Question: Sergeant X is in the U.S. Army. He is badly injured in an automobile accident while off duty. He is unable to perform his normal duties and is assigned to "medical holding company" until he can either get better and return to regular duties or it becomes clear that he will not be able to return to regular duties at which time he would be medically retired. While in medical holding company, Sergeant X receives his normal Army pay but he performs no duties. If Sergeant X files a claim for Social Security disability benefits, how will it be treated?
Answer: Social Security's Program Operations Manual Series (POMS) addresses this. There is nothing which automatically disqualifies active duty military personnel from receiving Social Security benefits. The work done by Sergeant X is not substantial gainful activity since he was not performing any actual duties. Social Security fully accepts that individuals in Sergeant X's situation may file Social Security disability claims and have them adjudicated normally.
Sergeant X is entitled to have his case expedited under Social Security's policy on wounded warriors under another POMS section since the policy does not require that the disability be combat related or even service related.
POMS is effectively the Junior Woodchuck Manual for field offices and State agencies: it’s a place to look for all answers, no matter what the question. (Too bad SSA restrictively publishes only parts of POMS.) Those advocates who deal with ALJs, however, would be better advised to look past POMS to SSA’s regulations and rulings.
ReplyDeleteThe opening sentence of the POMS section Mr. Hall has linked is this:
“A person in the military service who is being treated for a severe impairment usually continues to receive full pay.”
That sure looks like a restatement of 20 CFR 404.1574(a)(3):
“Since persons in military service being treated for severe impairments usually continue to receive full pay, we evaluate work activity in a therapy program or while on limited duty by comparing it with similar work in the civilian work force or on the basis of reasonable worth of the work, rather than on the actual amount of the earnings.”
The regs don’t have the operational details that can be found in POMS. But the rulings do tend to flesh out the regs. Here are a couple of paragraphs from SSR 84-24.
“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.
JOA
POMS = Program Operations Manual SYSTEM, not Series.
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