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SGA - SSDI (Title II)

In the Social Security Disability Insurance (SSDI) program, the determination of whether or not you are engaging in Substantial Gainful Activity (SGA) is important both when you are applying for SSDI and after you complete your Trial Work Period (TWP).

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 waiting period after application, 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.

Applying for SSDI

SSA sets as the "Onset" date of your disability the first day that you meet the definition of disability; that is, the date of coincidence of:

·     Absence of substantial gainful activity (SGA), and

·     A medically determinable severe impairment, and

·     Duration expectation of 12 months or death.

If you should engage in SGA before 12 months from the established onset date have passed, SSA may determine that you are ineligible -- even if you have received your final letter of determination saying that you are eligible. (If you have received SSDI payments, you may be required to pay them back to SSA.)

NOTE: A full discussion of the rules concerning engaging in SGA before 12 months have passed from the established onset date can be found in SSA's POMS at DI 13010.105.

After Your Trial Work Period

If you are a SSDI (Title II) beneficiary, then your SSDI cash benefits will stop during each month you engage in Substantial Gainful Activity (SGA) after you have completed your Trial Work Period (TWP) and subsequent 3-month Grace Period.

If you engage in SGA at the end of your Extended Period of Eligibility (EPE), then you will be terminated from the SSDI program. (See Medicare - Continued Coverage for information about continuing your Medicare coverage after your EPE.)

NOTE: See Unsuccessful Work Attempt (UWA) for details about determining SGA if you must stop engaging in SGA because of your disability within 6 months.

Calculating Earned Income for SGA Determination

Note that if you have disability related work expenses or a subsidy or special condition, the amount may be excluded from your earned income in determining if you are engaging in SGA by using an IRWE and/or Subsidy and Special Condition work incentive.

NOTE: 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)

If you are self-employed and have business expenses that are reimbursed by another agency, you may be able to exclude those expenses by using the Unincurred Business Expense work incentive.

NOTE: See Countable Income and Countable Earnings Overview for more information on the various ways in which these terms are used in SSA programs.

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