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Supplemental Security Income. Presented in 2008 by Scott Leonard with KCDDD, and Joanne O’Neil with the Arc of King County Department of Community and Human Services Developmental Disabilities Division. Social Security Administration. SSA.

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supplemental security income

Supplemental Security Income

Presented in 2008

by Scott Leonard with KCDDD, and Joanne O’Neil with the Arc of King County

Department of Community and Human Services

Developmental Disabilities Division

slide3
SSA
  • The Social Security Administration, or SSA, is a federal agency.
  • The headquarters, located in Baltimore, Maryland, provides support for over 60,000 employees.
  • Most people access to SSA through local field offices, the web at www.ssa.gov , and the SSA phone service: 1-800-772-1213.
slide4
SSA
  • The Social Security Administration administers three basic benefit programs:
    • Retirement Benefits (commonly called “Social Security Benefits”)
    • Social Security Disability Insurance, or SSDI;
    • Supplemental Security Income, or SSI.
ssdi ssdac title ii
SSDI / SSDAC (Title II)
  • SSDI benefits are paid to individuals (and their dependents) who have been employed and have paid Social Security taxes (FICA).
  • These individuals and their family members may receive benefits when they retire, become disabled, or die.
ssi title xvi
SSI (Title XVI)
  • SSI is funded through the general revenues of the Federal Treasury.
  • To receive SSI, you do not need to have a history of employment or payroll contributions.
  • SSI is a need-based benefit intended for those who are aged, blind or disabled who have little or no income and resources.
ssi vs ssdi
SSI rules focus on how much money a person has.

SSDI/DAC rules focus on a person’s ability to work.

SSI vs SSDI
eligibility disability determination
Eligibility - Disability Determination
  • As an adult, to be eligible for SSDI or SSI, a person must first meet some basic disability requirements:
    • The person must have a disability that is expected to last at least 12 months;
    • At the time of application, the applicant must either not be working, or earning under Substantial Gainful Activity (SGA) which is$940 gross / month in 2008).
disability determination
Disability Determination
  • Disability Determination Services, or DDS, are state agencies that make the disability decisions for Social Security.
  • In making a disability determination, DDS workers will request medical records, work history information, and, when necessary, pay for specific medical exams.
continuing disability reviews cdr
Continuing Disability Reviews (CDR)
  • SSA must periodically review the disability status of all beneficiaries and recipients.
  • Most people who are clients of WA DDD receive a CDR every 3 to 7 years, though certain circumstances can trigger a new CDR.
ssi redeterminations
SSI Redeterminations
  • In addition to the disability reviews, if you receive SSI, SSA will conduct non-medical redeterminations to update your income, resource, and living arrangement information.
  • These SSI redeterminations will occur every 12 months.
appeals
Appeals
  • You have the right to appeal an initial determination made by SSA, a denial of benefits, a reduction of benefits, termination of benefits, and overpayments.
managing ssa
Managing SSA
  • SSA is a tremendously large, bureaucratic organization.
  • It would be generally impossible for any organization this large to operate without making mistakes, or to always respond in a timely manner.
managing ssa14
Managing SSA
  • In cases of dispute, the burden of proof always falls on the individual! Therefore, individuals receiving SSA benefits should:
    • Keep all paperwork SSA!
    • Never throw anything away!
    • If he/she talks to someone from SSA over the phone or in person, he/she should record the person’s name, the person’s location, the date and time, and what was discussed.
ssi the application process

