SSR 65-62: SECTIONS 216(i), 222(c), and 223. -- DISABILITY -- CESSATION FOLLOWING TRIAL WORK PERIOD
20 CFR 404.1536, 404.1539
SSR 65-62
- In September 1962 the worker filed application and became entitled to disability insurance benefits beginning June 1962, the first month after a required 6-month waiting period. He began working in April 1964 and, despite impairments, had regained his ability to engage in substantial gainful activity January 1965. Held, because of the "trial work period" provisions of section 222(c) of the Act, the work he did in the period April-December 1964 (inclusive) may be considered "trial work" under section 222(c) of the Act; and further held, the worker has demonstrated by work performance that, despite continuance of a severe impairment, he has in January 1965 regained ability to engage in substantial gainful activity, requiring a finding that his disability ceased in January 1965. Therefore his period of disability and his entitlement to disability insurance benefits must be terminated as of March 31, 1965, the end of the second month after the month in which his disability ceased.
The worker, R, was injured November 19, 1961, at age 35 in an accident which resulted in amputation of one leg above the knee, permanent hip deformity, and other serious impairments. After filing of necessary applications in September 1962, R was found to be under a disability beginning November 19, 1961. A period of disability beginning that day was established for R, and he was awarded disability insurance benefits beginning June 1962, the first month after a 6-month "waiting period". (See SSR 62-41, C.B. 1962, p. 105, concerning the "waiting period" requirement.) His wife and three minor children were awarded wife's and child's insurance benefits, respectively, on his earnings record, also effective June 1962.
After 18 months of hospitalization, which included intensive orthopedic treatment, R was able to stand and walk (with the help of an artificial leg) for short periods, and to sit for extended periods without pain. His impairments continue to be severe. R engaged in no remunerative activity until April 1964, when the company for which he had been working at the time of his accident rehired him on a trial basis as a production clerk (he could no longer perform the duties of his former job as a machine operator). When contacted in January 1965, R had been working regularly and satisfactorily on his new job, since mid-April of 1964, receiving wages of $80 for a 40-hour work week.
The question presented by these facts is what effect, if any, R's work and earnings will have upon the benefits previously awarded to him, his wife, and his children.
If, despite the handicap of severe impairments, the beneficiary demonstrates by his work and earnings that he has regained the ability to engage in substantial gainful activity, his disability will be found to have ceased. Cessation of the beneficiary's disability requires termination of his entitlement to disability insurance benefits and (subject to an exception for blindness, not applicable here) of his period of disability, effective with the end of the second month after the month in which his disability ceased. Upon such termination of his disability insurance benefits, any other benefits awarded on his earnings record must be terminated simultaneously. Thus, a finding that R's disability has ceased by reason of his demonstrated ability to work would require termination of his period of disability, his disability insurance benefits, and the benefits of his wife and children, effective with the end of the second month after the month in which the disability ceased.
As an incentive to rehabilitation, section 222(c) permits a disability beneficiary who returns to work despite his impairments, to continue to receive his benefits during a designated period even though his work otherwise is of a nature to constitute substantial gainful activity. After a "trial work period," which may not exceed 9 months, it may be found that he is able to engage in substantial work and no longer under a disability, that is, his disability has ceased. This "trial work period" permits beneficiaries who have not medically recovered from their impairments to attempt work without the fear of losing their right to benefits before they have demonstrated their ability to work for a significant period of time. Under section 223, the beneficiary will receive his benefits for the month in which his disability ceases and for the following 2 months.
A trial work period ends with whichever is earlier: the ninth month in which the beneficiary works (the 9 months need not be consecutive), or the month in which his condition has so improved as to justify a finding that his disability has ceased. In the present case, there has been no such improvement in R's impairments. R thus qualifies for the protection of a trial work period. R did not begin work until April 1964, which is accordingly the first of the 9 months of trial work. Since he worked in each of the 8 months thereafter, his trial period ends with December 1964.
Therefore, it is held, that since R had regained his ability to work, was working full time as a production clerk at substantial wages despite his severe impairment, and is no longer entitled to a period of trial work, he is now able to engage in substantial gainful activity. It is further held that his disability ceased in January 1965, the first month after the end of his trial work period. Accordingly, his period of disability and his entitlement to disability insurance benefits, and the entitlement of his wife and children to benefits of his earnings record, terminate as of March 31, 1965, the end of the second month after the month in which his disability ceased.