TN 9 (12-99)

DI 10501.020 Special Development Situations

A. Policy - Development Responsibilities for SGA

Primary responsibility for development of a claimant's work activity and the decision as to whether such activity during a given period of work is at an SGA level lies with the field office (FO). However, when a determination as to disability cannot be reached on the basis of work activity alone, the Disability Determination Services (DDS) is responsible for resolution of the remaining medical-vocational issues related to the question of ability to work and will receive cases in which an SGA decision has been made by the FO regarding periods of work but no determination as to disability has been made. Since the work a claimant has done or is doing (whether at an SGA level or not) is a significant part of the claimant's total background, it is useful for DDS examiners to be familiar with the concepts involved.

DDS responsibilities concerning SGA questions include:

  • being alert to evidence of work activity not previously developed by the FO, but which would be pertinent to the disability decision;

  • determining if a period of work was an unsuccessful work attempt (see DI 11010.145);

  • determining if the skills and abilities involved in SGA performed by a Title II statutorily blind claimant age 55 or over are comparable with those required by the person's previous work and;

  • being alert to the possible effect of periods of work on the date of onset of disability.

In the overwhelming majority of cases, the DDS is able to determine without development or without contacting the FO whether past work was SGA, and can document that determination with a brief statement in the rationale. In the unusual situation in which, for example, past work earnings are between the upper and secondary levels and the DDS is faced with a complex decision regarding comparability or economic worth, or, in the rare case in which, as another example, an individual alleges that earnings from past work were subsidized, even though such work occurred during a period for which no disability is alleged, the FO should be requested to develop and decide the issue. Some intellectual disability cases are likely to feature subsidized past work earnings.

Performance of SGA 07/01/87 or later, is not a basis for finding that disability ended in Title XVI claims (once the requirements for initial eligibility, including any applicable duration requirement, have been met).

SGA is not a consideration when statutory blindness is established for a Title XVI claimant. A statutorily blind Title XVI claimant is eligible for payments even if engaging in SGA, provided the other requirements for eligibility are met, e.g., income and resource specifications.

B. Effect of SGA on Disability Status

By working an individual may furnish direct proof of ability to engage in SGA, at least for the time worked. However, a finding that work was not SGA during a particular period does not answer the ultimate question of ability to engage in SGA. To resolve this question, the DDS must consider all the medical and vocational evidence, of which the work performed after alleged onset of disability is only a part. In some cases, the complete evidence may show that (1) the individual's impairment is less severe than alleged or (2) that the person has the physical, mental and vocational qualifications necessary for SGA despite an impairment causing marked functional limitations. Other instructions furnish guides on how to evaluate the total spectrum of medical and vocational evidence for this purpose.

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DI 10501.020 - Special Development Situations - 09/09/2016
Batch run: 09/09/2016