When a beneficiary works after completing the TWP, determine if the work activity
shows an ability to engage in SGA.
If it does, the disability has ceased, if it does not, determine that the disability
Returning to work may present a medical improvement issue. If this issue is present,
and the beneficiary is not protected from a medical CDR, consider if the beneficiary
may be protected from a medical review under the Ticket to Work program, or under
Section 111 of the Ticket to Work and Work Incentives Improvement Act of 1999 (see
DI 55001.001 or DI 13010.012).
If the beneficiary is not protected from a medical review, send the case to the Disability
Determination Services (DDS) for a medical CDR. If SGA continues for at least one
month following completion of the TWP, and the beneficiary has met all the other rules
related to SGA cessation, use the SGA exception to medical improvement, and find that
disability ceased. For instructions on how to complete the SSA-833-U3, see DI 13010.170).
EXAMPLE: If the ninth TWP month is 12/2002, and we made a SGA decision on 01/2003, there
must have been actual performance of SGA in the month of 1/2003 before we can find
that the disability ceased in 01/2003. If work does not continue for at least one
month at the SGA level, you can not use the SGA exception to medical improvement.
NOTE: Section 303 of the 1980 amendment provides a re-entitlement period, or EPE, to beneficiaries
who have completed their TWP. The re-entitlement period is a period of time where
the beneficiary may test his or her ability to work, and receives a disability payment
for any month that he or she does not perform SGA.
When evaluating work after the TWP, your determination must take into consideration
whether substantial gainful work is continuing, or, if it has stopped. Also, how long
has the work lasted? What was the reason the work stopped? Finally, consider all relevant
work incentives: i.e., unsuccessful work attempts (UWA) averaging, IRWEs, unincurred
business expenses, and subsidy, when applicable. Evaluate work activity, and decide
if it is SGA by using the SGA policies. Disability ceases when the beneficiary demonstrates
a continuing ability to engage in SGA.
DI 10501.015, Tables of Substantial Gainful Activity (SGA) Earnings Guidelines and Effective Dates
Based on Year of Work Activity
DI 10505.001, General - Evaluation and Development of Employment