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What is disability according to Social Security Disability law?

By   /  November 11, 2012  /  56 Comments

Learn about disability as defined by the Social Security Administration and see how working while disabled fits into getting Social Security disability.

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what-is-disability

Watch the video: “What is disability according to Social Security Disability law? “

How Social Security Defines Disability

For adult claimants, including disabled adult children, the Social Security Administration, known as SSA, answers the question “What is disability?” with the following definition: “[Disability is] the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted, or can be expected to last, for a continuous period of not less than twelve months.”

Work and Social Security Disability

As you see, the definition is made up of several requirements, but before we go into detail about what each part of the definition means, we’d like to point out that it is often difficult to tell whether or not work that you performed after the date you claim disability will prevent you from being approved. Sometimes the only way to know for sure is to file a claim; however, you may also find it helpful to talk with a lawyer who is experienced in Social Security Disability claims.

More about SSA’s Definition of Disability

Now for a closer look at Social Security’s definition of disability. The definition contains several special terms that have legal definitions. For example, substantial gainful activity, abbreviated as SGA, is work activity that the Social Security Administration determines is “substantial” and “gainful.”

“Gainful” work is work performed for pay or profit, or a type of work that is generally performed for compensation, or work that is intended to result in a profit, whether or not you have a profit. This means that “gainful” is not always defined just by the amount you earn. Substantial gainful activity is determined differently for employees, for self-employed individuals, and for the blind.

For employees, there is a dollar amount that serves as a general guideline for substantial work. The amount has increased over the years, due to inflation. In 2015, monthly gross earnings of $1,090.00 or more are generally defined as substantial for non-blind workers. The SGA guideline for blind workers is usually $1,820.00. However, for the self-employed and sometimes even for employees, additional factors can apply when the Social Security Administration assesses whether a person is performing SGA.

The SGA assessment for self-employed workers is even more complex than for employees. For example, the work of blind, self-employed workers is evaluated considering “countable” earnings; however, under Social Security rules, some types of income earned by a blind person are not counted when assessing whether the work is substantial.

This discussion of Social Security’s definition of disability provides an overview answer to the question “What is disability?” For a discussion of how this definition is applied to your Social Security Disability claim, visit our article “How Does the Social Security Administration Apply Social Security Disability Laws to Determine If I Am Disabled?”

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56 Comments

  1. Sarah says:

    i was awarded to be medically disabled from a judge, my case was 3 months ago from a workers comp injury almost 3 years ago . If I was awarded to be medically disabled will I get ssi benefits? I’ve 2 daughters and married and haven’t received any money from comp in a year.. Will my girls also get benefits they are young..

    • Kay Derochie says:

      Dear Sarah,

      The Social Security Administration administers two disability benefit programs: Social Security Disability (SSDI) and Supplemental Security Income (SSI). The definition of disability is the same for adults under both programs. For SSDI, you must have enough work credits, including in a specified period of time before your disability began. If you are eligible for SSDI and you have worked enough to provide a family benefit, your daughters will receive benefits. SSI requires that your family income and assets fall below certain limits, which vary depending on the type of income and number in the family. SSI does not pay benefits to your family. Your award letter from the judge should tell you which program or programs you have been approved for. If you have SSDI benefits for the same months as you had workers compensation and/or you got a lump sum workers comp settlement, your SSDI may be reduced somewhat in an offset for workers comp.

      Sincerely,
      Kay

  2. BDB says:

    Hi Kay, I’ve been waiting on my hearing and finally I have a date. My question is I have twin boys who are disabled and receive SS beneifits, Will my case change their benefits? They both receive 733.00 a month. I have a lawyer but I’m concerned. I have a list of diagnoses from anxiety,PTSD,depression,bipolar,high blood pressure, hypertension,chronic migraines, vertigo, fatigue,insomnia, sensitivity o light and noise, weakness, pain all over body ect. My husband is also the only one who can work but also has to care for my twins. Will he be eligible for benefits also?

    • Kay Derochie says:

      Dear BDB,

      Your disabled children are receiving Supplemental Security Income (SSI), not SS (Social Security) benefits. Because you say that you have not been working, I assume that your application is also for SSI. If it is and you are approved, your approval will not affect your children’s SSI benefits. Your husband will not be eligible for benefits because SSI does not pay dependent benefits.

