1150—EARNINGS REQUIREMENT—GENERAL AND SPECIFIC
1150A—General
The law requires that a disabled person must have a specified amount of social security
credits during a particular period of time. A person disabled before age 24 must have
credit for at least 6 calendar quarters (1 1/2 years) of work under social security
during the 3-year period ending with the quarter in which the disability begins.
A person disabled at ages 24 through 30 must have credit for work under social security
in at least one half of the calendar quarters beginning with the quarter after age
21 and ending with the quarter in which the disability begins.
A person disabled at age 31 or later must meet two covered work requirements:
(1) he/she needs 20 calendar quarters (5 years) of work under social security during
the 10-year period ending with the quarter disability begins.
(2) he/she also needs credit for 1 calendar quarter of work for each year after 1950
(or after reaching age 21, if that is later) up to the year the disability begins.
In the second instance, the credits may have been earned at any time.
1150B—Specific
One of the requirements of the law is that a person disabled (1) or (2) or (3).
(1) before age 24 must have credit for at least 6 calendar quarters (1 1/2 years)
of work under social security during the 3 year period ending with the quarter in
which the disability begins.
(2) at ages 24 through 30 must have credit for work under social security in at least
half of the calendar quarters beginning with the quarter after age 21 and ending with
the quarter in which the disability begins.
(3) at age 31 or later must meet two covered work requirements:
-
(a)
-
needs 20 calendar quarters (5 years) of work under social security during a 40-quarter
period (10 years) ending in or after the quarter the disability begins.
-
(b)
-
he/she also needs credit for 1 calendar quarter of work for each year after 1950 (or
after reaching age 21, if that is later) up to the year disability begins.
In the second instance, the credits may have been earned at any time.
1151—DIB AND FREEZE—DISABILITY REQUIREMENTS
To be considered disabled for social security purposes, a person must be unable to
do any substantial gainful work because of a medical condition which has lasted or
can be expected to last for a continuous period of at least 12 months or must be expected
to end in death. His/Her impairment must be severe enough to prevent him/her from
working not only in his/her usual occupation but in any other substantial gainful
work. His/Her age, education, remaining functional capacity, training, and work experience
are considered in determining how his/her impairment affects his/her ability to work.
1152—DIB AND FREEZE—DISABILITY AND EARNINGS REQUIREMENTS
To be considered disabled for social security purposes a person must be unable to
do any substantial gainful work because of a medical condition which has lasted or
can be expected to last for a continuous period of at least 12 months or must be expected
to end in death. His/Her impairment must be so severe as to prevent him/her from working
not only in his/her usual occupation but in any other substantial gainful work considering
his/her age, education, remaining functional capacity, training, and work experience.
In addition, the disability must exist at a time when the earnings requirement is
met.
To meet the earnings requirement, a person disabled (1) or (2) or (3).
Your/M 's social security record shows that you/he/she last met this earnings requirement
on . To qualify for disability benefits, your/his/her disability must have begun on
or before this date. A medical condition which may have occurred or become disabling
after the earnings requirement is last met cannot qualify a person for disability
benefits.5
(1) before age 24 must have credit for at least 6 calendar quarters (1 1/2 years)
of work under social security during the 3 year period ending with a quarter in which
the disability begins.
(2) at ages 24 through 30 must have credit for work under social security in at least
one-half of the calendar quarters beginning with the quarter after age 21 and ending
with the quarter in which the disability begins.
(3) at age 31 or later must meet two covered work requirements:
-
(a)
-
he/she needs 20 calendar quarters (5 years) of work under social security during the
10-year period ending with the quarter disability begins.
-
(b)
-
he/she also needs credit for 1 calendar quarter of work for each year after 1950 (or
after reaching age 21, if that is later) up to the year disability begins.
In the second instance, the credits may have been earned at any time.
1152.1—DWB—DISABILITY REQUIREMENTS
1152.1A—To meet the disability requirements of the law, a widow/widower/ surviving
divorced spouse must have a medical condition so severe as to prevent him/her from
doing any gainful activity. This condition must last or be expected to last a continuous
period of at least 12 months or must be expected to end in death.
1152.1B—To meet the disability requirements of the law, a widow/widower/ surviving
divorced spouse must have a medical condition so severe as to prevent him/her doing
any gainful activity.
This condition must last or be expected to last for a continuous period of at least
12 months, or must be expected to end in death. (Use one of the optional statements.)
