In initially determining SGA, assume, absent evidence to the contrary, that SEQY postings in excess of the SGA level for a particular year represent continuous work activity at the SGA level for all months of that year. These years are called “PRESUMED SGA YEARS.”

Review the SEQY to determine SGA. Years before 1990 with over $3600 posted and the years 1990 on with over $6000 posted are PRESUMED SGA YEARS (see DI 10515.015).

Count back 48 months from the date SSA received the request for review to find the beginning of the DEVELOPMENT PERIOD. In counting back, do not count years where the SEQY shows annual earnings at the SGA level or months where any other exclusion listed in DI 12586.035C.1. is applicable.

SSA-820/821(s) will usually not be needed. Obtain SSA-820/821s only:

1. a. 

   If all SEQY years are presumed SGA years (see B.5., regarding SGA denials), or

2. b. 

   To document work activity not reflected on the SEQY that may affect the DEVELOPMENT PERIOD.

In the following examples, the AOD is earlier than the earliest year cited in the sample postings.

EXAMPLE 1: The SEQY shows the following postings for the Stieberger period:

Claimant's request for Stieberger relief was received in 3/93. Per the SEQY, 1992 and 1993 are PRESUMED SGA years. No SGA is indicated for 1988-1991. Work other than that reflected on the SEQY is not an issue; no SSA-821 is needed. The DEVELOPMENT PERIOD begins 1/88.

EXAMPLE 2: The SEQY shows the following postings for the Stieberger period:

Claimant's request for Stieberger relief was received in 4/93. The only years that are not presumed SGA years are 1991, 1985, and 1982. Each presumed SGA year counts for 12 months. Therefore, counting back from the month of request for review, 48 non-excluded months cannot be found. In this case, the DEVELOPMENT PERIOD begins in 1/82, the first month in the earliest non-SGA year within the Stieberger period.

EXAMPLE 3: One of the other development exclusions applies and the SEQY shows the following posted earnings for the Stieberger period:

In this case two DEVELOPMENT PERIOD exclusions apply; a period adjudicated in a non-New York denial (covering the period 3/90-10/91) and presumed SGA years (as reflected in the SEQY postings). In counting back 48 months from 4/ 93 (the month of receipt of the request for review), the months in the presumed SGA years of 1993, 1992, 1987 and 1986 are excluded. Also excluded are the months from 10/91 back to 3/90, the period covered by the non-New York denial.

After considering the applicable exclusions, counting back 48 non-excluded months would go as follows:

Per B.3 above, obtain SSA-820/821s where all years on the SEQY are presumed SGA years. Use the developmental tolerances in DI 12586.070 to develop work activity. Prepare an SGA denial if there is no period of non-SGA lasting at least 12 consecutive months.

See DI 12586.095, Exhibits 13 and 14 for title II and title XVI SGA denial letters. For concurrent title II and title XVI claims, follow Exhibit 13, DI 12586.095 and add the disclaimer paragraph 842 for the title II claim; and for title XVI follow Exhibit 14, DI 12586.095 and add the disclaimer paragraph in 1487 (NL 00804.240).

Send copies of all SGA denial notices to the class member, any representative, and to the Litigation Staff (address in DI 12586.020E). Annotate the Litigation Staff copy, “SGA denial for input to CATS.”