I need help with a Social Science question. All explanations and answers will be used to help me learn.
you are a disability employment coach . you will need to read the A SUMMARY GUIDE TO EMPLOYMENT SUPPORTS FOR PERSONS WITH DISABILITIES UNDER THESOCIAL SECURITY DISABILITY INSURANCE (SSDI) AND SUPPLEMENTAL SECURITY INCOME (SSI) PROGRAMS
please respond with 350 words
Please follow the instructions
Regarding the TIcket to Work, it asks you to identify one individual (somebody with whom you work) who could be helped by this program and to explain how that program could assist the individual in becoming and staying employed.
2019 RED BOOK
A SUMMARY GUIDE TO EMPLOYMENT SUPPORTS FOR PERSONS WITH DISABILITIES UNDER THE
SOCIAL SECURITY DISABILITY INSURANCE (SSDI) AND SUPPLEMENTAL SECURITY INCOME (SSI) PROGRAMS
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TABLE OF CONTENTS
INTRODUCING THE 2019 RED BOOK. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
WHATS NEW IN 2019. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Automatic Adjustments Effective January 1, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
CONTACTING US . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
How to Reach Social Security. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
my Social Security. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Request copies of the Red Book or other Social Security Publications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
HOW DO WE DEFINE DISABILITY?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Our Definition of Disability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What is Substantial Gainful Activity (SGA)?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How Do We Evaluate Your Work Activity for SGA Purposes?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What If You Are Self-employed?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
5
5
5
Social Security Disability Insurance Program (SSDI). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Supplemental Security Income Program (SSI). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
When You Receive Both SSDI and SSI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Comparison of the SSDI and SSI Disability Programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
7
7
8
OVERVIEW OF OUR DISABILITY PROGRAMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
RETURNING TO WORK. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
What Are Your Responsibilities When You Return to Work?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
When Will We Review Your Disability?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
When Will Your Benefits Stop?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
HOW DO EMPLOYMENT SUPPORTS HELP?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
SSDI Employment Supports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
SSI Employment Supports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Guide to Employment Supports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
RESOURCES TO ASSIST YOU RETURN TO WORK. . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Work Incentive Liaison (WIL). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Area Work Incentives Coordinator (AWIC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Benefits Planning Query (BPQY) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Work Incentives Planning and Assistance (WIPA) Projects. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Work Incentives Seminar Events (WISE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Employment Network and State Vocational Rehabilitation Providers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Protection and Advocacy for Beneficiaries of Social Security (PABSS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Individual Development Accounts (IDA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Achieving a Better Life Experience (ABLE). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
American Job Centers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Job Accommodation Network (JAN). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
The Guidepost to Success. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Financial Literacy Information for Young People with Disabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Federal Employment of People with Disabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
AmeriCorps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
RESOURCES TO ASSIST YOUTH WITH THE TRANSITION TO A SUCCESSFUL
ADULTHOOD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
SSDI AND SSI EMPLOYMENT SUPPORTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Subsidies and Special Conditions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Unsuccessful Work Attempt (UWA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Impairment-Related Work Expenses (IRWE). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Examples of Deductible and Non-Deductible IRWE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Plan to Achieve Self-Support (PASS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Who Can Help You Set Up a Plan to Achieve Self-Support (PASS)?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Examples of a PASS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Ticket to Work (TTW). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Continued Payment under Vocational Rehabilitation or Similar Program (Section 301). . . . . . . . . . . . . . . 28
Expedited Reinstatement (EXR). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
SSDI ONLY EMPLOYMENT SUPPORTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Trial Work Period (TWP). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Extended Period of Eligibility (EPE). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Unincurred Business Expenses (Self-Employment) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Continuation of Medicare Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Medicare for Persons with Disabilities Who Work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
