(PPS-112)
SSR 84-24
SSR 84-24: TITLES II AND XVI: DETERMINATION OF SUBSTANTIAL GAINFUL
ACTIVITY FOR PERSONS WORKING IN SPECIAL CIRCUMSTANCES -- WORK THERAPY
PROGRAMS IN MILITARY SERVICE -- WORK ACTIVITY IN CERTAIN
GOVERNMENT-SPONSORED PROGRAMS
PURPOSE: To state the policy for determining whether the work
activity of employees in two types of situations is substantial gainful
activity (SGA) under the disability provisions of the law. The two
situations are (1) work therapy programs in the military service and (2)
work activity in certain government-sponsored programs.
CITATIONS (AUTHORITY): Sections 216(i), 223(d), and 1614(a) of the
Social Security Act, as amended; Regulations No. 4, Subpart P, sections
404.1571-404.1576; Regulations No. 16, Subpart I, sections
416.971-416.976.
INTRODUCTION: Under the disability provisions of the law, except
within the trial work period (TWP) provisions, a person who is engaging in
SGA is not eligible for payment of disability benefits. (There was a
temporary provision of the Act, section 1619(a), in effect until December
31, 1983, that authorized continued disability payments to title XVI
recipients engaging in SGA, provided their income was within specified
limits. These payments are being continued for the year 1984 under a
demonstration project (49 Federal Register 9774, March 15, 1984).)
SGA is defined in the regulations (sections 404.1572 and 416.972) as work
that "involves doing significant physical or mental activities" and that,
in the case of employees, "is the kind of work usually done for pay. . .
." Social Security Ruling (SSR) 83-33,
Program Policy Statement (PPS)-107, Determining Whether Work Is
Substantial Gainful Activity -- Employees, discusses the evaluation of
work activities of employees generally. This PPS about work in special
circumstances contains additional guides concerning the evaluation of work
activity of employees in the military service and in certain
government-sponsored programs.
POLICY STATEMENT: (The two distinct types of work situations
described in this PPS will be discussed separately.)
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1. For persons in the military service who are being treated for severe
impairments, the amount of pay is not an appropriate basis for making an
SGA evaluation. The service person may be on limited duty status and
working in a therapy program while receiving full pay. For SGA purposes,
we compare the military work activities with those in civilian occupations
and assess the reasonable worth of the work. Several bases for comparison
are provided.
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2. For civilians in certain government-sponsored job training and
employment programs, we evaluate on a case-by-case basis under the usual
SGA earnings and services tests discussed in
SSR 83-33, PPS-107. In programs such as
these, subsidies often occur. The value of any subsidy must be subtracted
so that only "countable earnings" are considered.
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For volunteers under the Domestic Volunteer Service Act of 1973
(Public Law 93-113) (DVSA) and the Small Business Act (SBA) 15 U.S.C.
section 631 et seq., we do not consider for SGA (or TWP) purposes any
stipends, support services payments, expense allowances, or reimbursement
of out-of-pocket expenses. Likewise, the SGA tests of "comparability" and
"worth of work" (as discussed in SSR
83-33, PPS-107) do not apply to such volunteers with regard to their
DVSA or SBA activities.
Evaluation of Work Activity in
Work Therapy Programs in Military
Service
The following relates to Policy Statement 1.
A person in the military service who is being treated for a severe
impairment usually continues to receive full pay. Therefore, for SGA
purposes, it is not appropriate to evaluate his or her work activity based
on the amount of pay received. Instead, it is necessary to use nonmonetary
SGA criteria in assessing the work activity of a service person receiving
treatment at a military hospital and working in a designated therapy
program or on limited duty. That is, we compare the activity with similar
work in the civilian work force and determine its reasonable worth.
Severely impaired service persons may, for example, be placed on limited
duty status and put to work in a hospital, office, mailroom, laboratory,
or the like. The controlling factor in these cases is an objective
evaluation of the work activity itself, and not the service person's duty
status, or whether or not a formal therapy program is involved. The fact
that a therapy program or limited duty status is involved necessarily
suggests that special conditions may exist.
This requires that we consider the real value of the work effort within
the military setting and then equate its value to similar work in a
nonmilitary setting.
Description of Military Work Activities
The service person is the primary source of information about the
activities involved in his or her particular work therapy program.
Documentation will help to resolve the extent of any subsidy in the
military service pay and the actual worth of the limited duties.
If, however, the service person's description of duties is equivocal or
apparently inaccurate, or if it shows activities not readily correlated to
jobs in the civilian community, corroborative information is necessary.
Military personnel having supervisory and administrative knowledge of the
details and status of the limited work should be contacted.
Comparison of Military and Civilian Work Activities
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1. Comparison based on firsthand knowledge: In some situations the
person's description of job duties may offer reasonable assurance that the
work activity can be readily identified and compared to a similar type of
civilian occupation, such as clerk-typist, truck mechanic, or the like.
The adjudicator may be sufficiently aware of prevailing work and pay
scales in the community to be able to equate service persons' job duties
with those in the nonmilitary economy and to determine the worth of the
services performed. In appropriate situations the file should reflect the
details of such knowledge, inasmuch as the SGA determination must be made
on the basis of what the person does and how much such activity would be
worth in the civilian community.
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2. Comparison based on military occupation manuals: If no obvious
comparison can be made between the person's military work duties and a
civilian occupation, it may be necessary to consult the military
occupation manuals. These manuals, published by each branch of military
service and available at military hospitals and installations, provide a
classification system for all military service occupations for enlisted
personnel, commissioned officers, and warrant officers. They describe the
duties and personnel qualifications for each listed military occupation.
