TN 49 (08-08)
DI 11010.175 Work Comparability Provisions for Title II Disabled Individuals Age 55 and Older
A. Policy – disabled individuals age 55 and older
A blind worker 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. The comparability provisions for blind individuals age 55 and older apply to blind workers (the wage earner on whose account payments are being made), blind disabled adult children, and blind disabled widow(er)s.
B. Explanation – eligibility for benefits
If an individual engages in non-comparable SGA, he or she may be entitled to disability benefit status (see SSA-831 (Disability Determination Transmittal), (item 18B.), but cash benefit payments are suspended as long as the individual is actually engaging in any SGA. This suspension applies to workers, disabled adult children, and disabled widow(er)s.
A blind individual 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, who have been denied for cash benefit purposes because of SGA, and must, therefore, file a new application when SGA ceases in order to receive disability benefits. See Eligibility for Disability Insurance Benefits (DIB) or the Disability “Freeze” - DI 10105.005B and Claimant in Freeze Status Files for DIB DI 41005.010 for information about disability freeze for statutory blind individuals.
D. Waiting period
Under the comparability provisions, if a worker age 55 or older, is determined to be statutorily blind and engaging in non-comparable SGA, the period of time beginning with the 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 with the first month of non-SGA. This contrasts with the requirement for blind workers in regular “freeze” status only, who must serve a waiting period after the cessation of SGA in order to be entitled to disability benefits.
E. Comparability decisions - age-55-or-older DIB claims
Disability determinations under this provision require 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 individuals age 55 or older, are made by the Disability Determination Services (DDS) in initial and reconsideration cases, and in continuing disability cases where a medical issue exists. Program Service Center-Disability Processing Branch (PSC-DPB) makes 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 is generally performed over several years, a determination of comparability may involve year(s) in which the pre-1978 SGA test applies and other year(s) in which the blind SGA test applies. The use of one or both tests may be necessary in evaluating a single period of SGA, and may necessitate field office (FO) preparation of more than one SGA determination.
When an individual, age 55 or over, alleges blindness and is engaging in SGA, develop and prepare an SGA determination (use the SSA-820 (Work Activity Report-Self Employed ) or the SSA-821 (Work Activity Report-Employee) as appropriate) for each job which lasted 12 months or longer (not necessarily 12 consecutive months) in the 10- year period prior to the later of either:
Onset of blindness; or
Attainment of age 55.
Also, develop and prepare SGA determinations for each period of work after the later of:
Onset of blindness; or
Attainment of age 55.
NOTE: Apply the earnings guideline that is appropriate for the year in which the work was performed. See Tables of SGA Earnings Guidelines and Effective Dates Based on Year of Work Activity - DI 10501.015