SSI – The Application Process

Application

Documentation

Questions

when should a person apply
When should a person apply?
  • If a person is under the age of 18, the parents’ income and resources will be considered.
  • If a person is over the age of 18, only the individual’s income and resources are considered.
how does one apply for ssi
How does one apply for SSI?
  • A complete application for SSI cannot be done over the internet.
  • An applicant should call SSA at 1-800-772-1213 to set up an appointment. This person will choose to either meet with an SSA representative in person, or arrange for an interview to be conducted over the phone.
what information should i include with my application
What information should I include with my application?
  • The more documentation you can bring, the better!
  • What you must bring:
    • Birth Certificate (original or certified copy)
    • SSN
    • Other Benefit Info – Unemployment, Child Support, Food Stamps, etc.
    • Bank Statements (2 months)
    • Any wage information (2 months) or tax returns
    • Rent / Mortgage payment information
    • Resource information (stocks, bonds, burial funds, etc.)
    • Spouse’s wage information if working
what information should i include with my application20
What information should I include with my application?
  • What you should bring:
    • Any documentation regarding your disability;
    • Names, addresses, and records of schools attended. Include names of teachers and counselors.
    • Names, addresses, telephone numbers, dates of treatment, and records from
      • all physicians;
      • all therapists;
      • all clinics and hospitals.
    • Statements by relatives, friends, and other people who know you, your disability, and the obstacles you face.
when should i apply
When should I apply?
  • Individuals should apply for SSI benefits as soon as possible, even if all documentation is incomplete.
  • If you call and indicate you want to apply for SSI, the date of your phone inquiry will count as the official application date IF the entire application is completed within 60 days of the phone call.
  • SSI benefits begin the first month following the month of application.
  • You will likely receive a retroactive SSI benefit check.
how long will it take
How long will it take?
  • The waiting period for eligibility determination is approximately 120 days.
appeals23
Appeals
  • If denied eligibility, you have the right to appeal.
  • A detailed description of the Appeals process is included.
what is ssi
What is SSI?
  • SSI is Supplemental Security Income. It is also known as Title XVI.
  • People qualify for SSI if:
    • They are aged, blind, or disabled; AND
    • They have little work history; AND
    • They have little income and resources.

People receiving SSI also receive Medicaid.

how much is it
How Much Is It?
  • SSI is based on what’s called the Federal Benefit Rate (FBR).
  • For 2008, the FBR is $637.
  • If you are a couple receiving SSI, the SSI amount will be $956/mo.
  • Other states have additional State Supplemental Payments; WA does not.
ssi what it covers
SSI – What It Covers
  • The FBR, $637, is considered the minimum amount that a person needs in order to live on a monthly basis.
income
Income
  • Any income that an SSI recipient receives must be reported to SSA.
  • Income can impact:
    • a person’s eligibility for SSI; and
    • the size of the person’s SSI check.
income30
Income
  • Income is often referred to as being either “Earned” or “Unearned”.
  • Earned Income is gross income that you get paid from a job.
  • Unearned Income is money that you didn’t earn:
    • SSDI;
    • Gifts;
    • Child Support;
    • Etc.
income31
Income
  • Earned and Unearned Income affect SSI differently.
ssi and living arrangement
SSI and Living Arrangement
  • A person is expected to use his/her SSI to pay food and shelter costs.
  • If a person is receiving support and not paying a fair share of living expenses, then SSA can reduce that person’s SSI amount.
ssi and living arrangement example 1
SSI and Living Arrangement, Example 1
  • Chip is living with his parents. Chip is not working, so his parents don’t feel it’s fair to charge him rent. His parents also give him food and do not receive compensation.
  • Because Chip’s basic expenses are being paid, SSA does not need to pay the full SSI amount. As such, SSA reduces his SSI by 1/3rd. (He will receive $425 / mo as opposed to the full $637.)
ssi and living arrangement example 2
SSI and Living Arrangement, Example 2
  • Bella is living with her parents. She pays for her fair share of food. She pays for rent; however, her parents explained to SSA that they would charge a higher amount if the renter was not their daughter.
  • SSA reduces Bella’s SSI check, because her rent is being partially subsidized. At most, SSI will be reduced by 1/3, but it may be reduced by a lesser amount.
what are the resource restrictions
What are the Resource Restrictions?
  • To be eligible for SSI, a person must have less than $2,000 in resources ($3,000 if applicants are a couple and recipients of SSI).
  • Exclusions to this restriction include:
    • Personal home;
    • A car;
    • Money sheltered in a Special Needs Trust;
    • Money sheltered in a PASS;
    • Money and equity in a self-owned business;
    • Burial funds, up to a certain amount;
    • Retroactive SSA payments for a certain period.
over resources example
Over-resources Example

Jessica receives SSI. Her grandmother passes away, leaving her an inheritance of $10,000.

