TN 64 (09-09)

DI 11055.095 Claimant Engaging in Substantial Gainful Activity (SGA)

A. Policy when a claimant is engaging in SGA and does not allege a visual impairment

If the claimant is engaging in SGA and does not allege a visual impairment, AND either:

  1. SGA began before the month of filing, or

  2. SGA began in or after the month of filing and there is no possibility that the duration of the claimant’s disability lasted at least 12 months,

THEN, the FO will do a SGA denial.

NOTE: If the SSI claimant is engaging in SGA and does allege a visual impairment, the FO sends the case to the Disability Determination Services (DDS) for a disability determination.

B. Procedure for processing SGA denials electronically

Always process an SGA denial electronically, unless a Certified Electronic Folder (CEF) exclusion applies. For processing instructions, refer to DI 81010.140C.

C. Procedure for processing SGA denials in CEF-exclusion cases

If the claimant is engaging in SGA and the claimant meets the conditions in this section at DI 11055.095A:

  1. Obtain an SSA-820-F4 (Work Activity Report -- Self-Employed Person) or an SSA-821-F4 (Work-Activity Report - Employee), as appropriate.

  2. Complete Form SSA-831(Disability Determination and Transmittal). For completing SGA denials in Title XVI claims, see DI 11055.135.

  3. Adjudicate the SGA denial.

  4. Place the folder copy of the SSA-831 in the official folder.

  5. Retain the claim in the field office (FO) until requested for folder shipment.

  6. Send a copy of the SSA-831 to the Wilkes-Barre Direct Operations Center, Attention: Form SSA-831.

  7. Destroy the remaining copies of the SSA-831.

EXCEPTION: If the FO is processing concurrent Title XVI/Title II SGA determinations, process in accordance with DI 11055.045 and DI 11010.090.

NOTE: If the claimant is engaging in SGA and earnings are above the income break-even point per SI 00810.350, completion of the SSA-831 is not necessary. Deny the claim for excess income per the Abbreviated Application Process SI 00602.001C.

References:


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