What is Substantial Gainful Activity?

Step 1 of the Social Security Administration’s 5-Step Sequential Evaluation Process asks whether you (the claimant) are engaging in “substantial gainful activity,” or SGA. If the answer is yes, then you will be ineligible for benefits regardless of the nature or severity of your medical impairments.

SGA is generally defined as work activity that is both “substantial” and “gainful.” Substantial work activity is work activity that involves doing significant physical or mental activities. Your work may be substantial even if it is done on a part-time basis or if you do less, get paid less, or have less responsibility than when you worked before. Gainful work activity is work activity that you do for pay or profit. Work activity is gainful if it is the kind of work usually done for pay or profit, whether or not a profit is realized. Generally, the Administration does not consider activities like taking care of yourself, household tasks, hobbies, therapy, school attendance, club activities, or social programs to be substantial gainful activity. See 20 CFR § 404.1572.

In 2018, SGA is defined as earning $1,180 or more per month for non-blind individuals, and $1,970 for blind individuals; however, SGA is more than just a number. For instance, volunteer work, criminal activity, and running a small business can all be considered substantial gainful activity even if you are not making any money. If you are self-employed (performing contract work, odd jobs, freelancing, or running a small business), the Administration will assess whether your work is SGA using one of three tests. Which test the Administration uses depends on when your business was started and why the SSA is reviewing your work activity. See 20 CFR §§ 404.1574 (if you are an employee) and 20 CFR § 404.1575 (if you are self-employed).

Conversely, if your employer pays you more than the actual value of your labor, the Administration will consider the amount over the actual value to be a subsidy. For example, a sheltered workshop where people with mental disabilities work usually subsidizes workers’ pay. The Administration will not include the subsidy amount when determining whether your work is SGA. Additionally, the Administration will consider whether your work activity was an “unsuccessful work attempt.” Generally, if you worked for a period of six months or less and had to stop or reduce the amount of work you did due to your impairments, the work done will not be considered SGA. In other words, any earnings from an unsuccessful work attempt will not be counted for purposes of making an SGA decision. See 20 CFR § 404.1574(c).

Remember that SGA relates only to money you earn from working. Passive income, such income from investments or retirement funds are not considered SGA. However, passive income may affect eligibility for the Supplemental Security Income (SSI) program.

If you or someone you know are unable to work due to a medical condition, please contact us for a free evaluation of your claim!

Monthly SGA dollar amounts since 1975: https://www.ssa.gov/oact/cola/sga.html

By: Thomas Klint of Premier Disability Services, LLC^®

World Hepatitis Day is July 28th

Approximately 300 million people worldwide are living with viral hepatitis unaware. Without finding the undiagnosed and linking them to care, millions will continue to suffer, and lives will be lost. On World Hepatitis Day, July 28, the World Hepatitis Alliance calls on people from across the world to take action, raise awareness and join in the quest to find the “missing millions”.

Hepatitis causes 1.34 million deaths per year and causes 2 in every 3 liver cancer deaths. The five hepatitis viruses – A, B, C, D and E – are distinct; they can have different modes of transmission, affect different populations, and result in different health outcomes.

• Hepatitis A is primarily spread when someone ingests the virus from contact with food, drinks, or objects contaminated by feces from an infected person or has close personal contact with someone who is infected. Hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause serious symptoms. Hepatitis A can be prevented through improved sanitation, food safety, and vaccination.
• Hepatitis B is often spread during birth from an infected mother to her baby. Infection can also occur through contact with blood and other body fluids through injection drug use, unsterile medical equipment, and sexual contact. The hepatitis B virus can cause both acute and chronic infection, ranging in severity from a mild illness lasting a few weeks to a serious, chronic illness. If infected at birth or during early childhood, people are more likely to develop a chronic infection, which can lead to liver cirrhosis or even liver cancer. Getting the hepatitis B vaccine is the most effective way to prevent hepatitis B.
• Hepatitis C is spread through contact with blood of an infected person. Infection can occur through injection drug use and unsafe medical injections and other medical procedures. Mother-to-child transmission of hepatitis C is also possible. Hepatitis C can cause both acute and chronic infections, but most people who get infected develop a chronic infection. A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer. With new treatments, over 90% of people with hepatitis C can be cured within 2-3 months, reducing the risk of death from liver cancer and cirrhosis. The first step for people living with hepatitis C to benefit from treatments is to get tested and linked to care. There is currently no vaccine for hepatitis C but research in this area is ongoing.
• Hepatitis D is passed through contact with infected blood. Hepatitis D only occurs in people who are already infected with the hepatitis B virus. People who are not already infected with hepatitis B can prevent hepatitis D by getting vaccinated against hepatitis B.
• Hepatitis E is spread mainly through contaminated drinking water. Hepatitis E usually clears in 4-6 weeks, so there is no specific treatment. However, pregnant women infected with hepatitis E are at considerable risk of mortality from this infection. Improved sanitation and food safety can help prevent new cases of hepatitis E. A vaccine to prevent hepatitis E has been developed and is licensed in China, but is not yet available elsewhere.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

Sources:

http://www.worldhepatitisday.org/

http://www.who.int/who-campaigns/world-hepatitis-day/2018

https://www.cdc.gov/hepatitis/worldhepday.htm

By: Joyce Trudeau of Premier Disability Services, LLC^®

Disability Determination Services and Social Security Disability Claims

There is an agency in every state that employs disability claims examiners who decide the disability claims for Social Security and Medicaid cases for all applicants of that state. In many states, the agency is called “Disability Determination Services,” or DDS, but the agency goes by various names. For instance, Florida calls its agency the Division of Disability Determinations (DDD), California calls it the Disability Determination Service Division (DDSD), and Pennsylvania calls it the Bureau of Disability Determination (BDD). All states have at least one office for the disability determination agency and some states — those that have chosen a “decentralized system” — have several.

The disability determination agency is the state-level agency whose basic task is determining the eligibility of disability applicants (claimants) to receive monetary disability benefits or benefits from the state’s adult Medicaid program. Examiners at DDS decide both Social Security Disability Insurance claims and Supplemental Security Income disability claims. DDS is where the question of medical eligibility for disability is resolved at both the initial application and reconsideration levels.

When your file arrives from a Social Security office, it is assigned to a disability claims examiner. The examiner immediately begins to order medical records from all of the doctors’ offices, hospitals, and other medical providers that you listed on your application. The disability examiner may call you for more information about your work or medical history. Alternatively, the examiner may send you a questionnaire form that you need to fill out and return. The examiner will usually ask questions to clarify the details of information that you included on your disability application.

Once most of your medical records arrive at DDS, the examiner can begin to go about the task of deciding whether you will qualify for disability. The examiner will consider whether you are currently working, whether you suffer from at least one severe impairment, whether your condition(s) meet a disability listing, and, lastly, whether you are able to work full time according to the Social Security Administration’s rules. Typically, the vast majority of disability claims evaluated by DDS are denied, requiring disability claimants to have their cases heard by an administrative law judge at a disability hearing before they can be approved for benefits.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

By: Joyce Trudeau of Premier Disability Services, LLC^®