TN 64 (09-09)

A. Cases requiring a DDS determination

The field office (FO) should route the case to the Disability Determination Services (DDS) for a medical determination when the claimant meets the non-medical requirements, and any of the following criteria:

• The claimant is engaging in work activity, but the field office (FO) concludes that the work activity is not substantial gainful activity (SGA);

• The claimant was engaging in SGA after the alleged onset, but ceased SGA (Develop the reason for discontinuance or reduction of work.); or

• A Title XVI claimant is engaging in SGA, but alleges a visual impairment.

NOTE: For Title XVI, make an SGA determination on or after the month of application. For Title II, the month in which the claimant began engaging in SGA must have been within 14 months prior to the month of application.

B. Cases not requiring a DDS determination

After consideration of all work exclusions, deny the claim if the claimant is engaging in SGA.

If earnings are above SGA but below the income break-even point, process an SGA denial (see DI 11055.095).

If earnings are above SGA, and above the income break-even point, deny for excess income (see SI 00602.001C).

References:

• DI 10501.001, Meaning of SGA and Scope of Subchapter

• DI 10501.025, Responsibilities and Procedures – Work Issue Cases

• DI 10505.035, Documenting Employment Cases

• DI 10510.025, Documenting Self-Employment Cases

• DI 11055.095, Claimant Engaging in Substantial Gainful Activity (SGA)

• DI 13010.110, Return to Work Within A Year Of Onset (Title XVI)