Social Security Disability Benefits and Supplemental Security Income: Understanding the Impact of Work on Benefits….Removing the FEARof WORK!
fear Why do people going to work while receiving SSDI/SSI benefits?
FEAR: • Loss of Cash Benefits • Loss of Medicare and/or Medicaid • Not Understanding Work Incentives • Reapplying for Benefits • Overpayments • Work=Not Disabled • Not understanding Impact of work on other programs/benefits
WHAT IF a Beneficiary… • Could keep cash benefits • Could keep Medicare or Medicaid for long periods • Wouldn’t have to worry about reapplying for benefits if the job doesn’t work out • Had resources to help understand work incentives and has CHOICE in how work affects benefits? • Could purchase needed services?
Can you get both? D I S A B I L I T Y SSI Low income Low assets SSD Based on someone's work – an Insurance Program Medicaid Medicare APD
Definition of Disability • Adult:Inability to Engage in any Substantial Gainful Activity by Reason of any Medically Determinable Physical or Mental Impairment or Combination of Impairments which has lasted or can be expected to last for a continuous period of not less than 12 months or result in death. *Age 18 or older • Child: Inability to Engage in any Substantial Gainful Activity by Reason of any Medically Determinable Physical or Mental Impairment or Combination of Impairments which causes “marked and severe functional limitations” and that 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 12 months. APD
FEAR:Maintaining Cash Benefits • SSDI: • TWP/Extended Period of Eligibility • Any Amount for 9 month ($720 TWP) • EPE – Under $1000 Gross (in general w/no exclusions-Blind $1640)) • SSI: • Earned Income Exclusion: $65 • $20 General Exclusion • $1 for $2 adjustment
Fear: Jeopardizing Cash Benefits Safety Net: Trial Work Period • Nine service months • Employee: $720 gross/mo (2011); Self-employed: $720 net* • Full SSDI benefits payable • Medicare continues (if applicable) • Only one TWP during period of disability *After 24 months of benefits (initial or EXR)
What Happens After TWP? • Extended period of Eligibility (EPE) • 36 months after TWP • Benefits continue if under SGA • $1000 non blind • $1640 blind • Benefit Cessation when earnings over SGA • Benefits payable for first SGA months + 2 “grace” months • Suspension vs. termination
Impairment Related Work Expenses (IRWEs) • Related to medically established impairment • Necessary to Work • Reasonable Expense • Proof of out of pocket payment
Examples of IRWE • Medications • Attendant care services • Medical devices • Work-related assistive devices • Modifications to vehicle/residence • Some transportation costs • Job Coaching
How Does IRWE Work? Assume: Wages=$1500 month SSDI=$1200 month $1500 (Gross wages *Note- ↑SGA) - 550 (Beneficiary pays for IRWE-job coach) $ 950 (Remainder) = Countable for SSDI $1200 (SSDI ck)+1500 wages = TOTAL INCOME: $2700 Check is payable!
Subsidy = Support provided by Employer Special Conditions = Support by others More pay than Value of work performed Dollar value attached to extra help, supervision, etc. Job Coaching SUBSIDY & SPECIAL CONDITIONS
How Does Subsidy Work? Assume: Wages=$1000 month SSDI=$1200 month $1000 (Gross wages *Note- ↑SGA) - 150 (Beneficiary pays for IRWE-job coach) - 500 (Subsidy=50%) $ 350 = Countable for SSDI $1200 (SSDI ck)+1000 wages = TOTAL INCOME: $2200 Check is payable!
SSI Calculation 1085 (Gross wages)* - $20 (General Exclusion) 1065 (Remainder) - $65 (EIE) 1000 (Remainder) ÷ 2_______ 500 (Total countable earned income) $674(full SSI ck)-500 = $174 (new SSI amt) TOTAL INCOME: $1259 $174(SSI)+$1085(wages) Breakeven Point: $1433
FEAR: What happens to Medicare if you receive SSDI and if you work? Beginning in October 2000 premium-free Medicare Part A, along with supplementary medical insurance (Medicare Part B), continues for at least 93 months (7 yrs, 9 months) after the end of the TWP. …Medicare can be purchased if disability continues AFTER the end of the 93 month period.
FEAR: But…what happens to Medicaid??? • If you lose all or part your SSI check because of your wages you can keep your Medicaid under 1619(a) or (b) • If you lose your SSI check for ANY other reason you also lose Medicaid • Medicaid may be stopped because excess resources. • *Assuming recipient is eligible for/receives SSI (SSI/Medicaid)
Section 1619 (B) - Continued Medicaid • Have been eligible for SSI Payment for at least 1 month • Still disabled • Meet all other eligibility rules • Need Medicaid in order to work and • Have gross income insufficient to replace SSI, Medicaid and any publicly funded attendant care (individualthreshold) OR $28,753 per year (2011)
FEAR : Reapplying/Benefit TerminationSafety Net: Expedited Reinstatement • SSDI or SSI • Current work is under SGA • Same or related disabling condition • Prior termination due to work activity • Within 60 months of last entitlement • 6 months Provisional Benefits
FEAR: Will SSA Review my Medical Disability if I work? Work Reviews Medical reviews Medical CDR Protection – That’s the Ticket!
FEAR: Where Do I Begin?Safety Net: Ticket to Work Program Great-- You Got A Ticket!But-- What Can It Do For You?
The New Ticket Can: • Provides CHOICE • Could help to find a job • Adds “Employment Networks” to the choices of who will assist without cost • Protects from Continuing Medical Disability Reviews!
An SSI Exclusive!Report Wages By Telephone! • You, your payee or deemor can call in wages every month • Call toll-free from the 1st to the 6 day of each month to report gross wages paid in the previous month • You get a receipt mailed automatically! • CALL 1-866-772-0953
What/How to Report to SSA • Report work to SSA • Name, address and phone number of employer • Report to both departments if you receive two checks • Be able to estimate future earnings • Know if and when checks will stop • Request a Receipt
Resources • Social Security Administration • 1-800-772-1213 • AWIC, WIL • www.socialsecurity.gov/work • WIPA • Disability Rights Florida • 1-800-342-0823 or 1-800-346-4127 (TDD) • Disabilityrightsflorida. • PASS Cadre • 1-800-254-9489 • Maximus • 1-866-YOURTICKET or 1-866-833-2967 (TDD) • www.yourtickettowork.com
THE END If you have the courage to begin, you have the courage to succeed.” David Viscott Marlene Ulisky North Florida Area Work Incentives Coordinator 1-866-296-4879 Ext 16801 $$