**Jason Dewaine Davis**  
737 Summit Ridge  
Lewisville TX 75077 
(940) 340-9369


**Date:** 02/12/2026

**RE:**  Jason Davis  
**SSN:**  441-74-0923  
**Claim/File Number:** [if known]  
**Subject:**  Additional Information for SSA‑821 – Work Activity Report

To the Social Security Administration Claims Representative,

I am writing to provide additional context for the SSA‑821 Work Activity Report I am submitting. I want to be certain that my situation is clearly understood.

**I did not work at all during the period from March 15, 2024, to the present.**  
I was laid off from my last job on [insert date you last actually worked]. After my separation, I received a severance/lay‑off payment from my employer. This is the income reported in Question 2 of the SSA‑821. I did not perform any work—not a single day—for that money, nor did I seek or obtain any other employment during this time.

**The reason I did not work is that I was completely disabled by severe major depressive disorder with catatonic features.**  
During this period I experienced prolonged episodes where I was essentially non‑functional. I would lie on the couch for hours—often an entire day—unable to move, speak, or initiate even the smallest task. I vividly recall staring at the clock and perceiving the hour hand moving as quickly as a second hand; time itself had lost all meaning for me. I felt utterly alone, trapped in my own body, and I struggled daily with suicidal ideation. I could not concentrate, could not interact with others, and could not have sustained even a simple, sedentary job.

I have not worked since my layoff because my condition made it impossible to search for work, attend interviews, or perform any job duties. I remained at home, often isolated, and relied on my severance pay to survive.

I am under the care of [doctor’s name, if you have one] and my medical records document this period of disability. I have authorized SSA to obtain those records.

I hope this statement helps clarify why no work activity appears on the SSA‑821 and why I am unable to engage in substantial gainful activity. Please contact me if you need any further information.

Sincerely,

**Jason Davis**  
[Signature]  
[Printed Name]

---

## ✅ **What to do with this statement**

1. **Type it** (or print it clearly) on a blank sheet of white paper.  
2. **Attach it** behind your completed SSA‑821 form, **before** you mail or fax.  
3. **Keep a copy** for yourself.

This statement does **not** replace medical records or the formal function report—but it gives the person reading your file a human connection to your case. Many disability examiners have said that a well‑written claimant statement can make a real difference.

If you don’t have a doctor’s name yet, simply remove that sentence. If you want to add more details (e.g., specific dates, how you spent your days), you can expand it.

Would you like me to adjust the tone, shorten it, or add any other specific details you haven’t shared yet?