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SGA before Final Determination of SSDI Eligibility

When the Social Security Administration (SSA) makes a final determination of your eligibility for Social Security Disability Insurance (SSDI - Title II), you receive a notification of final determination. If you have not received that notification, or if you do not know whether or not you have received it, you should answer No to the question, "Has SSA notified you that a final determination of your eligibility for SSDI has been made?" If you do not know, contact your SSI claims representative to find out your status.

ALERT: All work activity must be reported to SSA. You should always contact SSA before you engage in any work activity to determine what effect, if any, working might have on your SSDI benefits.

If you have not received a final determination notification (SSA calls this an "Award Certificate" form SSA-L-30C1, and it shows your established onset date and your month of entitlement to benefits), then your claim may not be finally adjudicated. This could mean that SSA has not determined an established date of onset, which could be different than either the date of your application or your alleged onset date. It could also mean that SSA has not made a determination of your disability.

Returning to work at the Substantial Gainful Activity (SGA) level under the conditions listed above, or during the five-month application waiting period, or within one year of the established date of onset, could possibly result in SSA determining that your disability has ceased and that you are not eligible for SSDI.

You should be aware that if, prior to the final determination date, you have earnings that exceed the Substantial Gainful Activity (SGA) amount, you may be determined ineligible for SSDI unless you have an Unsuccessful Work Attempt.

NOTE: In deciding whether the person is performing SGA, only the pay that has been earned through a person's own effort is counted. If, for example, it is necessary for an employer to provide special help for an individual to work, the value of such special assistance may be considered a subsidy. As such, only those earnings that are based on the individual's own productivity are used in determining total earnings. Additionally, impairment-related work expenses incurred by a disabled individual will be deducted from earnings before determining whether the SGA level is met. SGA determination is always done in the same manner and is not affected by any timing considerations, such as whether the time period in question is before or after the onset date of disability, application for SSDI, or final determination of disability. (see SSA POMS: DI 24001.025)

The rules do say, however, that if you begin engaging in SGA a year or more after the "onset" of your disability, then rather than lose your eligibility you will retain your SSDI benefits under the Trial Work Period (TWP) provisions -- even if you have not yet received notification of final determination. Unfortunately, the rules for determining the date of "onset" are quite complex. (See Onset of Disability for more information.)

If you have not received notification of final determination and you have an opportunity to attempt working at the SGA level, you should contact your SSA claims representative to find out if doing so would jeopardize your SSDI eligibility.

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