What will happen to her SSI?

example continued
Example Continued
  • If Jessica does nothing, she will lose her SSI and Medicaid because she is over the $2,000 resource limit.
  • Jessica can spend down her $10,000;
  • Or, Jessica can shelter the money in a Special Needs Trust.
special needs trust
Special Needs Trust
  • A special needs trust preserves assets that would otherwise disqualify someone from SSI and Medicaid.
special needs trust40
Special Needs Trust
  • One available trust is the Developmental Disabilities Life Opportunity Trust.
ssi and medicaid
SSI and Medicaid
  • SSI recipients also receive Medicaid*, the green and white coupon mailed monthly.

*In 32 States, including WA.

medicaid
Medicaid
  • Unlike SSI, Medicaid is a state administered program. Each state sets its own guidelines subject to federal rules and guidelines.
  • There are a few different types of Medicaid in WA.
  • When a person receives Medicaid with SSI, it is referred to as CNP, or Categorically Needy Program Medicaid.
medicaid45
Medicaid
  • Medicaid is not the same as Medicare.
medicaid generally what it covers
Medicaid – Generally What It Covers
  • CNP Medicaid pays for mandatory health services such as:
    • Physician services,
    • Inpatient and outpatient hospital care;
    • Nursing home care;
    • Some Dental Care
    • Medicaid Personal Care;
    • Physical, occupational, and speech therapies; and
    • Prescriptions.*

*If a person receives both Medicare and Medicaid, prescription costs will be covered under the Medicare Drug Plan.

earned income and ssi
Earned Income and SSI
  • If a person is working, SSA will adjust a person’s SSI amount based on his / her gross monthly wages.
earnings and ssi reporting
Earnings and SSI - Reporting
  • When the person first begins working, he/she must notify SSA.
  • The person will then be required to send in copies of wage stubs to the local SSA office every month.
  • Social Security will mail envelopes in which the wage stubs can be sent.
  • The person should include his/her SSN on all wage stubs.
earnings and ssi reporting51
Earnings and SSI - Reporting
  • Social Security takes wage information and reduces SSI accordingly.
  • This process takes 2 months. The SSI amount in December is based on wages earned in October.
earnings and ssi calculations
Earnings and SSI – Calculations
  • The general idea is that SSI is reduced by $1 for every $2 earned.
  • If SSI was reduced $1 for every $1 earned, there wouldn’t be an incentive to work.
  • By working and receiving SSI, a person receives more income than by just receiving SSI alone.
calculation example
Calculation Example

Nikki receives $637 SSI. She begins working and gets paid $885 gross per month.

What will be the new amount of her SSI?

calculations example
Calculations Example

$885 gross wages

- $ 65 exclusion

- $ 20 exclusion

$800

$800 / 2 = $400 Countable Income

$637 FBR* - $400 = $237 SSI.

calculations example56
Calculations Example

If Nikki is paid $885 gross/ month, she will receive a $237 SSI check, for a total of $1,122.

ssi calculations determine the ssi amount for each person
SSI Calculations – Determine the SSI Amount for Each Person
  • Petunia receives $637 SSI and earns $1,085 gross per month.
  • Mr. Chablis receives $637 SSI and earns $70 gross per month.
  • Georgia receives SSI and begins earning $1,440 gross per month.
ssi calculations determine the ssi amount for each person58
SSI Calculations – Determine the SSI Amount for Each Person
  • Petunia: $137 SSI; $137 SSI+ $1,085 wages =$1,222.
  • Mr. Chablis: $637 SSI; $637 SSI + $70 wages = $707.
  • Georgia: $0 SSI; $0 SSI + $1,440 wages = $1,440.
georgia
Georgia
  • By earning $1440 gross per month, Georgia will receive $0 SSI check.
  • Does this mean Georgia now becomes ineligible for SSI and Medicaid?

