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Substantial Gainful
Activity (SGA)
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Is
the performance of significant physical or mental
activities in work for pay or profit
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SGA
amounts are adjusted each year based on the national
average wage
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For
2004, SGA level is set at $810 a month.
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For
those who are self-employed, usually 80 hours per month |
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Step One: The Trial Work Period |
Have
you worked in the past five years and earned over the TWP earnings
level while receiving SSDI?
(TWP earnings level: $200/month prior to 12/31/00. $580/month
after 1/1/04)
If NO
You can work for nine months within a 60-month period, earn any
amount of money, and continue to receive your monthly check from
SSDI! Any month in which you earn less than the TWP earnings level
is not counted. TWP months do not have to be consecutive.
If YES
How many months did you earn more than the TWP earnings level? If
you worked less than nine months, subtract the number of months
you worked from nine. The result will be the remaining Trial Work
months that you are still eligible to use.
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Step Two: Extended Period of Eligibility (EPE) |
After
the Trial Work Period you will enter the Extended Period of
Eligibility (EPE). For at least 36 months, Medicare coverage
continues and your monthly earnings level will determine whether
you receive a benefit check. Social Security considers earning
$810 a month as substantial gainful activity (SGA).
If you earn less than $810 a month:
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You
will receive your full SSDI check
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Your
Medicare coverage remains in effect
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If
you are still disabled after the EPE, and continue to earn
under $810 a month, your
benefit check and Medicare coverage will continue |
If
you earn more than $810 a month:
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You
will receive three more monthly checks, then your checks
will stop
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Medicare
continues for an additional 93 months after the TWP, as
long as your disabling condition still meets SSA rules
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You
don’t have to pay for Medicare Part A
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You
do have to pay for Medicare Part B
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You
can deduct disability-related work expenses that might
bring earnings
below the $810 SGA |
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Impairment
Related Work Incentives
Impairment Related Work Expenses (IRWE) are items or
services that are essential to you being able to work.
These can be deducted from monthly earnings and if they
reduce your income below $810, or SGA, you will continue
to receive monthly SSDI cash benefits. IRWEs can be
deducted only if you pay for the item or service yourself
and you are not reimbursed by an agency. Some examples of
deductible expenses are prescription drugs, deductibles
and co-payments not covered by Medicare, a wheelchair,
etc. Check with your SSA representative for a complete
list of IRWEs.
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Step Three: What
if I Get Sick Again or Lose My Job? |
Expedited
Reinstatement of Benefits.
If
you are unable to work because of your medical condition, you
would be able to request reinstatement of benefits. You must file
the request for reinstatement with Social Security within 60
months from the month of their termination. While Social Security
is making a new determination, you may receive up to six months of
provisional benefits, including Medicare and Medicaid, as
appropriate. If Social Security decides that the medical condition
no longer prevents you from working, the provisional benefits
would not be considered an overpayment.
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Continuing
Eligibility Review
Social
Security reviews cases of people who receive SSDI to
determine if they are still medically disabled or if they
can perform SGA. HIV/AIDS cases are currently being
reviewed every three years.
It is important to keep accurate and up-to-date
documentation of your disability, because if SSA
determines you are no longer disabled, your SSDI benefits
will stop. Benefits do not cease if you are in a
vocational rehabilitation program or can prove that you
are entitled to continue receiving SSDI.
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Vocational
Rehabilitation: The Ticket to Work and Work Incentives Act
of 1999
This
law establishes the Ticket to Work and Self-sufficiency
program. Social Security beneficiaries will receive a
“Ticket” to obtain vocational rehabilitation (VR) or
other support services from an approved provider. Those
services are designed to provide you with training or
other assistance you need to update your job skills, start
a new line of work, or go to work for the first time. SSA
does not provide those services but will pay for them when
certain conditions are met.
If you enter a vocational rehabilitation program,
your monthly benefit check would continue until the end of
the program. The Ticket program is voluntary. Once you
begin using the Ticket, Social Security cannot initiate a
continuing disability medical review. |
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If
you want to begin a Trial Work Period, tell your
Social Security Administration representative, and
he or she will review your case and help you to
calculate the length of your Trial Work Period.
Note:
During
the TWP, Impairment Related Work Expenses (IRWE)
and subsidies CANNOT be deducted from gross
earnings. After TWP, IRWE are deducted to
determine SGA. For those who are self-employed and
earn under $580/month, the number of hours worked
in the business is used to determine if a month
counts as a TWP month, usually 80 hrs/month.
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IRWEs
can lower your countable income:
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Gross
Monthly Earned Income |
$850 |
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Deduction
for IRWE |
-
$250 |
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Adjusted
Amount of Earned or Countable Income |
=
$600 |
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Return to Top
For
more information, contact:
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Social
Security Administration
Phone: (800) 772-1213
http://www.ssa.gov

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