SSDI at a Glance What Happens When You Go to Work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
SSI ONLY EMPLOYMENT SUPPORTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Earned Income Exclusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Examples of the Earned Income Exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Student Earned Income Exclusion (SEIE). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Special SSI Payments for Persons Who Work Section 1619(a). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Reinstating SSI Eligibility Without a New Application. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Special Benefits If You Are Eligible Under 1619 and Enter a Medical Facility. . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Medicaid While Working Section 1619(b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
SPECIAL RULES FOR PERSONS WHO ARE BLIND. . . . . . . . . . . . . . . . . . . . . . . . . . . 41
How We Apply Substantial Gainful Activity (SGA) Under SSDI to Persons Who Are Blind. . . . . . . . . . . . . . 41
Blind Work Expenses (BWE). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Comparison of Monthly SSI Payment With BWE Versus IRWE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Accommodations for Persons Who Are Blind or Visually Impaired. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
ADDITIONAL HELP WITH HEALTH CARE FOR PERSONS WITH DISABILITIES. 44
Medicaid Buy-In for Working Persons with Disabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Help with Medicare Part A Premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Affordable Care Act (ACA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
EXAMPLE OF CONCURRENT BENEFITS WITH EMPLOYMENT SUPPORTS . . . . 46
Summary of Example with Concurrent Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
DEMONSTRATION PROJECTS UPDATE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Benefit Offset National Demonstration (BOND) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Promoting Readiness of Minors in Supplemental Security Income (PROMISE). . . . . . . . . . . . . . . . . . . . . . . . 50
Promoting Opportunity Demonstration (POD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Supported Employment Demonstration (SED). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Retaining Employment & Talent After Injury/Illness Network (RETAIN). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Promoting Work through Early Interventions Demonstration Project (PWEID) . . . . . . . . . . . . . . . . . . . . . . . 51
Current Events. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
GLOSSARY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
INTRODUCING THE 2019 RED BOOK
Purpose of the Red Book
One of Social Securitys highest priorities is to support the efforts of beneficiaries with disabilities who want
to work by developing policies and services to help them reach their employment goal. The Social Security
Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs include a number of employment
support provisions commonly referred to as work incentives.
The Red Book is a general reference tool designed to provide a working knowledge of these provisions. We
write the Red Book primarily for educators, advocates, rehabilitation professionals, and counselors who serve
persons with disabilities. We also expect that applicants and beneficiaries will use it as a self-help guide.
In particular, Social Security recognizes the importance of supporting youth in their efforts to navigate
the path toward adult life. In this edition of the Red Book, we included resources to assist youth with this
transition. We provide general information to assist youth and the parents, providers, or representatives of a
youth receiving SSI or SSDI to locate national and community supports and resources. See pages 17-20.
Also, we send an annual notice and informational brochure entitled, What You Need to Know About Your
Supplemental Security Income (SSI) When You Turn 18 to these transition-aged youth between the ages of
14-17. It is also available online at www.socialsecurity.gov/pubs/EN-05-11005.pdf. You can also get a copy from
your local office or by calling our toll-free number 1-800-772-1213, or at our TTY number 1-800-325-0778,
between 7 a.m. and 7 p.m. Monday through Friday.
The Red Book contains a general description of our disability-related policies. For information specific to your
situation regarding eligibility or benefits, you may need to contact us. You will find our contact information on
page 3.
The Red Book, including the Spanish language version, is available online at: www.socialsecurity.gov/redbook.
The Red Book is also available in alternative formats. See page 43 for alternative media contact information.
Purpose of Employment Supports
Congress intended the employment support provisions to provide you with the assistance you need to move
from benefit dependency to independence. Employment supports help you to enter, re-enter, or stay in the
workforce by protecting your eligibility for cash payments and/or health care until you achieve this goal.
Different rules apply to benefits based on retirement or age. We cover those rules in other publications. Most
Social Security publications and other public information materials are available at our internet site, Social
Security Online, located at www.socialsecurity.gov.
Plain Language
We tried to keep the Red Book clear and brief. We followed Plain Language guidelines. We generally
use we, us, and our to refer collectively to Social Security, the Social Security Act, our regulations,
and operating instructions. We use you and your to refer to the person who is claiming benefits based
on disability.
Previous Editions
This 2019 edition replaces all previous editions.
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WHATS NEW IN 2019
Automatic Adjustments Effective January 1, 2019
Substantial Gainful Activity (SGA)
The SGA amount for persons with disabilities other than blindness is $1,220 per month in 2019 .
For persons who are blind, the amount of earnings that indicate SGA is $2,040 per month in 2019 . Details on
SGA are on page 5 .