No!

1619b status
1619b Status

Even though she is not receiving an SSI benefit check, Georgia keeps her SSI eligibility and Medicaid eligibility because she has entered 1619b status.

1619b occurs when an SSI-eligible individual receives no SSI check due to gross wages. In this situation, the individual stops receiving a check but maintains eligibility for SSI and Medicaid.

In 2008, a person can earn up to $27,143 gross in the year and maintain 1619b status.

1619b status individualized threshold
1619b Status &Individualized Threshold

If a person has high support costs covered by Medicaid, he / she may be able to request a Individualized Threshold beyond the State 1619b threshold.

complications with 1619b status
Complications with 1619b Status

When a person enters 1619b, it can cause an overpayment, and it can cause some strange happenings.

The SSI amount for any particular month (say, May) is calculated from earnings two months prior only if the person is eligible for at least $1 SSI in that particular month (May). If the person is not eligible for at least $1 in the month, then the person cannot receive any SSI check for that month (never mind how much was earned or not earned two months prior.) Since SSI is always two months behind, they will send the individual SSI checks (in May and possibly June) and then want them back 2 months later.

If wages later drop allowing SSI payments to begin, SSA will follow a set of (illogical) rules to determine the amount of the SSI for the next few months.

student earned income exclusion
Student Earned Income Exclusion

An SSI recipient may be able to utilize the Student Earned Income Exclusion (SEIE) if he / she is:

  • Regularly attending school; and
  • Under the age of 22; and,
  • Working.

Under the SEIE, a person can earn up to $1,550 / month, up to a total of $6,240 in 2008, and SSI will not be reduced.

student earned income exclusion66
Student Earned Income Exclusion
  • The Transition Program typically qualifies as “regularly attending school” for SEIE purposes.
  • The first time that student’s wage stubs are mailed to SSA, the following should be included:
    • School documents showing student status (IEP);
    • SSA’s policy regarding the SEIE (enclosed);
    • A brief note explaining the individual is a student and that the exclusion should apply.
  • The student must still report income to SSA on a monthly basis.
unearned income
Unearned Income
  • Unearned Income is any income that is not earned:
    • SSDI / SSDAC
    • Child Support
    • Gifts
    • Inheritances
    • Etc.
unearned income69
Unearned Income
  • Unlike wages, unearned income is weighed much more heavily by SSA.
  • Whereas wages are looked at as roughly $1 for every $2 earned, unearned income is looked at, after a $20 exclusion, dollar for dollar.
  • When calculating SSI, SSA will look at unearned income first, and earned income second.
example
Example
  • Clover, who is not working, receives both SSDI and SSI. Her SSDI is $440 / month. How large will her SSI check be?
example72
Example

$440 SSDI

- $ 20 Exclusion

$420 This is Clover’s Countable Income.

$637 FBR

- $420 Countable Income

$217 SSI

If Clover receives $440 SSDI, she will also receive $217 SSI, for a total of $657.

example73
Example
  • Clover receives SSDI in the amount of $440 and SSI in the amount of $217.
  • Clover begins working and gets paid $300 gross / month.
  • What happens to her SSI?
example74
Example
  • SSA will first look at SSDI:

$440 SSDI

- $ 20 Exclusion

$420 Countable Income

$637 FBR

- $420 Countable Income

$217 SSI

example75
Example
  • Next, they will look at Earned Income:

$300 gross wages

- $ 65 exclusion

$235

$235 / 2 = $117.50 Countable Earned Income

$217 SSI - $117.50 CI = $99.50 SSI

example76
Example

Clover receives $440 SSDI, $300 gross income, and $99.50 SSI for a grand total of $839.50 monthly.

