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Substantial Gainful Activity

Posted on:7/16/2012
Unlike the Old Age Assistance Program, eligibility for benefits under the Social Security Disability Insurance Program (SSDI) are not age based.


Unlike the Old Age Assistance Program, eligibility for benefits under the Social Security Disability Insurance Program (SSDI) are not age based. However, applicants must show that they are suffering from a disability and cannot to engage in “substantial gainful activity” (SGA) due to a mental or physical impairment that is likely or has lasted for at least one year or is likely to result in death. Failure to accept an offer of service is grounds for disqualification.

 

As of July 1, 1999, a disability claimant whose earnings exceeded $700 per month (or $1,050 per month if blind) was presumptively engaging in SGA and would be denied disability-based benefits. If individuals are not disqualified on the basis of earnings, they must establish that they have a covered disability. To do so, claimants present medical evidence that describes their symptoms, signs of illness, and laboratory findings. This information is compared with disability listings maintained by the SSA. If the applicant's condition “matches” a condition on the list, the applicant is deemed disabled and eligible for benefits. If the applicant's condition does not match a listed condition, whether the condition is equivalent to a listed condition is determined.

 

Equivalence may be medical. For example, the applicant may have the signs, symptoms, and laboratory findings associated with a listed condition, but the diagnosis may not fit precisely with a listed diagnosis, or the applicant may have a functional equivalence. A condition is functionally equivalent to a listed condition when the question “Is the applicant's ability to function limited as if the condition were medically equivalent?” can be answered affirmatively. A finding of medical or functional equivalence will result in the granting of benefits. 
  
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