Option 1
In addition, the condition must have started no later than 7 years after the death
of your/M 's husband/wife. In your/M 's case this requirement will be met until/was last met on (date).
or
Option 2
In addition, the condition must have started no later than 7 years after you/ M last received mother's/father's benefits In your/her case this requirement will be
met until/was last met on (date).
or
Option 3
In addition, the condition must have started no later than 7 years after you/ M last received disabled widow's/widower's benefits. In your /his/her case this requirement
will be met until/was last met on (date).
A medical condition which becomes disabling after the 7-year period cannot qualify
a person for disabled widow's or widower's benefits.5
1152.2—DWB—DISABILITY AND SPECIFIED 7-YEAR REQUIREMENTS—GENERAL
A widow/widower/surviving divorced spouse may be considered disabled only if he or
she has a physical or mental impairment that is so severe as to prevent a person from
doing gainful activity. This disability must last or be expected to last for a continuous
period of at least 12 months or must be expected to end in death.
In addition, the disability must have started within a specified 7-year period. It
must have started not later than 7 years after the month of death of the wife or husband;
or, for a widow, widower or surviving divorced spouse formerly entitled to mother's
of father's benefits, no later than 7 years after the month those benefits ended.
For a widow, widower or surviving divorced spouse who was previously disabled and
who becomes disabled again, not later than 7 years after the prior period of disability
ended.
The 7-year period in your/M 's case ended on (date) .
A physical or medical impairment which may have become disabling after the latter
of these dates cannot qualify a person for disabled widow's, widower's, or surviving
divorced spouse's benefits5
1152.3—DWB—SEVERE IMPAIRMENT ALLEGED TO HAVE EXISTED IN THE PAST BUT WHICH DOES NOT
EXIST AT ANY TIME WITHIN THE SPECIFIED 7-YEAR PERIOD
A medical condition which may have been disabling before but not during the specified
period explained above cannot qualify a person for disabled widow's /widower's/surviving
divorced spouse's benefits.
1154—CHILDHOOD DISABILITY REQUIREMENTS
To be considered disabled for social security purposes a child must be unable to do
any substantial gainful work because of a medical condition which has lasted or can
be expected to last for a continuous period of at least 12 months or can be expected
to end in death. His/Her impairment must be severe enough to prevent him/her from
doing any substantial gainful work considering his/her previous training and work
experience. The child's disability must have been before age 22.
1155—WILLFUL FAILURE TO FOLLOW PRESCRIBED TREATMENT
If a person refuses to follow prescribed treatment without good cause that could restore
his/her ability to work, he/she may not become entitled to disability benefits.
1156—DIB—EXPLANATION OF CONTINUING ELIGIBILITY
To be considered disabled for social security purposes a person must be unable to
do any substantial gainful work because of a medical condition which has lasted or
can be expected to last for a continuous period of at least 12 months or can be expected
to end in death. His/Her impairment must be so severe as to keep him/her from working
not only in his/her usual occupation but in any other substantial gainful work considering
his/her previous training and work experience. For a person to remain entitled to
a period of disability or disability benefits, he/she must show that his/her disabling
condition continues to be severe enough to prevent him/her from doing substantial
gainful work.
1157—DIB-CDB CESSATION—NOT DISABLED
To be considered disabled for social security purposes, a person's medical condition
must be so severe as to prevent him/her from engaging not only in his/her usual occupation
but also in any other kind of substantial gainful work, considering his/her remaining
functional capacity, age, education, training, and work experience. Disability benefits
end when a person is not disabled within the meaning of the law. The law provides,
however, that benefits may be continued for 2 months after the month in which the
person's condition does not meet the disability requirement.
1157.1—DWB CESSATION—NOT DISABLED
A widow/widower/surviving divorced spouse may be considered disabled for social security
purposes only if he or she has a medical condition that is so severe that it would
prevent him/her from doing any gainful activity. Disability benefits end when a person
is not disabled within the meaning of the law. The law provides, however, that benefits
may be continued for 2 months after the month in which the person's condition does
not meet the disability requirement.
1158—DIB-CDB CESSATION—WORK ACTIVITY—TRIAL WORK PERIOD
To be considered disabled for social security purposes, a person must have a medical
condition so severe as to prevent him/her from engaging not only in his/her usual
occupation but also in any other kind of substantial gainful work, considering his/her
age, education, training, and work experience. Disability benefits end when a person
is not disabled within the meaning of the law. If a person works while still under
a disability, the law provides that benefit payments may continue during 9 months
of trial work. Then, if it is determined after the 9 months that he/she has demonstrated
his/her ability to do substantial gainful work and therefore is not disabled according
to the social security law, his/her benefits are paid for 3 more months.