Trial Work Period (TWP) Months
The monthly earnings amount that we use to determine if a month counts as a TWP month is $880 per
month in 2019 . Details on the TWP are on page 30 .
Federal Benefit Rate (FBR)
For 2019, the Supplemental Security Income (SSI) FBR is $771 per month for an eligible individual and
$1,157 per month for an eligible couple .
Student Earned-Income Exclusion (SEIE)
For 2019, the amount of earnings that will have no effect on eligibility or benefits for SSI beneficiaries who are
students is $7,550 a year . The amount of earnings that we can exclude each month, until we have excluded
the maximum for the year, is $1,870 . Details on the SEIE are on page 37 .
Medicare Part A Hospital Insurance
For 2019, the monthly Medicare Part A Hospital Insurance base premium is $437, and the 45 percent reduced
premium is $240 .
Medicare Part B Supplementary Medical Insurance
For 2019, the Part B Supplementary Medical Insurance monthly base premium is $135 .50
(or higher depending on your income) . Social Security will tell you the exact amount you
will pay for Part B in 2019 . For more information, see link for How much does Part B cost?:
www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html online .
Medicaid While Working
For 2019, we increased the Medicaid While Working State Threshold Amounts for persons with disabilities . We
use yearly state threshold amounts to decide if earnings are high enough to replace SSI and Medicaid benefits .
The 2019 amounts for each state can be located at http://policynet.ba.ssa.gov/poms.nsf/lnx/0502302200 online .
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CONTACTING US
How to Reach Social Security
Internet Access
Our internet site, Social Security Online, is located at www.socialsecurity.gov . Most Social Security publications
and other public information materials are available at this site .
Links that may be of interest to the community serving persons with disabilities:
www.socialsecurity.gov/disability This site provides comprehensive information on our disability
benefits programs .
choosework.ssa.gov This site provides information on our Ticket to Work program .
By Telephone
For questions about work incentives and to find out more about our Ticket to Work Program, please call our
Ticket to Work Help Line at 1-866-YOURTICKET (1-866-968-7842), between 8 a .m . and 8 p .m . Eastern time,
Monday through Friday . If you are hearing impaired, please call 1-866-833-2967 . You can also contact us by
email at [email protected] .
For general Social Security inquiries, call us toll-free at 1-800-772-1213 . We can answer most questions over
the phone . If you are hearing impaired, our toll-free TTY/TDD number is 1-800-325-0778 . We can be reached
at these phone numbers between 7 a .m . and 7 p .m ., Monday through Friday .
Find Your Local Office
If you have a problem or question, try our toll-free telephone number first . Our telephone representatives will
either help you or put you in contact with your local office, if needed . Many local telephone directories list
local offices under Social Security .
If you have internet access, you can find your local office by going to the Social Security Office Locator on
our website, Social Security Online, at www.socialsecurity.gov/locator . Enter your postal ZIP code to get the
address, telephone number, and directions to your local office .
By Mail
If you have been unable to resolve a problem after calling our toll-free telephone number or after contacting
your local office, you may write to the Office of Public Inquiries:
Social Security Administration
Office of Public Inquiries
6401 Security Blvd .
Baltimore, MD 21235-6401
my Social Security
Get your free personal online my Social Security account today! If you receive benefits, you can:
Get your benefit verification letter;
Check your benefit and payment information;
Check status of your Social Security benefit application or appeal filed with us;
Change your address and phone number;
Start or change your direct deposit;
Get a replacement SSA-1099 or SSA-1042S for tax season;
Request a replacement Medicare card; and
Report wages for your Social Security Disability or Supplemental Security Income benefits .
Setting up an account is quick, secure, and easy .
Visit our website at www.socialsecurity.gov/myaccount to find out how .
3
You may now request a replacement Social Security card online if you live in selected states or the District
of Columbia. If you are not requesting a name change or other change on your card and you have a valid
drivers license or a state-issued I.D. card, you may be able to apply for a replacement card online with a
my Social Security account at www.socialsecurity.gov/myaccount.
Request copies of the Red Book or other Social Security Publications
If you want copies of the Red Book or other public information materials, you can:
[email protected];
410-965-2037;
410-965-2039; or
Social Security Administration
Office of Supply & Warehouse Management
Attn: Requisition and Quality Control Team
2508 Robert M. Ball Building
6401 Security Blvd.
Baltimore, MD 21235-6301
We will not ship to Post Office boxes.
