When the field office (FO) or disability determination services (DDS) receives an
allegation that monthly earnings are below the TWP service month threshold level (for
the TWP service month amounts, see DI 13010.060) in an initial entitlement case, and we do not have evidence indicating that the
may actually engage in SGA, or
is in a position to defer or suppress earnings (see “NOTE” in DI 10505.003B.1. in this section).
do not re-contact the claimant on the work activity or complete a SSA-821-BK; and
do not determine the exact amount of monthly countable earnings.
accept the claimant’s allegation if his or her statement does not conflict with any
other information in the file. Document your findings according to the instructions
in this section.
When the FO receives a reconsideration on the initial claim determination, follow
instructions in DI 12005.010.
EXAMPLE: A claimant files for disability 12/10/2011, and states that he or she stopped working
due to his or her disability on 11/02/2011. The FO forwards the claim to the DDS,
and documents the alleged onset date 11/02/2011. The DDS receives notification from
the claimant that he or she started working one morning a week for her employer again
(performing light clerical duties) in 01/2012, and is earning $200 a month. Since
the claimant is earning below the TWP service amount, and he or she is not in any
position to suppress or defer his or her earnings, AND the DDS does not have any evidence that conflicts with the claimant’s allegation,
the DDS does not have to send this case to the FO to make an SGA decision. The DDS
makes a determination that the earnings are clearly not SGA, and continues to process
NOTE: Do not apply this policy to earnings amounts that are equal to or greater than the
TWP service amounts, expedited reinstatement (EXR) cases, self-employed individuals,
or for individuals who are in a position to control their earnings, such as closed
family corporations. You must process self-employment cases and questionable work
activity cases following the self-employment SGA guidelines in DI 10510.001.
a. FO procedure for developing and documenting work that is clearly not SGA
If alleged earnings are below the TWP threshold, and there is no conflict with earnings
data in our records (i.e., queries such as the Office of Child Support and Enforcement
(OSCE) query), stop development and follow these guidelines:
Document the monthly earnings allegations and write “clearly not SGA” on the Remarks
section of the (Disability Report-Field Office) in the electronic disability claim
system (EDCS). For instructions on how to document the SSA-3367, see DI 11005.045
In title XVI only cases, document your findings in EDCS and also on the IBIE screen
(MSOM INTRANETSSI 014.032 Work Expenses — Blind Work Expenses and MSOM INTRANETSSI
014.033 Work Expenses— Impairment — Related Expenses).
If you have transferred the case to the DDS, alert the examiner to your “clearly not
SGA” determination in EDCS, via the update after transfer (UAT) , following instructions
in DI 81010.095.
If an exclusion prevents you from documenting your determination in EDCS, write your
determination on a SSA-5002 and fax it into the non-disability repository for evidentiary
documents (NDRed), following the instructions in GN 00301.322. In addition, file your determination in the MDF.
DI 13010.700 Office of Child Support and Enforcement Data Query
b. DDS procedure for developing and documenting work that is clearly not SGA
You have the authority to determine that earnings are clearly not SGA in initial entitlement
cases, and continue case processing. Do not send a clearly not SGA case to the FO
to process an SGA determination if the criteria in DI 10505.003A. applies. If you have any doubts about whether or not the earnings may represent SGA,
send an action request (AR) to the FO for a determination on the work activity. Follow
these guidelines to process “clearly not SGA” cases:
If you receive information that a claimant is working, and his or her work efforts
result in earnings below the TWP threshold, and meets all other criteria of a “clearly
not SGA” case as outlined in DI 10505.003A, do not return the case to the FO. For TWP service amounts, see DI 13010.060A.
Instead, document your determination that the work is clearly not SGA using the following
Report of contact (SSA-5002);
The electronic case worksheet.
NOTE: Do not apply this policy to EXR cases, self-employed claimants, or for claimants
who are in a position to control their earnings, such as a closed family corporation.