Effective Dates: 11/19/2024 - Present

Identification Number:
DI 10505 TN 30
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Evaluation and Development of Employment
Type:POMS Full Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM

Part DI – Disability Insurance

Chapter 105 – Substantial Gainful Activity (SGA)

Subchapter 05 – Evaluation and Development of Employment

Transmittal No. 30, 11/19/2024

Audience

PSC: CA, CS, DE, DEC, DTE, ICDS, IES, ISRA, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, CR, CTE, CTE TE, ERE, FCR, FDE, RECONE, RECOVR;
OCO-ODO: BET, CST, DE, DEC, DS, RCOVTA, RECONE, RECONR, RECOVR;
ODD-DDS: DDS;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

ORDES

Effective Date

Upon Receipt

Background

We updated this Section with the current authorization requirements to access The Work Number and any other SSA-approved wage verification company. We added the Internet Ticket Operations Provider Support System (iTOPSS) data to the wage evidence priority list. We clarified that the work CDR system now automatically converts pay stub information into monthly totals. We provide gender neutral language throughout. 

Summary of Changes

DI 10505.005 Determining and Verifying Gross Earnings from Employment

Subsection A and B. We updated this section with gender neutral language.

Subsection C. We updated this section to explain that technicians should enter pay stub data into eWork and that it will automatically convert pay stub information into monthly totals based on pay periods. We incorporated information from EM-21069 which explains that we added data from the Internet Ticket Operations Provider Support System (iTOPSS) to the priority list of verification sources. We incorporated information from EM-23001 that explains that we now use a signed/attested form SSA-8240 as authorization to access The Work Number or any other SSA-approved wage verification company.

DI 10505.005 Determining and Verifying Gross Earnings from Employment

A. Determining gross earnings

When determining whether a claimant or beneficiary works at substantial gainful activity (SGA) levels, consider:

  • •

    when they worked; and

  • •

    how much they earned for the work activity for the period you are evaluating.

When developing monthly gross earnings, be alert to claimants or beneficiaries who:

  • •

    may be in a position to defer or suppress the amount of reported earnings (e.g., family employment, corporate officer); or

  • •

    received earnings, but may not have actually worked for them (e.g., sick leave, military casualty, vacation pay, paid time off, disability payments); or

  • •

    may be eligible for work incentive deductions. For policies on how to determine countable earnings when impairment related work expenses (IRWEs), special conditions, or subsidies may apply, refer to DI 10505.010.

    NOTE: To estimate monthly earnings, multiply weekly earnings (hourly rate of pay x hours worked) by 4.333.

B. Documenting work activity

Document work activity using the form SSA-821-BK (Work Activity Report - Employee) per DI 10505.035, to obtain the following information:

  • •

    name of employer and type of work;

  • •

    dates of employment;

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    hours worked;

  • •

    rate of pay and when they earned payments;

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    non-work pay (e.g., sick pay, special pay, etc.); and

  • •

    work incentive information (e.g., subsidies, IRWEs).

Review the information provided on the report to verify work activity following instructions in DI 10505.005C for post entitlement determinations and DI 10505.005D for initial claims.

NOTE: Do not complete an SSA-821-BK when earnings are “clearly not SGA.” For a definition of “clearly not SGA,” see DI 10505.003.

NOTE: It is not necessary to develop work incentive information if the evidence shows that the difference between gross and countable earnings would not change the SGA determination. For information about determining countable income, see DI 10505.010.

C. Verifying earnings for post-entitlement determinations

1. Policy for earnings when paid versus when earned

Section 825 of The Bipartisan Budget Act of 2015 simplifies post-entitlement SGA determinations by allowing us to presume post-entitlement earnings were earned in the month they were paid. Evaluate any readily available earnings verification sources and determine when earnings were earned. If there is no readily available evidence to determine when earnings were earned, use other sources of earnings verification even if the earnings source only documents when earnings are paid. This policy applies to all post-entitlement determinations made after September 23, 2016, including trial work period and reopening determinations.

NOTE: Our Due Process notice advises beneficiaries that we may have used earnings information based on when paid and advises the beneficiary of the opportunity to provide additional information regarding when the pay was earned.

2. Priority list of earnings verification sources

Verify earnings using the following sources in order. If you believe evidence from a source is not accurate, proceed down the priority list to find earnings that are more accurate. The Consolidated Wage Page (CWP) displays a consolidated view of commonly used wage data sources via the Electronic Disability Collect System (EDCS).

a. Earnings on file

Use earnings information that indicates when the monthly earnings were earned. Check the pay stub table in eWork for submitted wages. If the pay stub table has earnings from two or more sources for the same employer for the same period, but the information conflicts or is duplicate, prioritize the earnings in the following order:

  • •

    Earning posted by a Social Security employee (SSAE)

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    Earnings reported online by a beneficiary or representative payee (myWR)

  • •

    Earnings reported by the Employment Network (ENI)

eWork automatically converts pay stub information into monthly totals based on pay periods. Select the “verified by” code of Pay Stub for SSAE, myWR, and ENI earnings. For any months that you are unable to determine an accurate amount, proceed to the next available earnings source. You may use a combination of earnings sources to complete the review.

NOTE: You may also use pay stub evidence stored in other repositories. For example, you may also use the Supplemental Security Income Monthly Wage Verification Application (SSIMWV) or pay stubs scanned in Evidence Portal. Use SSIMWV pay stubs only if they include pay period information, and you can determine when the pay was earned.

b. Electronic wage verification company

If the employer participates with The Work Number or any other SSA-approved wage verification company, verify earnings using the third-party service. For a list of SSA-approved wage verification companies, see SI 00820.147. A signed or attested SSA-8240 serves as authorization to obtain wages from electronic wage verification companies. Generally, you can determine when earnings are earned based on pay period start and end date. Enter the earnings into the eWork pay stub table. eWork will convert earnings into prorated monthly totals on the employer Earnings Detail screen. Code as "verified by" EWV. If you are unable to determine when earnings were earned or the employer does not use an electronic wage verification company, proceed to the next source of earnings.

