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Periodically, Social Security will ask people who are working to complete a Work Activity Report -- Employee (SSA-821-F4 (7-85).

As you work, it would be helpful to keep track of your income and expenses and the other information requested in the form, as well as your Trial Work Months as you use them. While your local Social Security office may not request work earnings information from you as often as official guidelines dictate, they probably will do so eventually. A few minutes of time noting this information will save you an endless amount of time trying to reconstruct it later. For a simple way to keep track for employees, click here; for self employed people, click here.

For a list of information that will be requested and a sample log for tracking your income and IRWE expenses, see IRWE.

The form can be found at The Form Can be Found Online at offsite link

For tips about completing the form, click here. 


  • Ask your Claims Representative how frequently you should submit this form. You may want to photocopy it while it is blank so that you can complete it and send it in periodically (or, even better, personally deliver it and get a receipt) even if they don't send one to you regularly.
  • Also keep track of your Trial Work Months as you use them. Remember, Social Security is slow to process income data, so your Trial Work Months may expire well before Social Security realizes it. If they keep sending you payments after the expiration of your Trial Work Period, plus the three extra months to which you are entitled, Social Security will want that money back. If you remain aware of this situation and set the extra money aside, repayment won't be so painful. If you put the money into an interest bearing account, you may even earn a little money since Social Security doesn't charge interest on repayments.

How To Complete The Work Activity Report: Employees

Social Security will generally provide the reason why it is requesting information about your work activities. From your perspective, assume the reason is they are checking to see if you still qualify for SSDI -- and that if you do not answer the form your income may be cut off.

Your answers should relate to one of the following dates. You are expected to report all work from that date to the date that you complete and sign the form.

  • The Onset Date. The onset date is the date you officially became disabled
  • Entltlement Date. While Entitlement Date has a variety of definitions in Social Securit.
    • For purposes of SSDI , your date of entitlement to disability is generally five months after the date on which you made your intent officially known.
    • For purposes of Supplemtental Security Income (SSI), a need-based program, your date of entitlement to disability (should you qualify) is usually the date on which you made your intent to file known. 
  • Last Determination Date: If there was a determination about eligibility after your initial award, the date is the Last Determination Date.

NOTE: The cover note from Social Security will include the information Social Security has on file about your work. It is important that the answers you provide in the form at least include the information Social Security has.  Add additional work as you complete the form.

Information requested on the Work Activity Report:

The questions and answers on this form are straight forward. It is important to be accurate in your answers since they will likely be checked against what an employer says. If you do not have exact numbers or dates, contact the employer to help. 

If you do not have the exact answers and cannot contact the employer, say "See Remarks." In the Section 6 - Remarks, note the question number and provide an accurate explanation.

Question 4:  Other earnings in addition to wages such as tips, bonus, sick or vacation pay, free child care, meals, room or transportation. If you have any "Other earnings" and didn't keep track of the amounts, you will need to estimate the dollar value of each and how frequently you received them.

Question 5: The form asks if there was anything special about the employment such as working for a friend or relative or working as part of a training or rehabilitation program special help. It also asks about extra pay you may have received, or whether your duties were different from co-workers on any of your jobs. This information is needed to determine whether a part of your wages should be considered "Subsidized earnings." Such earnings do not count as earnings for eligibility purposes. See Subsidized Earnings and IRWE.

Some people may be embarrassed to let people know they've received help, but this is not the time to keep this information to yourself. This information is subject to Privacy regulations.

Question 7: The form also asks about any money you spent for things or services related to your condition that allowed you to work and for which you did not get paid back. The examples Social Security gives to help you recall these items range from medicines to wheelchairs, from special telephone or computer equipment to modifications to your home or a car. It also includes personal assistance, such as a personal care attendant. You're entitled to have these expenses deducted from your income before Social Security takes into account how much you earned -- so include every penny you can. Hopefully you have this information on hand, If not, now is the time to reconstruct it- and to start keeping track of these expenses for the future. These expenses may also be deductible from your income tax. See Tax.

Remarks: Include any "comments" that helps clarify your situation. Also elaborate on any answers that needed more space. Number any information in Comments carefully to match the item on the form.