      Sincerely,
      Kay

  3. rico says:

    I recently reinjured my back at work from an old auto accident.I had to resign a week ago. I laid on the floor for 10 minutes while my coworkers laughed at me while I was face down in water and chicken blood. I had to go to the emergency room and was told I strained my back and was put on pain meds and pills for my spasms and and inflammatory meds. I’m in a lot of pain that goes from my head to my neck to my back.can I apply for disability and what can I expect please help me out..I’m in a lot of pain .

    • Kay Derochie says:

      Dear Rico,

      To be eligible for Social Security or Supplemental Security Income benefits, you must be disabled or expected to be for twelve months. Disability for younger workers (under fifty and in some circumstances under sixty) means being unable to perform any occupation, not just the occupation in which you were working. I suggest that you discuss your condition with your doctors to get their opinions on about how long it will take you to get well and whether they think you will have any restrictions after that.

      Also, check with your employer to find out whether you are covered by a company-sponsored short-term disability policy or live in a state with state disability insurance for shorter disabilities.

      Sincerely,
      Kay

  4. Kathryn says:

    My Husband has had Bipolar with axiety all his life. He has had to be hospitalized several years ago. The medications he has been on now are slowing down his decision making and he was fired because of it. He has had to take FMLA several times in the last 4 years due to depression. He did speak with an Attorney and was told because he has worked his whole life and did not ask for accomodations he does not have a chance of getting disability. Is this true? He was afraid to ask for accomodations because he was afraid he would be fired because they had been micro managing him. I find it hard to believe that he would not be considered. He will never be able to bring in the incone and because of his meds it will be difficult if at all.

    • Kay Derochie says:

      Dear Kathryn,

      You do not say how old your husband is. If he is under fifty (or depending on his education and work background, even under sixty), to be considered disabled, he has to be unable to perform any occupation for which he has the education, training, or experience. That said, your husband might consider getting a second opinion from a different Social Security attorney. Also, he might talk with his physician about his limitations and see if the doctor would be willing to make a statement as to the cognitive side-effects of his medications. If he decides to file a claim, he might also try to get a statement from his employer that he was fired for job performance related to slow work. At the same time as he is investigating a disability claim, he might talk to your state’s Department of Vocational Rehabilitation or employment office to get some direction on another occupation that might be more suitable for his current capabilities.

      Sincerely,
      Kay

      • Susan says:

        Dear Kay,

        I would like to know if I am able to apply for disability while working? I am a widow and must work unless I can get disability. I have rheumatoid arthritis and fibromyalgia which is documented with labs and Doctor’s reports. I have carpal tunnel due to these conditions but it is inoperable do to the nature of my illness. I work but I am in a lot of pain and also am chronically tired not to mention the effects of my meds like methotrexate. Is it possible to file as must work but in pain? I would appreciate any information you might be able to give me. My age is 56, 57 all too soon.

        Thank you,
        Susan

        • Kay Derochie says:

          Dear Susan,

          If you are earning $1,090 or more gross per month and you file a claim, the claim will be denied. I suggest that you check with your employer to find out whether you are covered by a short-term disability policy that would pay benefits while you wait for your Social Security claim to be processed.

          Sincerely,
          Kay

  5. lisa says:

    hi feb 8 1998 i got married to Gary, was 15 yrs older than i. (gary 45 yrs old & i was 30 yrs old). at that point he had 25 yrs in as a union crane operator & continued to work every day.
    on march 26 1998 he died suddenly only leaving us married 6 weeks.
    2010 i qualified for SSDI, today i get 842.00 monthly.
    do i qualify for widowers/survivors benifets? or any type of bennefit & his retirement? we didnt have kids together, however he provided for my son & i. at garys time of death my son was 9 yrs old please help thank u

    • Kay Derochie says:

      Dear Lisa,

      The general requirement is that you be married to the deceased worker for nine months before his death. However, if your husband died in an accident, the nine-month marriage requirement is waived. There are also some other exceptions that will allow payment of widow’s benefit without a nine-month marriage. Because the law is complex, I suggest that when you are within three months of age fifty that you make an appointment with a Social Security claims representative to see whether any of the exceptions apply to you. If you do qualify, you will not be eligible for benefits until you are age fifty, the earliest age at which a disabled widow or widower can receive benefits

