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SGA - SSI

Substantial Gainful Activity (SGA) affects SSI applicants and recipients in three ways:

1.   If you are engaging in SGA when you apply for SSI (and you are not blind), you will be determined not eligible for SSI. (Applicants who meet the SSA criteria for blindness do not have to meet the SGA test.)

NOTE: In determining SGA, SSA takes into account the Work Incentives listed in SSI Work Incentives as affecting the initial eligibility decision:

Subsidy and Special Conditions

Impairment-Related Work Expense (IRWE)

Unsuccessful Work Attempt

Unincurred Business Expenses (Self-Employment Only)

NOTE ALSO: If you engage in SGA prior to receiving your final determination of eligibility letter from SSA (and you are not blind), you may be determined ineligible for SSI benefits.

2.   If you begin engaging in SGA after you have begun receiving SSI benefits and you have received your final determination of eligibility, you will be participating in a "Work Incentive" program called "1619(a)" that allows you to continue to receive cash benefits even though you no longer meet the SGA disability criteria. (Your cash benefits will continue to be reduced $1 for every $2 of earnings.)

3.   You will be scheduled for a Continuing Disability Review (CDR) to determine if you still meet the other SSI eligibility criteria.

NOTE: The Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA) established that:

Effective January 1, 2001, the Social Security Administration (SSA) does not conduct a continuing disability review of beneficiaries of Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) while the beneficiary is using a Ticket to Work.

Beginning January 1, 2002, SSA does not conduct a continuing disability review of a beneficiary's medical condition because the beneficiary is working – if the beneficiary has received Social Security disability benefits for at least 24 months.

SSA still conducts regularly scheduled medical reviews, unless the beneficiary is using a Ticket to Work.

(In either case, the existing rules for suspending benefits because of earnings amounts will apply. Thus, for SSI, earned income rules for reducing benefits would apply, and for SSDI, rules for determining the effects of Substantial Gainful Activity (SGA) apply.)

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 SSI 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 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 SSI.

Source

Some information for this topic was drawn from:
https://secure.ssa.gov/apps10/poms.nsf/lnx/0410501015#c

Additional information was drawn from the SSA Redbook.

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