To qualify for Social Security disability benefits you have to show that your disability prevents you from being able to work. In Social Security’s words, you have to show that you are unable to engage in a substantial gainful activity (SGA). SGA translates into a maximum dollar amount you are allowed to earn and still be potentially eligible for Social Security benefits.

For 2009, the most you can earn is $980 per month (before taxes or deductions).  If you earn more than this, Social Security may say that you are engaging in a substantial gainful activity and, therefore, not eligible for disability benefits.

The SGA issue is so important that it is the very first step of the 5 step sequential evaluation process – the way Social Security evaluates adult disability claims!

What do I do if I earn more than the substantial gainful activity amount? Does than mean I can’t get Social Security disability benefits?!?

Not necessarily. There are exceptions that may allow you to still qualify for Social Security disability benefits even if you are earning more than the SGA amount.

Some of these exceptions include:

1. Impairment Related Work Expenses (IRWE).
2. Subsidized Earnings and/or Sheltered Employment.
3. Unsuccessful Work Attempts (UWA).
4. Trial Work Period (TWP). Note: TWP are a way to test your ability to work if you are already on Social Security while still preserving eligibility for Social Security benefits.

If Social Security has said that you earn too much, it is not the end of your case.

Even if you know the definition of a substantial gainful activity (SGA), could you apply it? Can you be sure that the last job you tried before you applied for Social Security disability benefits was SGA?

Charles Hall proposes that substantial gainful activity (SGA) has become just too complicated.

If one is engaging in SGA, one cannot be considered disabled, but SGA is a term of art. Work may not be SGA if low earnings, unsuccessful work attempts, made work, subsidized employment, impairment related work expenses, trial work periods, etc. are taken into consideration. 

…The biggest problem now is that SGA is just too complicated. Claimants have no idea how it works. Even many Social Security employees who should understand how SGA works, don’t.

Read Charles Hall’s original article is by Charles Hall on his Social Security News blog.

I have to give credit to Gordon Gates for bringing Charles Hall’s article to my attention in the first place. Gordon responds:

I also agree with the assessment that SGA is too complicated. There are some very important exceptions and adjustments to the $980 per month SGA amount, including the unsuccessful work attempt. A thorough knowledge of these complicated SGA rules is critical because SGA exceptions can make the difference between winning and losing a claim (the cliff).

Here is one of the exceptions taken from the introductory section of the Substantial Gainful Activity regulations (20 CFR 404.1571):

Even if the work you have done was not substantial gainful activity, it may show that you are able to do more work than you actually did.

Basically, this says that even if you earn less than SGA, you still might have a problem with a disability claim.

To some extent, this makes sense. Let’s say you are able to do construction work, but your disabilities limit you to only part-time work, and you earn less than the SGA amount ($980 per month for 2009).

Non-SGA heavy work may suggest the ability to do SGA work at a lighter level. 

Being able to do part-time construction work might mean you could do full time lighter work, such as a cashier where your earnings would be more than the SGA amount (and potentially make you ineligible for Social Security disability benefits).  

What it all comes down to is that the SGA is complicated. And this is only one issue. See all the articles dealing with substantial gainful activity.

I have written about how Social Security defines disability, work, and a substantial gainful activity.

But, how does Social Security really evaluate a case?

Social Security reviews cases using the five-step sequential evaluation process to decide is a person is disabled.  Here are the 5 questions that make up the sequential evaluation process:

1. Does your impairment keep you from being able to perform a substantial gainful activity (generally full-time, competitive, work)?
2. Is your impairment severe?  AND, is your impairment expected to remain severe for at least 12 months?  
3. Does your impairment “meet or equal” one of Social Security’s “Listing of Impairments?” A listing of medical conditions, acceptable medical evidence, and the severity necessary for an impairment to be considered disabling.  There are separate listings for adults and for children.  
4. Does your impairment prevents you from being able to perform any job you performed over the last 15 years which was also a substantial gainful activity?
5. Does your impairment prevent you from being able to perform any other type of work which exists in substantial numbers of the national economy?

Let’s take these one at a time:

Step 1: Engaging in a Substantial Gainful Activity (SGA)

A.k.a.: Are you working?

Even you have a clearly disabling condition, if you are able to work at a substantial gainful activity level (SGA), you are not disabled.  

Example, you may be limited to crutches or a wheelchair, but you force yourself to work a full time, competitive, job.  Under Social Security regulations, you are not considered disabled.  

Because you are able to work, you do not qualify for Social Security disability benefits.  

There are exceptions to this.  

• If you are working full time, but your medical expense, which let you work, are so high that your pre-tax income is still below SGA threshold, then your Impairment Related Work Expenses (IRWEs) make your work not SGA.  So, you case should not be denied at step 1.
• If you are working at an SGA level, but the work is not competitive: you either got a job through a friend or family member and you not held to the same standards as another worker in the same position, or if you are being paid a “subsidy” — the value of your work is $600 a week, but you are being paid $800 a week.