      Sincerely,
      Kay

  6. I was Hospitalize for Depression and overdose , later down the road i was diagnos with Major depression , PTSD , OCD and Pantic Attacks now i now why i was never really able to hold a job with out just , Don’t like to be around people and have always been a loner but anyway can i apply for benefits for this reason i have work all my life but i have jump job to job also

    • Kay Derochie says:

      Dear Shawnta,

      I cannot predict whether you will be approved if you apply for disability benefits. The only way to find out is to apply and if you are currently unemployed because of your health, it could be appropriate to do so. I suggest that you also contact your state’s Department of Vocational Rehabilitation to see whether you might qualify for training into an occupation that does not have much contact or interaction with other people.

      Sincerely,
      Kay

  7. sandy says:

    I was in car accident Dec 2014 no there’s driver involved. I tore my rotator cuff broke shoulder and now an MRI found a herniated disc in my neck pressing on nerves and spinal cord after I told drs that I have been having terrible headaches and neck pain since accident .I have been out of work since accident an insurance comp. is paying medical and wages part of anyways. My question is I have been told I won’t be able to go back to my current job because it involves lifting 50-100lbs which is right in job description my HR sent me. I’m 57 and it took me 3 yrs to get this job do I qualify for disability

    • Kay Derochie says:

      Dear Sandy,

      Whether or not you will qualify will depend on whether you can do any of the occupations you have done in the past about twenty years. If you are uncertain about your eligibility, I suggest that you apply. Information about how to apply can be found under the “Apply SSD” tab at the top of each page of this Disability Advisor website. If you are denied and disagree with the reasons and decide to appeal, it would be advisable to get legal assistance. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from the retroactive award at the time it sends your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,
      Kay

      Sincerely,
      Kay

  8. Veronica Orejel says:

    I’m 38 yrs old I was diagnosed with hairy cell leukimia last year in July, I received chemotherapy and I’m in remission but I’m suffering from depression, anxiety, insomnia, fatigue and weaknesses. I applied for ssi what are the possibility i will get approved?

    • Kay Derochie says:

      Dear Veronica,

      If you are disabled by your psychiatric conditions, side effects from ongoing medications and treatment modalities, and/or residual weakness or fatigue from the leukemia and its past treatment, you may be approved.

      Sincerely,
      Kay

  9. Danielle says:

    I am requesting some advice, I am currently 28 years old, have fibromyalgia, asthma, GERD, Lupus, depression and anxiety, as well as physical defects in my legs that sometimes causes me to be unable to walk. I suffer often from pneumonia, and skin rashes, and am constantly in pain, and have had three surgeries in the last year. I rarely am able to work a full 40 hour week, what are my chances of receiving benefits?

    • Kay Derochie says:

      Dear Danielle,

      If you are working and have gross wages of $1,070 or more ($1,090 in 2015), you are not eligible for disability benefits. If you are earning less than that, I suggest that you file a claim. If your conditions are severe enough, you will be approved. To support your claim, gather together your medical records for the last three years and any before that time that would document any conditions that have not changed. Be thorough in providing full contact information for all your medical providers.

      Sincerely,
      Kay

  10. Crystal says:

    If your claim for mental disability takes over 120 days are you likely to be approved or denied ?

    • Kay Derochie says:

      Dear Crystal,

      The length of time a claim pends is not an indicator of whether it will be approved or denied.

      Sincerely,
      Kay

  11. I have TRIGGER FINGER on my right hand middle finger , I am right handed , and it becomes difficult to do the simplest things (example -turning a door knob) is this something SSI will recognize to qualify for benefits ?

    • Kay Derochie says:

      Dear Donna,

      The only way to find out whether you could be approved would be to apply for benefits. You might also consider consulting your physician about the possibility of surgery to correct the problem and/or contact the Department of Vocational Rehabilitation to see whether there are occupations that you could perform that require little use of hands.

      Sincerely,
      Kay

  12. ee says:

    can a a.l,j judge make me go to a general medical exam if my doctor says i can not take that kind of physical test ?

