Employee Work Activity Questionnaire

SSDI beneficiaries and SSI recipients qualify for payments when a physical or mental impairment prevents them from performing SGA. When disability beneficiaries attempt to return to work after receiving payments but are unable to continue working or have subsidized work, SSA contacts the employer by using Form SSA 3033, Employee Work Activity Questionnaire. SSA uses this form to contact the employer of the applicant or beneficiary to validate their allegation of unsuccessful work attempts and subsidies. The evidence provided by the employer on the SSA-3033 is used to determine whether the beneficiary is eligible for disability payments. The collection of this information is voluntary; however, failure to submit the information may result in non-entitlement to benefits. SSA employees may assist the employer in completing the form via the telephone, or the form may be mailed to the employer to complete. SSA uses this form for both initial claims and post-entitlement reviews. The respondents are employers of SSDI beneficiaries and SSI recipients who unsuccessfully attempted to return to work.

The latest form for Employee Work Activity Questionnaire expires 2027-11-30 and can be found here.