Step 2: Severity

For an impairment to be severe, it has to cause more than a minimal effect on your ability to perform daily activities? 

Example: many people have asthma.  However, asthma is not always disabling. Asthma is often well controlled with medications. When it is not well controlled, it may be a severe impairment.

As a Colorado lawyer, I do not see Social Security deny a lot of cases because they do not believe a impairment is severe.  However, every once in a while, this comes up.  Having a “severe” condition is a pretty low standard and it is usually fairly easy to show that a condition has more than a minimal effect on daily activities.

The second part of this is more difficult.  The condition has to be expected to remain severe for 12 months or longer.  

If you are denied because Social Security does not think your condition will be disabling for 12 months, it is called a “durational denial.”

I often see a durational denial, where there has been a traumatic accident (such as a car accident) or in cases of disability during the recovery period following serious surgery (such as a back fusion).

Social Security accepts that there will be a healing period where you may not be able to work.  But, unless you can convince Social Security that your condition will remain disabling for 12 months, you may be denied.  

Step 3: Listing Level Impairment

This is the “short-cut” step.  If you have a condition which is contained in the Social Security Listing of Impairments AND the medical findings match what is required for your listing, you may be found disabled without Social Security considering the last two steps.  This is “meeting a listing.”  

You can also be found disabled at this step if your condition “equals a listing.” Equaling a listing means that while your condition may not be mentioned in the Listing of Impairments, it is just a severe AND has the same findings as a listed impairment. 

In my experience with individuals who have already been denied once, the chance of meeting or equaling a listing level impairment is small.  But, it is always worth considering. 

Step 4: Ability to Perform Prior Work

If you are able to perform any of the past work you have done at a substantial gainful activity level, over the last 15 years before your disability began, Social Security can deny you.

Example: If you previously performed very physical work (construction work or nursing), but you also did worked as a manager for a few months, you may be denied based on your ability to still be able to perform the management job.  This may apply even though it is not your most recent work, the employer is no longer in business, or if you cannot get hired for that type of work any more.  

Keep in mind that this is just a general overview.  Every case depends on its specific circumstances. Also, there are a number of issues around this step including whether you worked long enough to learn the job.  

Step 5: Ability to Perform Other Work

Even if you are unable to perform any of your past jobs, you can still be denied if there are other jobs you can still perform which exist in substantial numbers in the national economy.  

This is a very complicated area where many cases are won or lost.   The rules at this step change depending on your age group (18-49, 50-54, and 55-60).

• If you are under 50, the rule of thumb is that you have to prove that there is no work in the national economy that you can still perform.  
• If you are over 50 years old, the rules get a bit easier, but you still have to eliminate most kinds of jobs to win your case. 

This is just a quick rundown of the five-step sequential evaluation process. There are exceptions and corollaries to this but I just want to quickly state the steps that Social Security goes through in evaluating a disability claim.

Updated 06/05/09.

Can a person work and still receive Social Security disability benefits or Supplemental Security Income (SSI) benefits?

The answer is a qualified “yes.”

Social Security wants people to try to go back to work. But, the regulations surrounding keeping your benefits while you try to go back to work make it tricky.

Are you engaged in a Substantial Gainful Activity?

Generally speaking, the test of disability is whether you can perform a substantial gainful activity (SGA)? That is, are your monthly gross earnings (income before taxes and deduction) equal to, or greater than the Substantial Gainful Activity amounts set by Social Security.

In 2009, if you are making at least $980 per month, before taxes, your work is a substantial gainful activity. To see the current SGA amount, or SGA amount for other years, click here.

So, if I my gross income is the SGA amount, or more, I have a problem,

But, if my monthlty gross income is less than SGA, Social Security will leave me alone.

That is generally correct and it is a good rule of thumb.

However, and this is a big however, this is not the end of the analysis. There are exceptions to allow your benefits to continue if you are earning more than SGA and exceptions that might stop your benefits even if you are earning less than SGA.

If you are receiving Supplemental Security Income, you can earn more than the SGA amount and still receive your SSI benefits. But, that is an article in itself.

If you earn more than the SGA amount:

There are a number of exceptions to allow your benefits to continue even if you earn more than the substantial gainful activity amount. Let’s take a look at them.

Unsuccessful Work Attempt (UWA)

Did the work last for less than 6 months? If yes, the work may qualify as an unsuccessful work attempt or UWA. This is the most common way to continue benefits if you return to work and earn more than the SGA amount.

Simply put, if you work at or above the SGA level for up to six months but have to stop because of your disability, as opposed to being laid off, or quitting, the work may be an unsuccessful work attempt.

There are a number of requirements for an unsuccessful work attempt, read about them here.

Impairment Related Work Expenses (IRWE)

If your work is performed at a SGA level, you may be able to reduce the income SSA considers through Impairment Related Work Expenses (IRWEs).  Any medically necessary expenses related to your impairment which are necessary to allow you to work may be deducted from your gross income as an IRWE.