For those occupations with a "direct, or reasonably related, civilian
counterpart," one or more "civilian source jobs" are listed according to
the job code or title in the Department of Labor's Dictionary of
Occupational Titles (DOT). This correlation of military service
occupations with civilian jobs classified in the DOT makes the military
occupation manuals an indispensable reference source for comparing
military and civilian work activities.
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Military reference materials should be used only when necessary for
equating the job duties of service persons with those performed in the
civilian sector. Access to the manuals will generally be through the
officer in charge of personnel matters at the military hospital or
installation where the manuals are maintained.
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3. Comparison based on contact with other sources: Other steps may
be indicated if reasonable doubt remains as to what represents an
equivalent civilian job or as to how the value of the service person's
work activities compares with the pay for similar civilian work.
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Contact may be made with employers, the U.S. Employment Service, or other
informed sources of employment and vocational data, including a vocational
specialist. These contacts are expected to be for advice and information
gathering only, to aid judgments in the case. In some instances the
military occupation manuals will not list, in conjunction with a military
job, any related civilian job. Or they may list only one civilian job
which happens not to exist in the community in which the comparison is
conducted. The title of the disabled person's military service occupation
and/or of the listed civilian job may, however, lead the vocational
specialist to identify closely related civilian occupations discussed in
the DOT with which the adjudicator may satisfactorily compare the military
service occupation.
Evaluation of Work Activity in Certain Government-Sponsored
Programs
The following relates to Policy Statement 2.
Under discussion are civilian government-sponsored job training and
employment programs, as well as volunteer programs.
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1. Job Training and Employment Programs
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Federal funds have been made available to State and local agencies to
provide job training and employment opportunities for economically
disadvantaged, unemployed and underemployed people to prepare them to
function acceptably in various kinds of competitive employment.
Documentation and Evaluation
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A. The work activity of a person in a government-sponsored job training
program must be evaluated under the usual criteria for earnings and
services as discussed in SSR 83-33,
PPS-107, in order to determine whether he or she is engaging in SGA. A
decision as to whether SGA is shown, and when such SGA may have begun,
should be based on information as to the person's "countable earnings" and
performance. Workers under any of these programs should not, therefore, be
treated as a group. Rather, each case should be evaluated on its own
merits.
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B. The "countable earnings" of a person involved in a
government-sponsored job training program are determined in the same
manner as for all types of employees, as discussed in
SSR 83-33, PPS-107. It should be noted,
however, that subsidies are frequently involved in work for such programs.
It is important, therefore, to consider this possibility and, when
appropriate, to develop thoroughly the issue of subsidy in accordance with
the above PPS.
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If, after the issue of subsidy (and/or of impairment-related work
expenses) is resolved, a person's "countable earnings" do not average more
than the primary amount shown in the SGA Earnings Guidelines, and if the
work does not meet either the test of comparability or the test of worth
of work, the work activity will not be found to represent SGA.
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C. Under some government-sponsored programs, part of the participant's
time may be devoted to on-the-job training. Whether the person's activity
is all work or whether such training is also involved, all of the SGA
tests as discussed above apply.
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D. For purposes of charging months of the TWP, the provisions in sections
404.1592 and 416.992 of the regulations apply.
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2. Volunteer Programs
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The Federal government has administered a number of programs for
volunteer activity under the DVSA and the SBA. Volunteers in such programs
may have received payments in the form of a minimal stipend, payment for
supportive services (such as housing, supplies, and equipment), an expense
allowance, and/or reimbursement of out-of-pocket expenses.
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Such payments cannot be counted as earnings, income or resources to
reduce or eliminate payments made under other government programs.
Therefore, neither payments made to volunteers nor the services performed
by them under the DVSA or SBA are to be evaluated for the purpose of
determining SGA (or TWP) under title II or title XVI of the Social
Security Act. This means that none of the SGA tests -- earnings,
comparability of work activity, or worth of work activity -- is to be
applied to volunteer activity under the DVSA or SBA.
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This exclusion from the SGA (and TWP) provisions applies only to
volunteers participating in programs explicitly mentioned in the DVSA and
the SBA: Volunteers in Service to America (VISTA); University Year for
ACTION; Special Volunteer Programs; Retired Senior Volunteer Program;
Foster Grandparent Program; Older American Community Services Programs;
Service Corps of Retired Executives (SCORE); and Active Corps of
Executives (ACE).
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The protection of the exclusion explained here does not cover volunteers
for any work they may undertake in activities outside the specified
programs. Nor does this protection apply to nonvolunteers
associated with the programs, that is, program operating personnel and
those persons served by the programs.
Documentation and Evaluation
Since the person involved may be unaware of the DVSA or the SBA, or the
organization or agency responsible for the volunteer programs, it is
important that any evidence of activity under one of these programs be
noted. If it appears that the person is involved in one of the programs,
the supervisor is to be contacted to establish whether the person is a
volunteer or an employee. A detailed description of his or her activities
is necessary, along with information as to the type and amount of
payment(s) received, such as wages, stipend, expense allowance, and
reimbursement of out-of-pocket expenses.
If it is found that the person engaged in volunteer activity in
one of the programs, neither the payments received nor the services
performed will be considered for SGA (or TWP) purposes. If, however, the
person is found to be an employee rather than a volunteer, his or
her earnings and services are to be evaluated in the usual manner for SGA
(and TWP) purposes.
EFFECTIVE DATE: The policy explained herein is effective as of the
date of publication of this PPS.
CROSS-REFERENCES: Program Operations Manual System, part 4,
sections DI 00503.140-00503.145; SSR
83-33, PPS-107, Determining Whether Work Is Substantial Gainful
Activity -- Employees.
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