 

c. Pay stubs

If the beneficiary can provide pay stub information within 15 days for field offices (FO) or 35 days for processing service centers (PSC), use the pay stub data. When pay period start and end dates are available, enter the earnings into the eWork pay stub table. eWork will convert earnings into monthly totals. Code as "verified by" Pay Stubs. If pay stub information is incomplete or inconsistent, and you need additional evidence of earnings, proceed to the next source of earnings. You may use a combination of pay stubs and other earnings sources to complete the review.

d. Internet Ticket Operations Support System (iTOPSS)

Access the CWP in EDCS to view iTOPSS data. iTOPSS contains pay stub wage data for Ticket to Work users. When pay period start and end dates are available, enter the earnings into the eWork pay stub table. Code as "verified by" Pay Stubs. If wage information is incomplete or inconsistent, and you need additional evidence of earnings, proceed to the next source of earnings. You may use a combination of pay stubs and other earnings sources to complete the review.

e. Supplemental Security Income (SSI) verified wages

Check SSI systems for verified monthly earnings. Input the earnings into the eWork Earnings Details screen and code as "verified by" SSI wages. Code as "verified by" NDNH.

f. National Directory of New Hires (NDNH)

Check the NDNH for quarterly earnings. Use the date work started information from the SSA-821-BK or the date hired information from the NDNH to determine the number of months worked in the quarter and divide the earnings amount accordingly. If there is no SSA-821-BK and no date hired information on the NDNH, divide quarterly earnings by three and enter monthly earnings on the eWork Earnings Details screen.

g. Summary earnings query (SEQY) or detail earnings query (DEQY)

Check the SEQY or DEQY. Use the date work started information from the SSA-821-BK or the date hired information from the NDNH to determine the number of months worked in the year and divide the earnings amount accordingly. If you are unable to determine the number of months worked in the year, use the Quick Distribution button to distribute earnings throughout the year and code as "verified by" SEQY/DEQY.

h. SSA-L725

The SSA-L725 is a last resort. Pursue all other sources of earnings verification before using it. However, if no other source of earnings verification is available, send an SSA-L725 request to the employer. Tickle the case for 15 days for FO and 35 days for PSC processing. If you receive earnings information, code monthly earnings as "verified by" SSA-L725.

NOTE: If the employer participates in an SSA-approved electronic wage verification company, but you are unable to access the information because you do not have appropriate authorization (i.e., you do not have a signed/attested SSA-8240), do not send the SSA-L725.

D. Verifying earnings for Initial Claims

1. Policy for determining when wages were earned

Adjudicators must verify when wages are earned to determine the potential onset date (POD). Resolve significant discrepancies between the claimant’s allegation and verification obtained. Significant discrepancies are those that:

  • •

    Cannot be accounted for and resolved as a difference between when earnings were paid versus when they were earned (or another posting reason); and

  • •

    Could result in a change in the POD.

For additional information about the POD, see DI 25501.220.

NOTE: Use the initial claim earnings priority when verifying earnings for requests for EXR.

2. Priority list of earnings verification sources for initial claims

Verify earnings using the following sources in order. If you believe evidence from a source is not accurate, proceed down the priority list to find earnings that are more accurate.

a. Immediately available earnings

Use the pay stub information that is available at the time of the initial claim and indicates when the monthly earnings were earned. If the earnings information is incomplete or inconsistent, proceed to the next source.

b. Electronic wage verification company

If the employer participates with The Work Number or any other SSA-approved wage verification company, and you have a signed or attested SSA-8240, verify earnings using the third-party service. For a list of SSA-approved wage verification companies, see SI00820.147. Use the Pay Distribution Calculator to convert weekly or bi-weekly earnings into monthly totals. If you are unable to determine when earnings were earned or the employer does not use an electronic wage verification company, proceed to the next source of earnings.

c. Pay stubs

If the beneficiary can provide pay stubs information within 15 days, use pay stub data. You may use the Pay Distribution Calculator to convert weekly or bi-weekly earnings from pay stubs into monthly totals. If additional evidence of earnings is needed, proceed to the next source of earnings.

NOTE: You may also use pay stub evidence stored in the SSI monthly wage verification application (SSIMWV). Use SSIMWV pay stubs only if they include pay period information, and you can determine when the pay was earned.

d. SSA-L725

Send an SSA-L725 request to the employer to determine when earnings were earned. Tickle the case for 15 days. If the employer does not return the form or the information is incomplete, proceed to the next source.

NOTE: If the employer participates in an SSA-approved electronic wage verification company, but you are unable to access the information because you do not have appropriate authorization (i.e., you do not have a signed/attested SSA-8240), do not send the SSA-L725, but instead proceed to the next source of earnings.

e. SSI verified wages

Check SSI systems for verified monthly earnings. Compare earnings data with SSA-821-BK information to determine when wages were earned.

f. NDNH

Use the NDNH only as a starting point when investigating earnings for SSDI claimants in initial claims. If you are unable to determine the monthly earnings based on NDNH information and the information on the SSA-821-BK, make your determination using the instructions in DI 10505.035E.1.

g. SEQY or DEQY

Use SEQY or DEQY data only as a starting point when investigating earnings for SSDI claimants in initial claims. If you are unable to determine the monthly earnings based on SEQY or DEQY information and the information on the SSA-821-BK, make your determination using the instructions in DI 10505.035E.1.

 


DI 10505 TN 30 - Evaluation and Development of Employment - 11/19/2024