    • Kay Derochie says:

      Dear EE,

      You are in a difficult situation because, of course, you don’t want to do anything that would be injurious to your health and, at the same time, if you don’t attend the examination, your claim could be denied. I suggest that you have your doctor write a letter to the judge, stating his opinion that it is not medically safe for you to take the examination and the medical reasons why. If it is only a certain part of the examination, then that part should be identified. If you have an attorney, talk to your attorney about the situation.

      Sincerely,
      Kay

  13. Frank Simon says:

    I am a 100% disabled (Bi-Polar) American Navy Vet (58 years old) who lives in England with my British wife who is my carer. I have applied for SSDI benefits and have not worked gainfully since August 2011 and want to know if my VA Benefits would fall into the SGA category? Also is it possible to draw both SSDI and VA Benefits at the same time? Frank

    • Kay Derochie says:

      Dear Frank,

      Substantial Gainful Activity (SGA) applies only to work earnings. You can receive both Social Security Disability (SSDI) and Veteran’s Administration (VA) compensation benefits at the same time. If you are receiving VA pension benefits, your Social Security benefits would cause your VA pension to be decreased or stopped.

      Sincerely,
      Kay

  14. Nicole says:

    Hello
    I applied for benefits due to PTSD .My question is if I make 980$ a month would I qualify for benifits and if so would the check be small because I have income?

    • Kay Derochie says:

      Dear Nicole,

      If you apply for Social Security Disability (SSDI), your earnings, if they are gross earnings, would not affect your eligibility and there would be no reduction in benefits. If you apply for Supplemental Security Income (SSI) and are approved, your earnings would reduce your benefit by about $442 a month. If you had no other income, your SSI payment would be about $279.

      Sincerely,

      Kay

  15. Sherri says:

    Hi Kay
    My sister is 100% disabled and has been since birth. As her legal guardian am I allowed to open a my Social Security account for her? We had to change her bank account and I need to change her direct deposit information. If so can you direct me to a site where I can print an official statement that this can be done to protect us in the future?

    • Kay Derochie says:

      Dear Sherri,

      Please explain what you mean by your “Social Security account” so that I can respond. Are you referring to a bank account or to your Social Security earnings record?

      Thank you,

      Kay

  16. Chris says:

    Dear Kay:
    I’m bipolar and am a convenience store clerk. Dealing with the public is getting really hard for me, as I feel my disease is worse than in years past. I currently make just a tad bit more than the SGA. Is there any hope that I could get disability?

    • Kay Derochie says:

      Dear Chris,

      Your claim would most likely be denied because you are performing Substantial Gainful Activity (SGA). It would be a good idea to talk to a psychiatrist about your increasing symptoms to see whether your medications can be adjusted. You might also consider looking for work that is more suited to your psychiatric needs. Goodwill Industries and similar organizations offer vocational guidance to individuals who have barriers to employment or need specific work situations to continue working.

      Sincerely,

      Kay

  17. Alfred says:

    Hi Kay,

    Thanks for all your input and advice. I have my approval! I had left a message on voicemail for the disability rep, and she called me back, saying a decision was made, and I’d be getting a letter in a few days. I asked her “are you able to tell me what it is? She said “you have nothing to worry about.” I guess they are not really allowed to tell people over the phone, totally understandable, but I’m glad she let me know. It really is a load off my mind, and now I can plan the rest of my life! God takes care of us, and I am so happy right now!

    Have a great day!

    Alfred

  18. Alfred says:

    Thanks Kate.

    I went yesterday to apply, the woman interviewing me asked a lot of questions, but I think it went well. She even asked about my savings, checking, stocks, etc. I don’t remember now if she asked me about 401k (which I do have), or my work pension, but that doesn’t kick in until 59 anyway(( turn 50 next month). They will see that anyway when they look at my records.

    She said that may send me a questionnaire for further information, or even send me to one of their doctors (which is understandable). I have faith that all will go well, but waiting three months or so to get a decision will drive me crazy.

