# SSR 69-46: SSR 69-46: SECTIONS 216(i) and 222(c). -- DISABILITY -- CHARGING TRIAL WORK MONTHS -- ACTIVITY THAT DOES NOT CONSTITUTE "SERVICES"

> Federal · Rulings · In force

URL: https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_69_46

## Section

- **Citation:** SSR 69-46
- **Heading:** SSR 69-46: SECTIONS 216(i) and 222(c). -- DISABILITY -- CHARGING TRIAL WORK MONTHS -- ACTIVITY THAT DOES NOT CONSTITUTE "SERVICES"
- **Jurisdiction:** Federal
- **Kind:** Rulings
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Social Security Rulings / DI / Disability, Period of Disability / SSR 69-46

## Text

20 CFR 404.1536 and 404.1539

SSR 69-46

The claimant, a patient in the X Hospital, was entitled to disability
insurance benefits because of a mental impairment. While being treated for
his neuropsychiatric condition, he had a severe heart attack. Because
anginal pain is precipitated on very little exertion he can do only
sedentary work.

Upon discharge a bed patient, the claimant participated int eh
rehabilitation project of the hospital for 1 year. during this period, he
lived in a rented room outside of the hospital and received outpatient
care and medication. He worked at the hospital in a room especially set up
for the project averaging 6 hours a day, 27 hours a week, and received
about $20 a week for his work. No special skills, knowledge, training,
mental, or physical demands were required. At first the calmant's work
consisted of placing pieces of metal in a machine; later, he assisted the
head therapist in preparing work for about 30 to 40 other patients and
instructing them.

The hospital furnished the following information concerning the
project:

Cooperating companies in the community send work to the hospital which is
performed by patients participating in the project. The work is carried on
in the hospital and is under medical supervision. The primary purpose of
the activity is treatment rather than employment. The company has not part
for choice in the assignment of patients to the shop. The patient may be
medically assigned for a few hours a week or for as many as 25 hours a
week. The persons engaged in the activity vary from day, depending upon
the mentality of the patient. Many patients have committed to the hospital
and do not have the mental competence to make an employment contract on
their own responsibility. The patient never comes in contact with a
company, receives no instructions or directions from a company as to what
is to be done or how it is to be accomplished
s engaged in the activity vary from day, depending upon
the mentality of the patient. Many patients have committed to the hospital
and do not have the mental competence to make an employment contract on
their own responsibility. The patient never comes in contact with a
company, receives no instructions or directions from a company as to what
is to be done or how it is to be accomplished. Most of the work that is
performed is low level repetitive type of activity and is given to the
hospital by cooperating firms primarily for the purpose of aiding in the
rehabilitation by cooperating firms primarily for the purpose of aiding in
the rehabilitation of patient.s It is not part of their normal workload
and is work which might of patients. It is not part of their normal
workload and is work which might not be otherwise carried on.

As a matter policy, it has been established that they shall be paid for
work at approximately what would be the national minimum wage. These
patients are not equal in ability to perform, but nevertheless, each
patient will receive his proportionate share for the time spent on the
project. The companies recognize certain patients will perform well below
the average, However, the total output will be comparable to the average
for any normal group of workers.

The companies make the hospital's estimate of the amount of time spent on
a project and furnish it with an amount of money equal to the number of
hours worked by all patients at the national minimum wages rate The money
is sent in a lump sum, and the hospital apportions it to the patients in
such a way as to achieve motivation and other psychological goals.
or any normal group of workers.

The companies make the hospital's estimate of the amount of time spent on
a project and furnish it with an amount of money equal to the number of
hours worked by all patients at the national minimum wages rate The money
is sent in a lump sum, and the hospital apportions it to the patients in
such a way as to achieve motivation and other psychological goals.

The work is performed within the hospital, under the supervision of the
medical and administrative staff of the hospital, under supervision of the
medical and administrative staff of the hospital, in quarters that are
furnished by the hospital, and using utilities which are furnished by the
hospital as an aid in physically and emotionally conditioning the patients
for posthospitalization employment.

Sections 404.1536 and 404.1539 of Social Security Regulations No. 4 (20
CFR 404.1536 and 404.1539) are pertinent in this case.

Section 404.1536 provides, in pertinent part, regarding a period of trial
work that:

* * * * * * *

* * * * * * *

Section 404.1539 provides, in pertinent part, regarding cessation of
disability that:

A question has been raised as to whether the claimant's activity in the
project constitutes "services" in period of trial work within the meaning
of section 404.1536 of Regulations No. 4 (20 CFR 404.1536) so as to
require consideration in determining whether his disability period.
* * * *

* * * * * * *

Section 404.1539 provides, in pertinent part, regarding cessation of
disability that:

A question has been raised as to whether the claimant's activity in the
project constitutes "services" in period of trial work within the meaning
of section 404.1536 of Regulations No. 4 (20 CFR 404.1536) so as to
require consideration in determining whether his disability period.

In applying the criteria of "services" set forth in section
404.1536( d ) supra, to the services of the claimant in the project,
it appears that his work activity does not fall under the exempted areas
of "daily routine around the home" or "self-care." the work activity was
not "training" in a true sense because the type of work performed was
essentially of a very simple and repetitive nature. The work activity
merely "a therapeutic measure" if no remuneration were involved. The
remuneration was an incentive to sustain patients' work activities and to
reward them in proportion to individual productivity.

It also appears that there was no employer-employee relationship with
respect to the services performed as the companies furnishing the work had
no right to control and direct the individuals performing the services.
These companies had no contact whatsoever with the individuals performing
the services or their amounts of remuneration. In view of these factors,
it is concluded the "services" of the claimant were not performed in an
employment relationship.

Further, it is apparent this work activity was not "of a type normally performed for remuneration or gain." The claimant was not
free to select his work activity; it was selected for him by his doctor.
The physical and mental conditions of the claimant and other participants
were constantly being checked. patients could rest whenever they wanted
to. These working conditions cannot be considered as normal working
conditions.
ivity was not "of a type normally performed for remuneration or gain." The claimant was not
free to select his work activity; it was selected for him by his doctor.
The physical and mental conditions of the claimant and other participants
were constantly being checked. patients could rest whenever they wanted
to. These working conditions cannot be considered as normal working
conditions.

Based on the foregoing it is determined that the work activities under
the rehabilitation project do not constitute "services" in a period of
trial work, within the meaning of section 404.1536 of Regulations No. 4
(20 CFR 404.1536).

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_69_46. Check the current official text before relying on it. Not legal advice.