1158.1—DWB CESSATION—WORK ACTIVITY TRIAL WORK PERIOD
A widow/widower/surviving divorced spouse may be considered disabled for social security
purposes only if he or she has a medical condition that is so severe that it would
prevent him/her from doing any gainful activity. Disability benefits end when a person
is not disabled within the meaning of the law. If a person works while still under
a disability, the law provides that benefit payments may continue during 9 months
of trial work. Then if it is determined after 9 months that he/she has demonstrated
his/her ability to do gainful work and therefore is not disabled according to the
social security law, his/her benefits are paid for three more months.
1159—DIB-DWB-CDB CESSATION—NOT DISABLED VS. WORK ACTIVITY CESSATION
The law provides for ending a period of disability if medical evidence shows that
a person can do substantial gainful work or if he/she has demonstrated his/her ability
to do such work. When a person has a severe impairment and returns to work, he/she
is allowed a trial work period of 9 months in which to demonstrate that he/she can
sustain the work activity. If ability to engage in substantial gainful work is demonstrated,
disability ceases.
The trial work period may not continue beyond the time it is established that the
individual is able to return to work. Benefits are continued for 2 months following
the month in which it is determined that the individual was not disabled.
1160—VARIATIONS ON LAW PARAGRAPHS
1160A—Whether or not an impairment in a particular case constitutes a disability is
determined from all the facts of that case. Primary consideration is given to the
effect of an impairment upon an individual's ability to work, as demonstrated by clinical
and laboratory findings. Due weight is also given to a person's age, education, and
work experience.
(May be used in conjunction with regular law paragraph when unusual emphasis is placed
on severity of a person's condition, and/or statements may be made that we have not
considered all the evidence.)
1160B—Whether or not an impairment in a particular case constitutes a disability is
determined from all the facts of that case. Primary consideration is not given to
diagnoses. The primary consideration is the effect of an impairment upon an individual's
ability to work, as this is demonstrated by clinical and laboratory findings. Due
weight is also given to a person's age, education, and work experience.
(May be used in conjunction with law paragraph when unusual emphasis is placed on
a specific diagnosis, e.g., arthritis, as being disabling.)
1160C—Sequential Evaluation Process
Whether or not an impairment in a particular case is disabling is determined from
all the facts of the case. However, primary consideration is given to the severity
of the impairment as demonstrated by clinical and laboratory findings. In fact, medical
considerations alone may determine the issue of disability. When a claimant's disability
cannot be determined on medical grounds alone and his/her impairment or impairments
prevent him/her from working at his/her regular occupation, his/her age, education,
and work experience are considered in deciding whether he/she is able to do other
kinds of substantial work.
For example, a marginally educated person who has worked for 35 to 40 years at arduous
unskilled labor and can no longer do so may be found to be disabled. Where these specific
criteria are not met, whether the person can perform his /her regular or some other
type of work is evaluated.
Under the latter type of criteria, a person must be unable to do his/her previous
work and also, considering his/her age, remaining functional capacity, education and
work experience, unable to do any other kind of work which exists in the national
economy. If he/she can do any work which exists in the national economy he/she cannot
meet these criteria. This is so regardless of whether such work exists in the immediate
vicinity where he/ she lives, or whether a specific job vacancy exists for him/her
or whether he /she would be hired if he/she applied for such work.
1161—MEDICALLY DETERMINABLE, DEFINITION OF
The social security law specifies that the impairment must be demonstrable by medically
acceptable clinical and laboratory diagnostic techniques. Regulations implementing
the law require that the medical evidence (signs, symptoms and laboratory findings)
be sufficient to enable a reviewing physician to arrive at an independent evaluation
as to the nature and limiting effects of the person's impairment, his/her ability
to engage in physical and mental activities, and the probable duration of the impairment.
1162—SGA, DEFINITION OF
1162A—SGA Earnings Levels for Nonblind
Substantial gainful activity is any work generally done for pay or profit that involves
significant duties. (Work may be considered substantial even if performed part-time
and even if it pays less or is less demanding than the individual's former work.)
In evaluating a person's work activity, we consider the duties of the job, the skill
and experience they require and the amount of earnings. (That current work might pay
less, be different, and be less complex than what he/she did before the disability
began does not necessary mean that he/she would be found eligible for disability benefits.)
We ordinarily consider that a person who has earnings averaging more than $300 a month,
after deducting disability-related work expenses, is doing substantial gainful work.