    Alfred

    • Kay Derochie says:

      Dear Alfred,

      If you are medically approved for disability, your 401K will not affect your Social Security application; however, it will be a determining factor in your eligibility for Supplemental Security Income (SSI) benefits. If you are found to be disabled, you have the right to withdraw from your 401k before age 59 1/2 without a tax penalty, and the amount in your 401K will count toward the $2,000 SSI resource limit. This means that if you have more than $2,000 in your 401K or your 401K and other countable assets exceed $2,000, you will not be eligible for SSI. Again, the 401K will not affect your eligibility for Social Security.

      Sincerely,

      Kay

      • Alfred says:

        Thanks Kay,

        The DDS sent me a questionnaire (disability report) to fill out on my activities of daily living,. I filled it out and mailed it back to them on Thursday, April 10. I know it’s not even two weeks yet, but how long should I expect to hear back from them? Should I call and follow up if I don’t hear from them by a certain point (2 weeks, 4 weeks, etc.)?

        Thanks,

        Alfred

        • Alfred says:

          Hi Kay –

          I ended up calling DDS, and they were very nice. They are waiting for my eye doctor to send them my records (they sent a request on April 4). I called and e-mailed my doctor’s office, and the receptionist in the records department will look into it for me. The rep at DDS said they will send a follow up request as well this week. She said once they get the records stating my condition, they will put the application through. Not sure if that means approval, or just the next step in the process.

          The waiting game is frustrating, but I’m glad I called.

          • Kay Derochie says:

            Dear Alfred,

            It sounds as if your claim will be approved if the information from your eye doctor’s office supports the diagnoses and limitations you are claiming.

            Sincerely,

            Kay

        • Kay Derochie says:

          Dear Alfred,

          How long it will take to get a decision depends on whether or not the Disability Determination Services (DDS) is waiting for other information such as from your doctors and on how heavy the workload is at the time. You could call to make sure the form has been received and to ask if they are waiting for anything from anywhere else so you can follow up to get the doctor or other party to submit it.

          Sincerely,

          Kay

          • Alfred says:

            Thanks Kay! I spoke to my doctor’s office this morning, and they will fax my records to the DDS rep working on my case, so it was good that I called to follow up. The rep said that once they get the records showing my (legally) blindness, they can put the application through. I’m not sure if she meant it will be approved, or just moving it to the next step.

            Thanks,

            Alfred

          • Kay Derochie says:

            Dear Alfred,

            As noted in my comment of a few minutes ago. I believe that the claims examiner is saying that your claim will be approved if she receives confirmation of your being legally blind.

            Sincerely,

            Kay

  19. Alfred says:

    I was born legally blind, and have worked (for the same company) since I got out of college in 1988. A few years ago, I knew the time would come that I would apply for social security disability.

    Two weeks ago, I was laid off from my job (my official termination / separation date is tomorrow, 4/1). After some thought, I decided to apply for SSDI, and I am going on Thursday.

    My eyesight is 20/200 in one eye, and 20/400 in the other. I never went much to a doctor, as my eyesight never really changed, but I have gone for the last three years, so I do have those medical records. I also have a letter from both the state commission for the blind and Helen Keller Services for the blind as well, recognizing me as a (legally) blind person. I will bring all this documentation with me when I apply.

    A couple of questions:

    1. The benefit I would receive, that would be the around the disability benefit that is on my Social Security annual statement – correct (it says “this is what you would receive if you became disabled right now)?

    2. Would they ask me something like “you worked all these years, why are you suddenly applying?” I just want to know what to expect.

    3. I am receiving severance pay through August, would that hurt my chances of applying/getting approved right now?

    Thanks!

    Alfred

    • Kay Derochie says:

      Dear Alfred,

      Yes, your benefit, if approved, would be approximately what is shown on your annual earnings statement. You may be asked why you are now stopping work, but regardless of the reason, if you are legally blind and not working, there should be no impediment to approval because of the severity of your condition. Just tell them the reasons. (Lay off, downsizing, declining job performance, whatever it might be.) Lastly, be sure to tell Social Security that the pay that you will get for April through August is severance pay and that you will not be working.

