember that Step 1 of the disability determination process is establishing that the applicant is not working above SGA levels
  • Note: SSA considers different SGA amounts, depending on the calendar year in which the work occurred
SSA uses this information to establish a “potential onset date,” which may differ from the date provided by the applicant, and forwards this information to DDS who is responsible for making the final decision about the date of onset.

Determining an Established Onset Date

DDS considers information provided by the applicant and the SSA field office to determine an “established onset date (EOD),” which is the date that the applicant’s impairments became severe enough that his/her countable income was reduced below SGA amounts. 

Tips for completing the SSA-821

For this form, SSA is only asking for information about jobs held after the alleged date of onset. This form differs from the SSA-3369, which asks about jobs held in the 15 years prior to the applicant becoming unable to work due to illness(es).

Cover Page:

On the cover page of the SSA-821, SSA will provide information they have about the applicant’s employers and earnings after the alleged onset date. They will ask the applicant to provide detailed information related to work for these employers, as well as any work for employers during this time frame that are not shown on the form.

Question 1:

This question asks if the applicant received any employment income or wages since the date listed in the identification section.
  • If yes, the applicant will skip to Question 3
  • If no, the applicant will answer Question 2 about other sources of income that may have been reported for him/her, such as Workers Compensation or holiday pay

Question 2:  

If this question applies (see Question 1), provide information about any income that does not come from work activity (e.g. alimony, pension). The applicant may need to provide documentation of this income. When finished, the applicant can skip to Question 7.

Question 3:

If this question applies (see Question 1), provided detailed information about work activity at each employer. This question also asks for details about earnings or pay stubs/wage print-outs.

Question 4:

This question asks about any payments or benefits the applicant received from an employer in addition to regular pay, such as sick pay, vacation pay, or childcare benefits.
For the last half of the form, SSA is exploring the presence of subsidies, impairment-related work expenses (IRWEs), and unsuccessful work attempts (UWEs).

Question 5:

Subsidies – Document any additional help the applicant received at work, or special accommodations the employer made, due to the applicant’s health conditions. The questions listed in this part of the form are excellent examples of how the employer may have provided accommodations.

Question 6:

Unsuccessful work attempts – These are work attempts that lasted less than six months and ended due to the applicant’s health condition or the removal of special accommodations that allowed the employee to work with his/her conditions.
For SGA determination purposes, DDS may disregard substantial work if it meets the criteria of an unsuccessful work attempt since disability evaluation is generally concerned with ability to work over an extended period rather than in short, isolated periods

Question 7:

IRWEs – These are actual costs that the applicant incurred due to his/her health condition that enabled him/her to continue working. This could be paying for medications, physician co-pays, special transportation/equipment, etc.
  • DDS will need receipts for these expenses
  • The expenses are not reimbursed, but they could be helpful in reducing counted income
Include any additional information about the applicant’s work activity that was not captured in the questions above.

Utilizing Individual Placement and Support Job Reports

  • Individual Placement and Support (IPS)  is often used as a supportive employment model for individuals experiencing serious mental illness.
  • IPS tools such as job follow along plans (PDF), job start reports (PDF) and job end reports (PDF) often contain information such as the individual’s employment goals and objectives, job titles, job duties, rate of pay, changes in job duties/schedule, reason for job ending (from the individual’s perspective and the employer’s perspective), and what support is/has been provided to the individual. 
  • Information gathered from an individual’s IPS documents can be helpful to include when completing the SSA-821, as well as the occupational history and functional information sections of the Medical Summary Report (MSR).

Worth the effort!

Providing detailed information if any of the above factors apply could help SSA determine an earlier onset date than the applicant’s final day of work. This could have implications on cash benefits and Medicare for SSDI or in establishing the 12 month durational requirement, so it is worth the extra time to carefully document supports the applicant received during his/her employment. 

For more information

To learn more about using vocational evaluations and assessments when assisting an individual with a SOAR application, view the recording of our webinar Understanding and Using Vocational Information for Quality SOAR Applications.