Email:
Fax:
Phone:
Mail:
Send Comments or Suggestions about the Red Book
Mail your comments to:
Social Security Administration
Office of Research, Demonstration and Employment Support
Attention: Red Book Editor
P.O. Box 17778
Baltimore, MD 21235-7778
or fax your comments to: 410-597-0825, Attention: Red Book Editor
or email: [email protected]
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HOW DO WE DEFINE DISABILITY?
Our Definition of Disability
To meet our definition of disability, you must not be able to engage in any substantial gainful activity (SGA)
because of a medically-determinable physical or mental impairment(s):
That is expected to result in death, or
That has lasted or is expected to last for a continuous period of at least 12 months.
Note: There is a separate definition of disability for children (under age 18) who are applying for the Supplemental
Security Income (SSI) program. A disabled child also qualifies for the SSI employment supports described later in the
Red Book.
What is Substantial Gainful Activity (SGA)?
We use the term substantial gainful activity to describe a level of work activity and earnings.
Work is substantial if it involves doing significant physical or mental activities or a combination of both. For
work activity to be substantial, it does not need to be performed on a full-time basis. Work activity performed
on a part-time basis may also be SGA.
Gainful work activity is:
Work performed for pay or profit; or
Work of a nature generally performed for pay or profit; or
Work intended for profit, whether or not a profit is realized.
We use SGA as one of the factors to decide if you are eligible for disability benefits. If you receive Social
Security Disability Insurance (SSDI) benefits, we use SGA to decide if your eligibility for benefits continues after
you return to work and complete your Trial Work Period (TWP) (see page 30). If you receive SSI benefits
based on disability, we apply different standards to determine if your eligibility for benefits should continue.
For details on how we calculate SSI benefits, see page 36.
We do not use SGA as a factor to determine initial eligibility for SSI benefits if you are blind.
How Do We Evaluate Your Work Activity for SGA Purposes?
We generally use earnings guidelines to evaluate whether your work activity is SGA.
The amount of monthly earnings we consider to be SGA depends on the nature of your disability. The Social
Security Act specifies a higher SGA amount for persons who meet the definition of blindness described by the
law. For details on our rules about earnings and blindness, see page 41. If your impairment is anything other
than blindness, earnings averaging over $1,220 a month (for the year 2019) generally demonstrate SGA. If you are
blind, earnings averaging over $2,040 a month (for the year 2019) generally demonstrate SGA for SSDI.
We usually adjust these amounts every year based on increases in the national average wage index.
What If You Are Self-employed?
If you are self-employed and your disability is not blindness, the way we evaluate your work activity for SGA
purposes will depend on whether we evaluate your work activity before or after you have received SSDI
benefits for 24 months and the purpose of the evaluation. We will evaluate your work under The Three Tests or
the Countable Income Test to determine if your work activity is SGA, depending on when you worked.
The Three Tests:
We apply three tests to evaluate your work activity when you initially apply for SSDI and before you have
received SSDI benefits for 24 months. We will also use the three tests to evaluate your work activity during the
re-entitlement period to determine if we can reinstate your benefits in the Extended Period of Eligibility (EPE)
(see page 31). Your self-employment work activity is SGA if:
You render significant services to the business, and you had average monthly earnings over the SGA level
($1,220 in 2019); or
Your work is comparable to the work of persons without disability in your community engaged in the
same or similar businesses; or
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Your work is worth more than the SGA level earnings in terms of its effects on the business or when
compared to what you would have to pay an employee to do the work.
The Countable Income Test:
We apply the countable income test if you have received SSDI benefits for at least 24 months. We will only use
the countable income test to determine whether you have engaged in SGA and if your disability has ended as
a result of that SGA.
We will compare your countable earnings to the SGA earnings guidelines. If your monthly countable earnings
average more than $1,220 (in 2019), we will determine that your work is SGA unless there is evidence that you
are not rendering significant services in the month. If your monthly countable earnings average less than
$1,220, we will decide that your work is not SGA.
If you are self-employed and your disability is blindness, we decide SGA based on whether you have
received a substantial income from the business and rendered significant services to the business. We make
this determination using your countable earnings. We also use your countable earnings to determine whether
your work is SGA and we can reinstate benefits during the EPE (see page 31).