      Sincerely,

      Kay

  20. rebekah says:

    I’m 24 years old. I have been on SSI for 6 years for Bipolar, Agoraphobia, PTSD, ADHD. I was recently reviewed and was still determined disabled and will be reviewed again in 3 years. I get $730.00 a month. How does Social Security expect a person to survive on that alone, and with a child? I’m not married. I live in an apartment with our daughter and my boyfriend. Both of our names are on the lease. I don’t get any assistance otherwise besides food stamps only for myself. My daughter isn’t eligible because her father makes too much. We are struggling really bad. And honestly if I wasn’t with my boyfriend how would i make it? It’s like they expect someone else to take care of you forever! I don’t have the luxury of any family to allow me to live with them or friends. It’s just me. I tell my ssi case worker how my whole check goes right to my rent every month and that isn’t even paying my rent. My rent is 925.00 + sewage + electricity+cable+phone. I’m not even making it, and that is with my boyfriend. It is a set up for failure honestly! I’m someone who is severely mentally ill, and can’t work, my doctors agree, ss obviously agrees, and I’m lost. My illnesses aren’t ever going to go away, their getting worst. Weight is just dropping off of me not being able to afford any food.

    • Kay Derochie says:

      Dear Rebekah,

      The only think I can think of that might help your situation would be for you and your boyfriend to evenly divide the rent and utilities so that your share was less than your whole check and possibly see whether you qualify for energy assistance to help with your heating bill. Also, sometimes disabled individuals can get a break on their telephone rates.

      Best regards,

      Kay

    • KATHRYN JUNE AGUILAR says:

      if your were approved for the things that you mentioned then do you think i will get approved for mine heres mine agarphobia ptsd generixed axiety panic attacts tricallimania skitzo effective and bi polor 1 disorder with phycotic epposodes my mental health doctore diagnosed me with theses

      • Kay Derochie says:

        Dear Kathryn,

        This site is not set up for visitors to communicate with one another. The best way to find out if you are disabled according to Social Security law is to file a claim.

        Sincerely,
        Kay

  21. Ramona S says:

    I am a bus driver I had rotator cuff repair on right shoulder 9/2010 now I had left rototor cuff repair 10/2013 I went out on short term diabilty from the job which turn out to be 90 days my insurance and short term disability from my job ended no more theraphy. I was getting theraphy for neuropathy for my feet n angles has pins and needle sesations I have to get shots n my knees n lower back all this is from driving that bus for 18 years my arm cant raise up now iam trying to theraphy myself its January now the doctor still have me down cant drive the bus shouldn’t I have a chance to apply for disability im 57

    • Kay Derochie says:

      Dear Ramona,

      To be eligibible for Social Security Disability, you must be disabled or expected to be disabled for twelve months. I suggest that you talk with the doctors who were treating you to get their opinion of whether you will be disabled twelve months. If they say yes or that they don’t know or can’t be specific on when you might be able to drive bus again, I suggest that you file for Social Security Disability. Be sure to explain that your treatment stopped for lack of funds. (You might also investigate coverage opinions and premium subsidies under the Affordable Care Act [Obamacare] to get treatment going again.

      Sincerely,

      Kay

  22. kathy Stokes says:

    I’ve had a lawyer for 4 yrs now just today after all the appealing and waiting for a yr from dds they denied me and in the letter they said they used medical records from back in May but where askin for current records they haven’t even used now wat do i do

    • Kay Derochie says:

      Dear Kathy,

      I am unclear from the information that you gave whether you were denied at the first reconsideration appeal or denied by a judge at the hearing level of appeal. Either way you can appeal. When you appeal, you and your attorney need to address the specific reasons for the denial and why you disagree with those reasons. In addition to following whatever advice your attorney has, it seems you would want to call attenti to the fact that your more current records were requested but not considered.

      Sincerely,

      Kay

  23. deborah ewig says:

    had surgery on sept. 9 2013 for 6.5 brain anerysym. am waiting for short term disibility to start. go back to neurology dr in 4 months & epelepsy clinic in 6 months while making sure medications are going be right. had continuous seizures after surgery. stayed in icu for week then went to rehab hosp for a week. can i apply for social security disibilty benefits while i am out of work all this time.

    • Kay Derochie says:

      Dear Deborah,

      Your must be disabled, or be expected to be disabled for twelve months to qualify for benefits; and the first five months are not paid. If you are expected to be off work for twelve months, then it would be appropriate to file an application. A chat with your neurologist should help in deciding whether to apply at this time.

      Best regards,

      Kay

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