Monthly Wage Form for Social Security Disability
The SSA does not consider your total income when determining whether you meet the definition of substantial gainful activity. Rather, it considers only your “countable” income, fromwhich it defines as wages, payments from benefits programs, free shelter or food from nongovernmental sources, and family income used for your support.
The following categories of income are not considered countable income:
- Subsidies: Subsidies are wages paid to an employee who suffers a serious medical impairment that are greater than the reasonable value of the actual services performed. In these cases, the SSA considers the excess wages as a subsidy rather than earnings and are not countable income.
- Impairment Related Work Expenses (IRWE): Impairment Related Work Expenses are certain items and services that a person needs in order to be able to work due to his or her disability. These expenses are deducted from the claimant’s earnings.
- Sick and vacation pay: The SSA only wages derived from actual work activity to be “earnings.” Therefore, wages that employees received in the form of sick or vacation pay are not countable income.
Fore more information about determining which of your earnings the SSA will consider countable, please contact the Social Security disability law firm of Turley, Redmond, Rosasco & Rosasco by using our online form or calling us at 877-693-2529 (New York City), 516-745-5666 (Garden City), 631-582-3700 (Ronkonkoma), or 631-399-0400 (Shirley/Riverhead).
If your earnings are close to the substantial gainful activity level (see 20 C.F.R. § 404.1574), documentation from your employer may be essential to show the Social Security disability examiner that you are not actually performing substantial gainful activity. Your W-2 form may work fine for last year, especially if there is no question concerning the dates you worked. If there is a question about the dates worked last year, you may need information from your employer.
If you are working in the current year and a recent paystub does not show all necessary information, you may need earnings information from the employer. This form will gather it.
Note that this form asks about vacation and sick pay. According to POMS DI 10505.010 C, only earnings paid as a result of actual work activity count. Thus, sick pay and vacation pay do not count for determining eligibility for Social Security disability benefits, although according to POMS DI 10505.010 D, bonuses do count.
Please show monthly gross income and income from vacation or sick pay for the months and years indicated:
Print Name: ________________________________