For example: if you have a disabling seizure disorder.  However, due to a new medication, your seizure disorder is controlled enough to allow you to go back to work.  The medications, doctors visits, and blood tests to test the level of medication in you blood stream may all be IRWEs and might reduce your income.

Subsidy

A subsidy is any compensation over the fair value of your work.  This often happens if you work for a family member or if you work through an agency like Goodwill.

If you are paid for a 40 hour week but you only work 25 hours, you have a 15 hour subsidy.  Another possibility is if the value of your work is $8.00 an hour, but you are paid $10.00 an hour (a $2.00 an hour subsidy).

If you subtract the subsidy, and your gross income is below the SGA amount, you might still be able to keep your Social Security benefits. Click for more information about subsidies.

Trial Work Period

If you are receiving Disability Insurance (not SSI), Social Security allows you a Trial Work Period: you can go back to work, and earn even more than the SGA amount, and still be considered disabled, for 9 months.

Click for more information about Trial Work Periods.

Even if you earn LESS THAN the SGA amount watch out!

Any work may create the impression that an individual is not really disabled.  That is the greatest risk of going back to work.

I have heard too many stories of Social Security stopping benefits and even claiming an overpayment, because they thought a person who had gone back to work was never disabled in the first place, or that their disability stopped months or years ago.

Performing a job at a non-SGA level, may suggest the ability to perform other work at a SGA level.

you could do a different job at a SGA amount.  Therefore, you are not disabled and your benefits should stop.

An extreme example of this is working a part time construction or labor job.

• You may be limited to only being able to do this work part-time.
• Your earnings may be less than the SGA amount.
• BUT, if you can do part-time construction, doesn’t that mean you may be able to do full time (SGA) work at an easier job, for example as an information clerk.

Lets get real here:  if there is a less demanding full time SGA job that you can perform, your disability benefits will be questioned sooner or later and you may be assessed an overpayment.

Are you structuring your work to be less than the SGA amount?

If you are keeping your hours below a certain amount, not for a medical reason, but just to earn less than the SGA amount, you are committing fraud.

Your benefits will probably be stopped, and you are looking at an overpayment and will probably have to repay Social Security. But things, can get much worse: Social Security may also refer your case to the Attorney Generals office for federal prosecution.

Do not game the system.  It is not worth it.

If your work is performed at a Substantial Gainful Activity (SGA) level you may be denied Social Security disability benefits.  However, you may be able to reduce the amount Social Security considers to bring your gross income below SGA levels.

One way to do this is through Impairment Related Work Expenses (IRWEs). Here is what Social Security describes IRWEs:

An IRWE means an expense for an item or service which is directly related to enabling an impaired individual to work and which is necessarily incurred by that individual because of a physical or mental impairment. Such an expense may involve payment for the purchase, installation, maintenance and repair of an impairment-related item or payment for an impairment-related service. Any medically necessary expenses related to your impairment which are necessary to allow you to work are deducted from your gross income.

If you are disabled, but some type of medical care or service allows you to be able to work, the cost of that care or services may be deducted from your gross income.

This might make you eligible to continue receiving Social Security benefits even though you are working, and your work is a substantial gainful activity (SGA).

One critical element of IRWEs is that you, the disabled individual, have to be paying for the medical care or service.  If insurance or another person is paying for the care, Social Security will not deduct it from your gross income as IRWE.

Here are some examples of IRWEs:

1. Routine drugs and routine medical services.
2. Some diagnostic procedures.
3. Attendant care services.
4. Medical devices.
5. Prosthesis.
6. Other equipment.
7. Guide dogs.

For many people, the most relevant potential IRWE will be “routine drugs and medical services.”  Here is what Social Security says about this:

The costs of routine drugs and routine medical services are not deductible unless the drugs or services are necessary to control the disabling condition so as to enable the individual to work. The amount of IRWE that may be deducted is subject to reasonable limits, and deductions for needed items and services will be made only if the cost is paid by the impaired individual.

In short, the reasonable cost of medications can be deducted from your gross income if the medications are necessary, they enable you to work, and you pay for the medications.

There are a lot of limits on IRWEs and this is only a brief overview.  For more information check out Social Security Ruling 84-26 and 20 CRF 404.1576.

A number of people responded to my prior post about “substantial gainful activity” amounts. To briefly review: the general rule is that you cannot earn more than the substantial gainful activity amounts to be found disabled.

What do I do if I am earning more than the substantial gainful activity amount? Does than mean I cannot get Social Security disability benefits?!?

Not necessarily. Earnings above SGA amounts are an important factor. But, there are exceptions (including sheltered work, subsidies, unsuccessful work attempts, impairment related work expenses, and trial work periods)  that may allow you to still qualify for Social Security disability benefits even if you are earning more than the SGA amounts. 

Check out our updated article for more information.  If you are earning more than the allowed SGA amounts, it is not the end for your case.