unearned income and ssi
***Unearned Income and SSI***
  • Social Security looks at Unearned Income first and Earned Income second when calculating SSI.
  • If Unearned Income (+$20) is less than the person’s SSI benefit, AND if the Earned Income is large enough to reduce the SSI to $0, the person enters 1619b.
  • If the Unearned Income (+$20)is larger than the person’s SSI benefit, that person may lose SSI and Medicaid.
suggestion for additional training
Suggestion for additional training…

To fully understand how SSDI and SSDAC benefits can impact SSI, it is important to understand how those benefits work.

slide80
Quiz
  • Mr. Holly doesn’t know what type of SSA benefits he gets, but he knows the amount is $760. Does Mr. Jolly get SSI?

No

Yes

slide81
Quiz
  • Mr. Holly doesn’t know what type of SSA benefits he gets, but he knows the amount is $760. Does Mr. Jolly get SSI?

No

Yes

slide82
Quiz
  • Jesse receives SSI and Medicaid and has recently started a job. His wages will be about $1,685 per month. What will happen to his benefits?

Jesse will lose his SSI and Medicaid.

Jesse will lose his SSI cash benefit but will remain eligible for SSI and Medicaid.

slide83
Quiz
  • Jesse receives SSI and Medicaid and has recently started a job. His wages will be about $1,685 per month. What will happen to his benefits?

Jesse will lose his SSI and Medicaid.

Jesse will lose his SSI cash benefit but will remain eligible for SSI and Medicaid.

slide84
Quiz
  • Matilda, who is a transition student and an SSI recipient, lands a part-time summer job. Will her SSI initially be reduced?

No

Yes, SSI is always reduced due to wages, after the $85 exclusion.

It shouldn’t, but you never know with SSA. If it is, then SSA has probably made a mistake.

slide85
Quiz
  • Matilda, who is a transition student and an SSI recipient, lands a part-time summer job. Will her SSI initially be reduced?

No

Yes, SSI is always reduced due to wages, after the $85 exclusion.

It shouldn’t, but you never know with SSA. If it is, then SSA has probably made a mistake.

slide86
Quiz
  • Boris, an 18 year old who has never worked, receives only $424 SSI / month and Medicaid. He’s never been notified that he has an overpayment. Why is Boris’ SSI less than his friend’s SSI, which is $637 per month?

Boris gets less SSI because he doesn’t have a work history.

Boris probably isn’t paying his fair share for room and board.

Boris is confused and actually receives SSDI.

slide87
Quiz
  • Boris, an 18 year old who has never worked, receives only $424 SSI / month and Medicaid. He’s never been notified that he has an overpayment. Why is Boris’ SSI less than his friend’s SSI, which is $637 per month?

Boris gets less SSI because he doesn’t have a work history.

Boris probably isn’t paying his fair share for room and board.

Boris is confused and actually receives SSDI.

slide88
Quiz
  • Jackie, age 30, receives $637 SSI per month. She begins working, earning $1085 per month. Her monthly SSI will be reduced to what amount?

$0

$137

$94.50

$637

slide89
Quiz
  • Jackie, age 30, receives $637 SSI per month. She begins working, earning $1085 per month. Her monthly SSI will be reduced to what amount?

$0

$137

$94.50

$637

slide90
Quiz
  • Triumph who would otherwise receive $637 SSI receives $580 SSDI and earns $665 in gross monthly wages. Has Triumph lost his SSI eligibility and Medicaid?

No

Yes

slide91
Quiz
  • Triumph who would otherwise receive $637 SSI receives $580 SSDI and earns $665 in gross monthly wages. Has Triumph lost his SSI eligibility and Medicaid?

No

Yes

thank you please fill out the evaluation before you leave

Thank you!Please fill out the evaluation before you leave.

Department of Community and Human Services

Developmental Disabilities Division