View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0960-0598
ICR Reference No:
202504-0960-004
Status:
Active
Previous ICR Reference No:
202308-0960-003
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Work Activity Report (Self-Employment)
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/12/2026
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/08/2026
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
07/31/2027
07/31/2027
07/31/2027
Responses
100,000
0
100,000
Time Burden (Hours)
159,405
0
100,941
Cost Burden (Dollars)
0
0
0
Abstract:
SSA uses Form SSA-820-BK to determine initial or continuing eligibility for (1) Title II Social Security disability payments, or (2) Title XVI Supplemental Security Income (SSI) payments. Under Titles II and XVI of the Act, recipients receive disability and SSI payments based on their inability to engage in substantial gainful activity (SGA) due to a physical or mental condition. Therefore, when the recipients resume work, they must report their work so SSA can evaluate and determine by law whether they continue to meet the disability requirements. SSA uses Form SSA-820-BK to obtain information on self-employment activities of Social Security Title II and XVI disability applicants and recipients. We use the data we obtain to evaluate disability claims, and to help us determine if the claimant meets current disability provisions under Titles II and XVI. Since applicants for disability or SSI payments must prove an inability to perform any kind of SGA generally available in the national economy for which we expect them to qualify based on age, education, and work experience, any work an applicant performed until, or subsequent to, the date the disability allegedly began, affects our disability determination. The respondents are applicants and claimants for Social Security disability payments or SSI payments. We are submitting a non-substantive Change Request to make minor revisions to streamline the form, enhance the clarity for the form, and better explain to the respondents the need for the information. We are making these revisions due to feedback from subject matter experts and from public comments on this form.
Authorizing Statute(s):
US Code:
42 USC 423
Name of Law: The Social Security Act
US Code:
42 USC 1383b
Name of Law: The Social Security Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
88 FR 62136
09/08/2023
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 78443
11/15/2023
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
Work Activity Report (Self-Employment) - In Office
Work Activity Report (Self-Employment) - Submittable PDF Version via Upload Documents
Work Activity Report - Self-Employment (Telephone)
Work Activity Report - Self-Employment (returned via mail)
SSA-820-BK
Work Activity Report (Self-Employment)
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
100,000
100,000
0
0
0
0
Annual Time Burden (Hours)
159,405
100,941
0
0
58,464
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
There are no changes to the public reporting burden. *Note: The total burden reflected in ROCIS shows the additional totals for the field office and telephone call system wait times (for those ICs that require them) as well as the rough estimate of a 30-minute, one-way, drive time in our calculation of the time burden (for the respondents who respond via telephone interview), and a 30 minute learning cost. This is why the burden estimates on ROCIS do not match the chart above.
Annual Cost to Federal Government:
$3,149,721
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
01/08/2026
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