If you are self-employed, your disability is blindness, and you are age 55 or older, special rules apply.
If your earnings demonstrate SGA but your work requires a lower level of skill and ability than the work
you did before age 55, or when you became blind, whichever is later, we will suspend, not terminate, your
benefits. Your eligibility for SSDI benefits continues indefinitely, and we pay your benefits for any months
earnings falling below SGA.
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OVERVIEW OF OUR DISABILITY PROGRAMS
We manage two programs that provide benefits based on disability or blindness, the Social Security Disability
Insurance (SSDI) program and the Supplemental Security Income (SSI) program.
Social Security Disability Insurance Program (SSDI)
SSDI provides benefits to disabled or blind persons who are insured by workers contributions to the Social
Security trust fund. These contributions are based on your earnings (or those of your spouse or parents) as
required by the Federal Insurance Contributions Act (FICA). Title II of the Social Security Act authorizes SSDI
benefits. Your dependents may also be eligible for benefits from your earnings record.
Supplemental Security Income Program (SSI)
The SSI program makes cash assistance payments to aged, blind, and disabled persons (including children)
who have limited income and resources. The Federal Government funds SSI from general tax revenues. Many
states pay a supplemental benefit to persons in addition to their Federal benefits. Some of these states have
made arrangements with us to combine their supplemental payment with our Federal SSI payment into one
monthly check to you. Other states manage their own programs and make their payments separately. Title XVI
of the Social Security Act authorizes SSI benefits.
When You Receive Both SSDI and SSI
We use the term concurrent to describe persons who are eligible for disability benefits under both the SSDI
and SSI programs. To show how a persons concurrent benefits would be affected by returning to work, we
have provided an example on page 46.
Note: The SSDI and SSI programs share many concepts and terms, however, there are also many differences in the
rules affecting eligibility and benefit payments. The following table summarizes differences between the SSDI and
SSI programs. These differences are important as many persons may apply or be eligible for benefits under both
programs.
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Comparison of the SSDI and SSI Disability Programs
SSDI
8
SSI
Source of payments
Disability trust fund .
General tax revenues .
Minimum Initial
Qualification
Requirements
Must meet Social Securitys disability
criteria . Must be insured due to
contributions made to FICA based on
your own earnings, or those of your
spouse or your parents .
Must meet Social Securitys
disability criteria .
Must have limited income
and resources .
Health Insurance
Coverage Provided
Medicare . Consists of hospital
insurance (Part A), supplementary
medical insurance (Part B), and
Medicare Advantage (Part C) . Voluntary
prescription drug benefits (Part D) are
also included . Title XVIII of the Social
Security Act authorizes Medicare .
Medicaid . A jointly-funded, FederalState health insurance program for
persons with limited income and
resources . It covers certain children,
and some or all of the aged, blind, and
disabled in a state who are eligible
to receive federally-assisted income
maintenance payments . Title XIX of the
Social Security Act authorizes Medicaid .
The law gives the states options
regarding eligibility under Medicaid .
How do we figure
your monthly
payment amount?
We base your SSDI monthly payment
amount on the workers lifetime average
earnings covered by Social Security . We
may reduce the amount if you receive
Workers Compensation payments
(including Black Lung payments) and/or
public disability benefits, for example,
certain state and civil service disability
benefits . Other income or resources do
not affect your payment amount . We
usually adjust the monthly payment
amount each year to account for
cost-of-living changes .
We can also pay SSDI monthly benefits
to dependents on your record, such as
minor children .
To figure your payment amount, we
start with the Federal Benefit Rate (FBR) .
In 2019, the FBR is $771 for a qualified
person and $1,157 for a qualified couple .
We subtract your countable income
from the FBR and then add your state
supplement, if any .
We do not count all of the income that
you have . The income amount left after
we make all the allowable deductions is
countable income .
The sections on SSI employment
supports explain some of the ways that
we can exclude income .
We usually adjust the FBR each year to
account for cost-of-living changes .
Is a State
Supplemental
Payment provided?
There is no state supplemental payment
with the SSDI program .
Many states pay some persons who
receive SSI an additional amount ca
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