TN 49 (08-08)
DI 11010.145 Unsuccessful Work Attempt (UWA)
A. To whom the policy applies
This policy applies to all Field Office (FO) employees who process Title II claims involving individuals claiming or receiving Title II benefits based on disability that, after working in employment or self-employment despite severe impairment, involuntarily discontinue or markedly reduce such work. Unsuccessful Work Attempts (UWAs) may be used in establishing onset date, and may affect Primary Insurance Amounts (PIA) and/or the retroactivity of disability benefits.
NOTE: DDS makes all initial claims UWA determinations. See DI 24005.001.B1.
B. Policy – FO responsibilities
A UWA is defined as an effort to do substantial work in employment or self-employment that discontinues or reduces to the non-Substantial Gainful Activity (SGA) level after a short time (no more than 6 months) because of the individual’s impairment or the removal of special conditions related to the impairment that are essential to the further performance of work. Work performed during a UWA does not preclude a finding of disability.
1. FO issue
To determine if a work attempt was unsuccessful, obtain an SSA- 821 (Work Activity Report – Employee) or SSA-820 (Work Activity Report – Self Employed Person) through eforms, the Electronic Disability Collect System (EDCS), or a paper form and, consider these three issues:
Was the work substantial enough to warrant a finding that the individual was engaged in SGA during the time he/she actually worked? See Definition of Substantial Gainful Activity (SGA) - DI 24001.001 for a definition of substantial gainful activity
How long did the work last?
Was the work reduced to the non-SGA level or discontinued due to the individual’s impairment or the removal of special conditions related to the impairment?
2. Disability Determination Services (DDS) issue
Regardless of the substantiality of the work, does the medical and vocational evidence warrant a finding that the individual was able to engage in SGA during or after the period of actual work?
Careful handling of these issues is necessary because a work attempt which is considered unsuccessful does not preclude a finding of disability during the time that such work was performed. See SGA Development Responsibilities - DI 24001.005 for information about DDS responsibility in these cases.
The UWA policy explained in this section must be used in initial disability cases. It must also be used in continuing disability cases in determining whether, because of work activity, disability continues or ceases. However, the UWA criteria do not apply in determining whether payment should be made for a particular month during the re-entitlement period after disability has been ceased because of SGA. See Extended Period of Eligibility - DI 13010.210 for information on the Extended Period of Eligibility (EPE). The EPE re-entitlement period begins with the month immediately following completion of the Trial Work Period (TWP) and ends 36 months later (or 15 months later if the beneficiary is not entitled to benefits after 12/1987).
The UWA does not apply to the TWP. However, if a period of work being considered for UWA partially falls within the TWP, the work must still be considered in the UWA determination. If the period of work is considered an UWA, the TWP months remain the same and only the months in the EPE are considered an UWA.
The period of work begins in May and ends in December. The TWP period ends in September. October, November and December cannot be considered an UWA because the entire period of work was eight months, May through December.
The beneficiary completed 7 months of the TWP and then stops working. This year the beneficiary worked above SGA beginning in March through July. March and April are TWP months. The adjudicator determines the work activity from March through July is an UWA. The decision will show the TWP is completed in April and the EPE months of May, June, and July are shown as non-SGA months.
NOTE: The FO has final responsibility for a determination of UWA only in continuing disability cases in which there is no medical issue.
C. Policy - event that must precede a UWA
1. The policy
There must be a significant break in the continuity of a person's work before he/she can be considered to have begun a work attempt that later proved unsuccessful. For a complete description of UWA criteria, see DI 24005.001D.
A significant break in the continuity of a person’s work occurs if the person:
Discontinued or reduced work activity to the non-SGA level because of the impairment, or the removal of special conditions related to the impairment, that are essential to the further performance of the work; or
Discontinued or reduced work activity to the non-SGA level prior to the onset date of the impairment for reasons unrelated to the impairment (e.g., retirement, or layoff);
The claimant has never previously engaged in work activity .
Work is considered to be “discontinued” if the person:
Was out of work for at least 30 consecutive days, or
Was forced to change to another type of work or another employer.
NOTE: On rare occasions a break lasting less than 30 days may satisfy this requirement if the subsequent work episode was brief and clearly not successful because of the impairment.
