Survivors and Disability Insurance
Proposed Decision-Benefit Offset Demonstration
Name and address
We have information about your work and earnings that could affect your Social Security
disability payments. Based on this information, it appears we will decide that your
disability ended because of substantial gainful work <F1>.
If we decide that your disability ended, it appears from the information we have that
we will also decide <F2>. Under the Benefit Offset Demonstration, we use your estimated
earnings to decide whether and how much to reduce your benefits. If your total countable
earnings exceed $<F3> ($<F4> monthly x <F5) for <F6, your total benefits will be reduced
by $1.00 for every $2.00 that you earn over $<F3>.
F2-1: to reduce your benefits payments based on your expected earnings
F2-2: to stop your benefit payments due to your expected earnings.
F6: yyyy; the period mm/yyyy through mm/yyyy
You told us that you would earn $<F7> in <F6>. Based on this information, <F8>
F8-1: your monthly payments should be $#### beginning mm/yyyy.
F8-2: you will not receive any payments for <F6> due to your expected earnings. The
last monthly payment you should receive is for mm/yyyy.
Optional: Use if IRWE/Subsidy or other deductions were
involved) You told us that you expect to have $<F9> We considered this amount when we determined
the amount of your payments. Please save your receipts for any expenses, and proof
of any deductions. We will ask to see them after the year is over.
F9: dictated text—provide total of IRWE, subsidy/special conditions etc…
We are writing this letter to give you a chance to give us more information that you
want us to consider. Please review the following information we are using to make
our decision. You have 10 days to give us more information before we make our decision
final. The 10 days start the day after you receive this letter. We assume that you
got this letter 5 days after the date on it unless you show us that you did not get
it within the 5-day period. If you need more time, let us know right away.
The Information We Have
We are considering the following reports in evaluating your claim:
Your signed statement regarding work and earnings
Social Security Administration earnings records
Work information reported to us by your employer
We are considering the following work in this decision:
There was no evidence to indicate that you did not fully earn the salary you were
The possibility of a subsidy from your employer(s) was considered in making this determination.
We considered the value of impairment related work expenses which you had to pay in
order to work when we considered whether your work was substantial gainful activity.
Based on the information we have, it appears we will decide that your disability ended
because of substantial work as of <F1>. Please read the following information about
what will happen to your payments if we make this decision.
What Happens When a Person Goes to Work
Going to work does not affect payments right away. That's because a person is allowed
a period of 9 trial work months to test his or her ability to work in spite of health
Beginning January 2007, a trial work month is any month in which a person earns more
$640 in gross wages, or
$640 in net self-employment earnings, or works more than 80 hours of work in self-employment.
In 2006, the trial work period monthly earnings amount was $620. The amount was $590
in 2005 , $580 in 2004, $570 in 2003, $560 in 2002 and $530 in 2001.
From January 1990 through December 2000, a trial work month was any month in which
a person earned more than:
$200 in gross wages, or
$200 in net self-employment earnings, or worked more than 40 hours of work in self-employment.
Beginning 1992, the 9 months of work must take place in a 60-month period to end the
trial work period. However, the 9 months do not have to be in a row.
Our records show your trial work period ended <F9> and that your nine months of trial
F10: mm/yyyy; mm/yyyy through mm/yyyy
What Happens After the Trial Work Period
if You Are Participating in the Benefit Offset Demonstration
After the trial work period, several things happen.
Your disability ends if your work activity shows you are able to do substantial gainful
work. See “What is Substantial Gainful Work?” below. We will pay benefits you for
the month disability ends and the following 2 months no matter how much you earn.
We call these three months the grace period. Based on the information we have, in
your case, this is <F1> through <F1>.
You get a 72-month extended period of eligibility that begins right after the trial
work period. If you work after the grace period and during the extended period of
eligibility, we may reduce your benefits based on your expected earnings. We will
reduce your benefits $1.00 for every $2.00 you earn over the substantial gainful work
amount as discussed in “What Is Substantial Gainful Work?” Generally, we will considered
your estimate earnings for the year and use your average monthly earnings to decide
whether and how much to reduce your benefits. We will deduct certain amounts from
our earnings to decide how much of your earnings to count. Based on the information
we have, it appears that we will decide <F12> as of <F13> due to your expected earnings.
F12-1—to reduce your benefit payments
F12-2 to stop your benefit payments
What is Substantial Work?
Generally, substantial work is physical or mental work a person is paid to do. Work
can be substantial even if it is part-time. To decide if a person's work is substantial,
we consider the nature of the job duties, the skills and experience needed to do the
job, and how much the person actually earns.
Usually, we find that work is substantial if gross earnings average over $900.00 a
month in 2007 ($860.00 a month in 2006) after we deduct allowable amounts. A person's
work may be different than before his/her health problems began. It may not be as
hard to do and the pay may be less. However, we may still find that the work is substantial
under our rules.
If a person is self-employed, we consider the kind and value of his/her work, including
his/her part in the management of the business, as well as income, to decide if the
work is substantial.
Information About Medicare
If you have Medicare and your disabling condition continues under our rules, your
coverage will continue for at least 93 months after your trial work period.
If We Do Not Hear From You
If we do not hear from you within the next 10 days, we will make our decision based
on the information we have now. The 10 days start the day after you receive this letter.
We assume you got this letter 5 days after the date on it unless you show us that
you did not get it within the 5-day period. When we make our decision, we will send
you another letter.
If You Have Any Questions
If you have questions, please contact your benefits counselor at <F14>, or <F15> at
F14: #800 number for state
OPTIONAL F15: DE name
OPTIONAL F16: DE phone number
Associate Commissioner for