Why do people going to work while receiving SSDI/SSI benefits? 2
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 3
WHAT IF a Beneficiary … Could keep cash benefits Could keep Medicare or Medicaid for long periods Wouldnt have to worry about reapplying for benefits if the job doesnt work out Had resources to help understand work incentives and has CHOICE in how work affects benefits? Could purchase needed services? October, 20084
5 SSA Disability Programs…what are all the SSSSs? SSDI = Social Security Disability Insurance SSI = Supplemental Security Income
Supplemental Security Income Payable to disabled children under 18 with limited income and resources; Parents must also have limited income and resources; Payable to disabled individual over 18 with limited income and resources SS Disability Insurance Benefits Payable to an individual disabled prior to age 22 with a parent who is disabled, deceased or retired Payable to an insured individual who is disabled. SS Benefits Payable to Children under 18 with a parent who is disabled, deceased, retired. No disability requirement APD6/13/2014
Can you get both? DISABILITYDISABILITY SSD Based on someone's work – an Insurance Program SSI Low income Low assets APD6/13/2014 Medicare Medicaid
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 6/13/2014
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 11
October, 200812 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)
October, 200813 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
October, 200814 Impairment Related Work Expenses (IRWEs) Related to medically established impairment Necessary to Work Reasonable Expense Proof of out of pocket payment
October, 200815 Examples of IRWE Medications Attendant care services Medical devices Work-related assistive devices Modifications to vehicle/residence Some transportation costs Job Coaching
October, 200816 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!
October, 200817 SUBSIDY & SPECIAL CONDITIONS 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
October, 200818 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!
20 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.
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) 21
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 (individual threshold) OR $28,753 per year (2011) 22
October, 200823 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
24 Work Reviews Medical reviews Medical CDR Protection – Thats the Ticket!
October, 200825 FEAR: Where Do I Begin? Safety Net: Ticket to Work Program Great-- You Got A Ticket! But-- What Can It Do For You?
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! The New Ticket Can:
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 28
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 29
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 30