821 ssa form 2025

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The document is a form (SSA-821-BK) from the Social Security Administration that requests information about a claimant's work activity to determine eligibility for disability benefits. It outlines the necessary steps for completion, including providing details about employment history, earnings, and any special conditions related to their work. The form emphasizes the importance of returning it within 15 days and includes resources for assistance and reporting fraud.

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Click ‘Get Form’ to open the SSA-821 form in the editor.
Begin by filling out your personal information in the Identification section, including your name and BNC number.
In the Work Activity Report section, answer whether you have had any employment income since the specified date. If yes, proceed to provide details about your employers and earnings.
For each employer listed, include their name, address, job title, rate of pay, and hours worked per week. Attach any necessary pay stubs or wage print-outs as indicated.
Complete additional sections regarding any special conditions related to your work and any expenses incurred due to your physical or mental condition.
Finally, review all entries for accuracy before signing and dating the form at the bottom. Ensure that all required fields are filled out completely.

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What is a work activity report from SSA?

Social Security uses the Work Activity Report form to learn more about the work activity of a disability applicant or beneficiary. If you are applying for disability benefits, the information you provide will help us decide if you can receive benefits.

What is form SSA 820 BK?

The field office (FO) and processing center (PC) use the SSA-820-BK or e820 (Work Activity Report Self-Employment) to document work activity and to determine if any work incentives apply prior to making a substantial gainful activity (SGA) determination for initial claims, appeals, and continuing disability review (CDR ...

Why did I get a SSA 821 BK?

In fact, the SSA directs form 821-BK to an individual who is already receiving disability insurance benefits (which means they are considered disabled and cannot be working) to make sure that the beneficiary hasn't been doing any work activity since the alleged onset date.

ssa 821 form printable

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What is an SSA 823 form?

A. Purpose of the work activity report To document the SGA decision and rationale, use the form SSA-823 (Report of SGA Determination \u2013 For SSA Use Only). Consider any applicable work incentives.

What is SSA 89 form used for?

Alert. The Social Security Administration published the revised Form SSA-89 (12-2020) (Authorization for the Social Security Administration (SSA) To Release Social Security Number (SSN) Verification) and Form SSA-89-SP (Spanish). You can access the revised forms in the CBSV Documents submenu located on the CBSV menu.

What is a BNC number?

On Social Security COLA notice, we began displaying a Beneficiary Notice Code (BNC). The BNC is an encrypted 13-character alphanumeric code that helps our employees identify the notice and the beneficiary, and further eliminates the need to include the SSN.

What is an SSA 3033 form used for?

SSA-3033, Work Activity Questionnaire (used to obtain more detailed information from the employer when SSA learns through completed Form 821-BK or other information that a subsidy or special condition may exist).

What is a SSA 795 form used for?

1. General information for recording statements on the SSA-795. Use an SSA-795 whenever a signed statement is required or desirable, except when we request some other form or questionnaire or we can readily adapt for the statement.