BASIC (01-08)

Use signature proxy for the following forms for Title TII and Title XVI claims:

• SSA-820 (Work Activity Report for Self Employed Person); and

• SSA-821 (Work Activity Report – Employee).

NOTE: If creating the SSA-820/SSA-821 for a CEF exclusion case with an MDF as the official folder, print and insert the report and attestation cover notice (when applicable) into the Modular Disability Folder (MDF) or mail them to the office with jurisdiction of the MDF. For further instructions involving CEF exclusions, refer to Certified Electronic Folder (CEF) Exclusions - DI 81010.030.

For additional information on signature proxy and attestation, see Alternative Signature Methods - GN 00201.015.

A. Completing the SSA-820/821 During an Initial Claim

As the attestation script outlined in Alternative Signature Methods - GN 00201.015 is performed at the beginning of the interview for Disability benefits, it is not necessary to perform the script specifically for the SSA-820/821.

When using form attestation for work activity reports through the Electronic Disability Collect System (EDCS):

• Enter “ATTEST” along with the office code and name of the interviewer beneath the penalty clause in the block provided for “Signature of claimant, Beneficiary or Representative”;

• Upload the SSA-820/821 into the CEF at the point of intake;

  NOTE: If the SSA-820/821 cannot be uploaded into the CEF via EDCS, print the form from e-forms and fax a copy of the SSA 820/821 into the CEF.

• Document the MCS/MSSICS DW01 with an “ATTEST” issue and enter the receipt date;

• After entering the receipt date on the DW01, the ATTEST issue locks and MCS/MSSICS indicates the office code and name of the interviewer in the remarks section. MCS/MSSICS retains the issue as the electronic equivalent of the claimant’s signature.

• Give or mail the claimant a copy of the attestation cover notice and the SSA 820/821.

B. Completing the SSA-820/821 After Case Transfer

• Perform the attestation dialogue as specified in Alternative Signature Methods - GN 00201.015F.2.

• Document the SSA-820/821 and MCS/MSSIC as previously instructed in DI 81010.120A. of this section.

• Use DPS to generate the form attestation cover letter;

  The notice is combined with the Attestation Cover Letter and is under the “Cover Letters” menu on DPS.

• Select “Print and Send to ORS” button to ensure the document for attestation (i.e. attestation cover) is in the Online Retrieval System (ORS);

• Give or mail the claimant a copy of the attestation cover notice and the SSA 820/821; and

• Fax a copy of the attestation cover notice into section E. Disability Related Development (blue) of the CEF unsing document type 1030 for the SSA-820 and 1040 for the SSA-821.