TN 7 (11-14)

A. Disability determination services (DDS) responsibilities for development of work activity

Primary responsibility for development of a claimant's work activity and the decision as to whether the work is substantial gainful activity (SGA) lies with the field office (FO). However, the DDS can make an SGA determination when the work activity is “clearly not SGA.” See DI 10501.025 for more information on “clearly not SGA” policy and procedures.

The DDS also has certain responsibilities. These include:

• recognizing evidence of work activity not developed by the FO, that may be pertinent to the disability determination, including unresolved questions and discrepancies on Forms SSA-3368-BK, SSA-3369, and within the medical evidence.

• determining whether a period of work was an unsuccessful work attempt (UWA), except in continuing disability review (CDR) cases with no medical issues. Refer to DI 24005.001 for an explanation of UWA’s;

• determining an onset date if a beneficiary returns to SGA within 12 months of the EOD see DI 13010.105; and

• considering the possible effect of a period of work on the onset date see DI 13010.105;

• determining if the skills and abilities involved in SGA performed by a Title II statutory blind claimant age 55 or older are comparable with those required in the person's previous work;

• providing the comparability decision and developing any additional necessary evidence. The DDS may request FO assistance if needed. If contact with an employer is needed, the DDS should call the FO concerning the claimant's consent for such contact if it is not in file. (Refer to DI 26005.001D for discussion of comparability provisions).

B. FO Responsibilities in developing work activity

In all cases with work issues, the FO completes a work activity report (Form SSA-821 or Form SSA-820) to develop the earnings and work activity, and all applicable work incentives to determine SGA per DI 10505.035 or DI 10510.025. , the FO completes Form SSA-823 to document the SGA determination prior to sending the case to DDS.

C. Responsibilities if DDS receives report that claimant is working

If DDS directly receives a report that the claimant returned to work, determine if the work activity is “clearly not SGA”. If so, follow instructions in DI 10505.003B.1.b to develop and document the work activity and continue to process the case. Notify the FO with a message or report of contact to prevent duplicate work issue development.

If DDS has sufficient information to permit a determination of denial on medical/vocational grounds, DDS will make the determination.

If DDS cannot make a determination on medical/vocational grounds and the work does not meet the criteria for “clearly not SGA”, the FO makes the SGA determination. The DDS will take the following actions:

• Cease all development and send an electronic assistance request (AR) in eView to the FO requesting SGA development. For more information on AR processing see DI 81020.100C. Electronic Assistance Requests (AR), (C) Initiating an Electronic AR and DI 81020.127 for Processing “No Determination” (ND) Claims – When the FO returns the AR to the DDS indicating that a DDS determination is not necessary.

• Annotate the case file to show the status of the medical and vocational development in the event you need to make a DDS determination, and

• Cancel any scheduled consultative examinations (CE).

If the FO determines that the work activity does not alter the case jurisdiction, the FO will record the work information on Form SSA-823 (Report of SGA Determination).

D. DDS Responsibilities if work activity is clearly not SGA

For more information, see DI 10501.025C.

E. FO learns claimant is working

Title II beneficiaries and Title XVI non-blind individual who return to SGA within one year of the established onset of disability (EOD) may not meet the 12-month duration requirement for receiving disability benefits. If the claimant informs the FO that he or she is working, and either the FO or payment center (PC) obtains additional evidence indicating SGA, the FO or PC will take the following actions depending on whether the DDS has established an EOD.

1. DDS established an EOD

The FO and PC will follow the instructions in DI 13010.105C.1. The FO or PC may request the DDS to provide an onset date for the purposes of the 12-month duration requirement. The DDS will annotate in item 34 of the SSA-831 the actual onset date for duration requirement purposes. The DDS will enter the following statement in item 34, “the onset date for duration purposes is [enter date].” The DDS will:

• annotate in item 34 of the SSA 831 the actual onset date for duration requirements purposes and

• enter the following statement in item 34, ‘the onset date for duration purposes is [enter date]’

2. DDS has NOT established an EOD

FO and PC will follow the instructions in DI 13010.105.

NOTE: If the DDS questions or problems arise related to an FO work issue determination, refer the DDS to the Area DDS Liaison and if not resolved, refer them to GN 01010.820, Assistant Regional Commissioner (ARC), Management, Operations and Support (MOS) Action on Request for Legal Opinion.

F. DDS- Evaluation of Blind cases

The DDS must make a blindness determination in both Title II and Title XVI cases if the claimant alleges a visual impairment, and a period of a disability based on blindness is possible. The FO will send the case to DDS for a blindness determination, regardless of the SGA determination see DI 26005.001 and DI 26005.005.

G. Work issues in continuing disability reviews (CDR)

The FO has jurisdiction of all work issues, including the determination of a UWA in CDR cases. The FO develops and documents all work activity before forwarding the case to the DDS if the beneficiary is working, regardless of whether or not he or she is engaging in SGA see DI 24001.005..

H. Work issues in foreign claims

The Office of International Operations (OIO) has jurisdiction and responsibility for work issues in foreign claims. If the DDS identifies a work issue on a case after the claim has been transmitted to international program service center (INTPSC), send the work report to INTPSC for processing.