D. Policy - event that must follow a UWA
After the first significant break in continuity of a person's work, the ensuing period of work is regarded as continuous until the impairment, or the removal of special conditions related to the impairment essential to the further performance of work, causes the work to be “discontinued”, or to be reduced to the non-SGA level as described in DI 11010.145B. (in this section). Each continuous period of work activity, separated by significant breaks, may be an UWA so long as the criteria related to duration and conditions of work are met, as explained in DI 11010.145E (in this section).
E. Policy- duration and conditions of work
To illustrate how UWA time periods are calculated, work from 11/05/05, through a date no later than 02/04/06, is for “3 months or less.” Work from 11/05/05, through at least 02/05/06, but through a date no later than 05/04/06, is “between 3 and 6 months.” A work effort of more than 6 months cannot be a UWA.
1. Work effort of 3 months or less
If the work effort does not exceed 3 months and the alleged reason work ended or was reduced has a reasonable relationship to the impairment, then verification of the reason work ended or was reduced is not required. If this requirement is not met, obtain the evidence described in DI 11010.145B (in this section).
To be considered a possible UWA, the work activity must have ended, or have been reduced to the non-SGA level, within 3 months due to the impairment or to the removal of special conditions related to the impairment that are essential to the further performance of work. (Examples of “special conditions” are given in DI 11010.145F. (in this section)).
2. Work effort of more than 3 months but less than 6 months
If work lasted more than 3 months, it must have ended or have been reduced to the non-SGA level within 6 months due to the impairment or to the removal of special conditions (see DI 11010.145F (in this section)) related to the impairment that are essential to the further performance of work, and:
There must have been frequent absences due to the impairment; or
The work must have been unsatisfactory due to the impairment; or
The work must have been done during a period of temporary remission of the impairment; or
The work must have been done under special conditions.
In considering why a work effort ended or was reduced to the non-SGA level, or if the work was performed under special conditions related to the impairment, do not rely solely on information from the worker. If impartial supporting evidence is not already a part of the claims file, confirmation with the employer is required. (If the information from the employer is inconclusive or if none is available, the DDS confirms the reason for work discontinuance or reduction with the person's physician or other medical source.) Answers on an SSA-5002 (Report of Contact) or SSA-821, to the following questions, helps verify the nature and duration of work and the reason it ended or was reduced:
When and why was the SGA-level work interrupted, reduced or stopped?
If special working conditions as described in DI 11010.145F. (in this section) were removed, what were those conditions or concessions? When, how and why were they changed?
Were there frequent absences from work? Were days and hours of work irregular and, if so, why?
Was job performance unsatisfactory because of the impairment?
Did the employer reduce the person's duties, responsibilities or earnings because of the impairment?
When the employee's work effort ended, was the continuity of employment broken? Did the employer grant sick leave or hold the position open for the person's return?
In the case of a self-employed person, what has happened to the business since the discontinuance or reduction of work? If the business has continued in operation, who manages and works in it, and what income does the disabled person derive from it? See Meaning of SGA and Scope of sections - DI 10510.001-.DI 10510.020 for development of self employment and SGA. Income alone is not always the deciding factor.
F. Special conditions
One situation under which SGA-level work may have ended or may have been reduced to the non-SGA level is “the removal of special conditions related to the impairment that are essential to the further performance of work.” That is, a severely impaired person may have worked under conditions especially arranged to accommodate his or her impairment or may have worked through an unusual job opportunity, such as in a sheltered workshop. Special or unusual conditions may be evident in many ways. For example, the person:
Required and received special assistance from other employees in performing the job; or
Was allowed to work irregular hours or take frequent rest periods; or
Was provided with special equipment or was assigned work especially suited to the impairment; or
Was able to work only within a framework of specially arranged circumstances, such as where other persons helped him or her prepare for or get to and from work; or
Was permitted to perform at a lower standard of productivity or efficiency than other employees; or
Was granted the opportunity to work, despite his or her disability, because of family relationship, past association with the firm, or other altruistic reason.
For development of special conditions related to the impairment, follow procedures in DI 11010.145E.2. (in this section) .