The field office (FO) should route the case to the Disability Determination Services (DDS) for a medical determination when the claimant meets the non-medical requirements, and any of the following criteria:

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  The claimant is engaging in work activity, but the field office (FO) concludes that the work activity is not substantial gainful activity (SGA);

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  The claimant was engaging in SGA after the alleged onset, but ceased SGA (Develop the reason for discontinuance or reduction of work.); or

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  A Title XVI claimant is engaging in SGA, but alleges a visual impairment.

After consideration of all work exclusions, deny the claim if the claimant is engaging in SGA.

If earnings are above SGA but below the income break-even point, process an SGA denial (see DI 11055.095).

If earnings are above SGA, and above the income break-even point, deny for excess income (see SI 00602.001C).

References:

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  DI 10501.001, Meaning of SGA and Scope of Subchapter

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  DI 10501.025, Responsibilities and Procedures – Work Issue Cases

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  DI 10505.035, Documenting Employment Cases

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  DI 10510.025, Documenting Self-Employment Cases

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  DI 11055.095, Claimant Engaging in Substantial Gainful Activity (SGA)

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  DI 13010.110, Return to Work Within A Year Of Onset (Title XVI)