(Use sentences in parentheses when appropriate.)
1162B—SGA Earnings Levels, Minus Subsidy—For Nonblind
A disability claimant is not entitled to benefits if he/she is able to do substantial
gainful work. Whether a person has shown such ability depends on the work the person
does in terms of the amount of earnings, skills, responsibility, productivity, hours
and duration involved. Earnings averaging more than $300 a month, after disability-related
work expenses are deducted, would ordinarily be considered substantial gainful work.
However, if his/her pay includes a “subsidy” which reduces the amount of his/her true earnings for the work, only his/her true
earnings would be considered. A subsidy would exist, for example, when an employer-because
of special consideration for a handicapped person-pays the employee more than the
reasonable value of his/her services. This often occurs when a person works in a “protected” or “sheltered” type of employment.
1162C—SGA Earnings Levels, Employees and Self-Employed
Generally, work which results in substantial earnings would show ability to engage
in substantial gainful work. However, regardless of the amount of earnings, where
the work is discontinued after a short time because of the person's impairment it
would not be considered substantial.
and
Option 1
(a) Earnings average more than $300 a month after deducting disability-related work
expenses, ordinarily would show ability to do substantial gainful work. Generally
earnings averaging less than $190 a month are not considered substantial.
Earnings average between $190 and $300 a month are not ordinarily consider substantial
unless the work is about the same, in amount and quality, as that of other workers
in the community who do such work for a living. If the work is the same in amount
and quality as that of other workers in the area who do such work for a living, the
individual is considered to be doing substantial gainful work.
or
(b) In determining the ability of a self-employed person to perform substantial gainful
work, earnings may not be as important as the extent of his /her activities in the
business and his/her supervisory, managerial or advisory services. Earnings or losses
from the business may be due to factors other than work activities. For example, a
person's work may be considered substantial even if his/her business operates at a
loss or earns only a small profit. Generally, a self-employed person's work is considered
substantial and gainful if it is reasonably worth over $300 a month to the business
or, in terms of total hours, duties and responsibilities, is comparable to that of
others in the area who are in similar businesses.
and (where applicable)
Option 2
If a person works under special conditions, for example in a sheltered workshop or
comparable facility, only earnings based on his/her own productivity (as distinguished
from a subsidy based on his/her financial needs or other nonwork factors) are considered.
The fact that the “sheltered” institution operates at a deficit and receives charitable contributions or governmental
aid does not necessarily mean that a particular employee is not earning his/her salary.
However, earnings of $300 a month or less in a sheltered workshop will ordinarily
not demonstrate ability to engage in substantial gainful work.
1163—FIVE-MONTH WAITING PERIOD
1163A—If you/M became disabled on , you/ he/she would not be entitled to disability benefits for any month earlier
than , the sixth full month of disability. The law provides for a 5 calendar month waiting
period before disability payments can begin.
1163B—To be entitled to disability benefits a person must be disabled throughout the
5-calendar month waiting period. Thus, it is often necessary to get medical evidence
near the end of the waiting period to decide whether this requirement has been met.
1163C—A claim for disability benefits may be filed at any time after disability begins
and can often be processed before the waiting period expires. We do not ordinarily
defer action on the claim until the end of the waiting period. In fact, we encourage
early filing, and many people who file during the waiting period get their first check
the third day of the month following the first month of entitlement.
1164—EXTENDED PERIOD OF ELIGIBILITY
If a person who still meets the disability requirement becomes unable to work again
within 15 months after 9 months of trial work, the monthly benefits can be started
again in most cases. A new application is not needed.
1170—INABILITY TO ENGAGE IN SGA NOT ESTABLISHED—DIB or CDB CLAIMANT CONFINED TO HOSPITAL,
INSTITUTION, ETC.
The fact that a person is confined in a hospital/institution/ does not, in itself, establish that he/she is disabled as defined by the social security
law. To be considered disabled for social security purposes, a person must be unable
to work because of a medical condition which has lasted or can be expected to last
for a continuous period of at least 12 months or can be expected to end in death,
in making a disability determination consideration is given to the individual's remaining
functional capacity, age, education, training, and work experience as well as to the
severity of his/her impairment. Disability is established when the evidence based
on all of these factors shows that the individual is unable to perform substantial
gainful work. Even though a person is confined to a hospital/ institution/ the evidence must still establish that it is his /her medical condition and not his/her
confinement that is preventing him /her from engaging in substantial gainful work