Form SSA-821-BK Work Activity Report
The SSA-821-BK is a Work Activity Report required by the Social Security Administration. It collects information about recent work activity to help determine eligibility for disability benefits. Completing this form is necessary to ensure proper benefit assessment.
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How do I fill this out?
To fill out this form, start by gathering your employment information. Carefully review each question and provide detailed answers to help with your case. Finally, ensure that you sign and date the form before submission.

How to fill out the Form SSA-821-BK Work Activity Report?
1
Gather your employment records and income details.
2
Read each question thoroughly and answer accurately.
3
Add any additional work information not listed.
4
Double-check the form for completeness and correctness.
5
Sign and date the form before submitting it.
Who needs the Form SSA-821-BK Work Activity Report?
1
Individuals applying for disability benefits need to provide work activity details.
2
Current beneficiaries might need to report recent employment to maintain eligibility.
3
Employers may be required to verify employment information if contacted.
4
Healthcare providers might need this information for related disability assessments.
5
Legal representatives might require this file for cases related to Disability Insurance.
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What are the instructions for submitting this form?
To submit the SSA-821-BK form, please first ensure all sections are completed accurately. You can submit it via mail to the Social Security Administration, P.O. Box 17769, Baltimore, Maryland, 21235-7769, or fax it to 1-800-771-1213. Always retain a copy for your records and consider using registered mail for physical submissions.
What are the important dates for this form in 2024 and 2025?
Important dates for the SSA-821-BK form include the deadlines for submission of updates related to work activity. These dates are crucial for beneficiaries to meet to ensure uninterrupted disability benefits. It is advisable to stay informed about potential revisions to form deadlines each year.

What is the purpose of this form?
The purpose of Form SSA-821-BK is to collect detailed information about an individual's work activity since their last assessment. This information is critical for the Social Security Administration to determine eligibility for continued disability benefits. Ensuring accurate and thorough completion of this form is essential for maintaining or securing financial assistance.

Tell me about this form and its components and fields line-by-line.

- 1. Claimant's Name: The full name of the individual submitting the form.
- 2. BNC#: The Beneficiary Notification Code that corresponds to the claimant.
- 3. Work Dates: The dates when the claimant worked, formatted as MM/YYYY.
- 4. Employer Information: Details about the claimant's current or past employers.
- 5. Income Details: Information on earnings, categorizing any form of income.
What happens if I fail to submit this form?
Failing to submit this form can result in a delay or denial of disability benefits. The Social Security Administration may rely on existing records, which may not accurately reflect current circumstances. It's important to ensure timely submission to avoid potential complications.
- Delayed Benefit Determination: Without the form, there may be delays in processing benefits.
- Possible Benefit Termination: Failure to submit could lead to a loss of benefits.
- Need for Alternative Evidence: SSA may need to use third-party data, which can be less accurate.
How do I know when to use this form?

- 1. Applying for Disability Benefits: Use this form if you're starting a new application for disability.
- 2. Reporting New Employment: This form is necessary for reporting new job details to SSA.
- 3. Updating Income Information: Any time your income situation changes, this report must be submitted.
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