Form SSA-16-INST (03-2017) UF
Discontinue Prior Editions
Social Security Administration
Page 1 of 2
OMB No. 0960-0618
REPORTING RESPONSIBILITIES FOR DISABILITY INSURANCE BENEFITS
CHANGES TO BE REPORTED AND HOW TO REPORT
FAILURE TO REPORT MAY RESULT IN OVERPAYMENTS THAT MUST BE REPAID
•
You change your mailing address for checks or
residence. To avoid delay in receipt of checks you
should ALSO file a regular change of address notice
with your post office.
• Your citizenship or immigration status changes.
• Any beneficiary dies or becomes unable to
handle benefits.
• You go outside the U.S.A. for 30 consecutive days
or longer.
• Custody Change - Report if a person for whom you are
filing or who is in your care dies, leaves your care or
custody, or changes address.
• You are confined to a jail, prison, penal institution or
correctional facility for more than 30 continuous days
for conviction of a crime, or you are confined for more
than 30 continuous days to a public institution by a
court order in connection with a crime.
•
You become entitled to a pension, an annuity, or a
lump sum payment based on your employment not
covered by Social Security, or if such pension or
annuity stops.
• Your stepchild is entitled to benefits on your record
and you and the stepchild's parent divorce. Stepchild
benefits are not payable beginning with the month
after the month the divorce becomes final.
• You have an unsatisfied warrant for more than 30
continuous days for a violation of probation or
parole under Federal or State Law.
• You have an unsatisfied warrant for more than 30
continuous days for your arrest for a crime or
attempted crime that is a felony of flight to avoid
prosecution or confinement, escape from custody
and flight-escape. In most jurisdictions that do not
classify crimes as felonies, this applied to a crime
that is punishable by death or imprisonment for a
term exceeding one year (regardless of the actual
sentence imposed).
• Change of Marital Status - Marriage, divorce, and
annulment of marriage. You must report marriage
even if you believe that an exception applies.
• You return to work (as an employee or self-
employed) regardless of amount of earnings.
• Your condition improves.
• You are under age 65 and you apply for or begin to
receive workers' compensation (including black
lung benefits) or another public disability benefit, or
the amount of your present workers' compensation
or public disability benefit changes or stops, or you
receive a lump-sum settlement.
• If you become the parent of a child (including an
adopted child) after you have filed your claim, let us
know about the child so we can decide if the child is
eligible for benefits. Failure to report the existence
of these children may result in the loss of possible
benefits to the child(ren).
HOW TO REPORT
You can make your reports online, by telephone, mail, or in person, whichever you prefer. If you are awarded benefits
and one or more of the above change(s) occur, you should report by:
• Visiting the section "my Social Security" at our web site at www.socialsecurity.gov;
• Calling us TOLL FREE at 1-800-772-1213;
• If you are deaf or hearing impaired, calling us TOLL FREE at TTY 1-800-325-0778; or
• Calling, visiting or writing your local Social Security office at the phone number and address shown on your
claim receipt.
For general information about Social Security, visit our web site at www.socialsecurity.gov. For those under full retirement
age, the law requires that a report of earnings be filed with SSA within 3 months and 15 days after the end of any taxable
year in which you earn more than the annual exempt amount. You may contact SSA to file a report. Otherwise, SSA will
use the earnings reported by your employer and your self-employment tax return (if applicable) as the report of earnings
required by law, to adjust benefits under the earnings test. It is your responsibility to ensure that the information you give
concerning your earnings is correct.
NOTICE ABOUT DOCUMENTS
We recommend that you keep a copy of all documents you submitted to us.
We are returning the documents you submitted with this claim.
