TN 5 (08-94)
DI 10515.015 Work Comparability Provisions for Blind Disability Insurance Benefits (DIB), Childhood Disability Benefits (CDB), and Disabled Widow(er) Benefits (DWB) Claimants, Age 55 and Older
A blind worker, CDB or DWB claimant age 55 or older, may be found disabled if he or she is unable to engage in substantial gainful activity (SGA) requiring skills or abilities comparable to those of any gainful activity in which he or she was previously engaged with some regularity and over a substantial period of time.
If such an individual does engage in noncomparable SGA, he or she may be entitled to disability benefit status (SSA-831-U3, item 18B.), but cash benefit payments will be suspended as long as the individual is actually engaging in any SGA.
A blind DIB, CDB, or DWB claimant entitled to disability benefit status under the special work comparability provisions whose benefits are suspended due to SGA need not file a new application when he or she ceases SGA in order to receive disability benefits. (This contrasts with the requirement for blind workers in regular “freeze” status only — CDB and DWB claimants are not eligible for “freeze” — who have been denied for cash benefit purposes because of SGA, and who must, therefore, file a new application when SGA ceases in order to receive disability benefits.)
C. Waiting period
Under the comparability provisions, if a worker or DWB claimant age 55 or older is determined to be statutorily blind and engaging in noncomparable SGA, the period of time beginning with first month of disability may be counted toward the waiting period while the individual is engaging in SGA. Therefore, if SGA continues for 5 full months or more, disability benefits may begin as soon as the individual ceases SGA. This contrasts with the requirement for blind workers in regular “freeze” status only (CDB and DWB claimants are not eligible for “freeze” ) who must serve a waiting period after the cessation of SGA in order to be entitled to disability benefits.
D. Comparability decisions: age-55-or-older DIB, CDB, and DWB claims
Determination as to disability under this provision requires a comparison of the skills and abilities utilized by the individual in the period before, and in the period after, the later of either the onset of blindness or the attainment of age 55.
Work-comparability decisions under the special definition of blindness for these DIB, CDB, and DWB claimants age 55 or older will be made by the Disability Determination Services (DDS) in initial and reconsideration cases, and in continuing disability cases where there is a medical issue; Office of Disability Operations/Payment Service Center (ODO/PSC) will make these decisions in continuing disability cases without medical issues.
In order to determine a work-comparability issue, the DDS must know whether the two periods of work under comparison are SGA. Since the work in either one or both periods will generally have been performed over several years, a determination of comparability may involve some year(s) in which the pre-1978 SGA test applies and other year(s) in which the SGA test specifically for blind persons applies. The use of one test or the other, or perhaps both tests, may be necessary in evaluating a single period of gainful work, and may necessitate DO preparation of more than one SGA determination in such cases.
When the issue of work comparability occurs, develop and prepare determinations as to SGA (using SSA-820-F4 or SSA-821-BK as appropriate) for:
each job which:
lasted 12 months or longer (not necessarily 12 consecutive months)...
in the 10 years prior to the later of either...the onset of blindness or the attainment of age 55.
Also, develop and prepare SGA determinations for:
each period of work after the later of:
the onset of blindness, or
the attainment of age 55.
Apply the earnings guideline that is appropriate for the year in which the work was performed (see DI 10501.015).