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1 (Benefits Boot Camp)- SECT BASIC Boot Camp for Understanding Benefits & Work Presented by: Supported Employment Consultation & Training (SECT) Center.

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Presentation on theme: "1 (Benefits Boot Camp)- SECT BASIC Boot Camp for Understanding Benefits & Work Presented by: Supported Employment Consultation & Training (SECT) Center."— Presentation transcript:

1 1 (Benefits Boot Camp)- SECT BASIC Boot Camp for Understanding Benefits & Work Presented by: Supported Employment Consultation & Training (SECT) Center 1100 Broadway Anderson, IN U:\My Music\03 Boogie Woogie Bugle Boy (Form Company B).mp3

2 2 (Benefits Boot Camp)- SECT Fall In! Your in Boot Camp now!!! Sergeants: Payne & Suffrin A.K.A. Dennis Born & Denise Norris as your Boot Camp Commanders

3 3 (Benefits Boot Camp)- SECT The purpose of your “BASIC” Training To give a brief overview of eligibility requirements for Title II and Title XVI Social Security and Medicaid programs. To provide tools for calculating the impact of work income on Social Security and Medicaid. Identify 2009 entitlement changes. To identify educational resources available to individuals, case managers, and families.

4 4 (Benefits Boot Camp)- SECT How Does Work Affect Benefits? “…subjects reject competitive employment …in view of the fact that the working person loses money from his/her pension check and risks losing the disability pension altogether if work continues for long. Warner and Polak, Community Mental Health Journal, Vol. 31, No. 5, Oct % of unemployed individuals with disabilities indicate the reason they are not working because the increase income from work may cause a loss or decrease in healthcare benefits. Indiana Medicaid Action Coalition, Healthcare Barriers to Employment Survey, 2000

5 5 (Benefits Boot Camp)- SECT Social Security Administration: Two Disability Programs: Title XVI SUPPLEMENTAL SECURITY INCOME (SSI) Title II SOCIAL SECURITY DISABILITY INSURANCE (SSDI)/SOCIAL SECURITY DISABLED ADULT CHILD (SSDAC)

6 6 (Benefits Boot Camp)- SECT Obtaining SS Information: Obtain Completed SSA Consent Forms for Release of a Benefits Planning Query (BPQY) to an Authorized 3 rd Party

7 7 (Benefits Boot Camp)- SECT Benefits Planning Query (BPQY) Confidential Social Security Data NAME: SSN: Social Security Disability Insurance (SSDI) Supplemental Security Income (SSI) RECORD See Below CASH Type of Benefit Current Status Statutory Blindness Date of Disability Onset Date of Entitlement Full Amount Net Amount Others Paid on This Record Total Family Cash Benefit Overpayment Balance Monthly Amount Withheld Disabled Adult Child Current Pay No 8/31/91 08/91 $ $78.00 No $ $0.00 Disabled Individual Current Pay No 08/01/04 08/04 $ No $0.00 None MEDICAL REVIEWS Next Medical Review Medical Re-exam Cycle 06/11 7+ years 09/23/07 3+ years REPRESENTATION Representative Payee Authorized Representative Yes No Yes No SSA-2459 Date Produced: 8/7/06 July 2001 Page 1 of 2

8 8 (Benefits Boot Camp)- SECT NAME: SSN: HEALTH INSURANCE MEDICARE MEDICAID Type PART A PART B PART C/D State determination Start 08/ / /2006 Stop Buy-In or Subsidy No No 100% SSI WORK EXCLUSIONS Blind Work Expense Impairment Related Work Expenses Student Earned Income Exclusion PASS Exclusion SSDI WORK ACTIVITY Trial Work Months Start: End: Used: 0 Months Month of Cessation N/A Current SGA Level $ RECENT EARNINGS ON RECORD YEAR EARNINGS YEAR EARNINGS MONTHS EARNINGS MONTHS EARNINGS 1989 $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ SSA-2459 Date Produced: 8/7/06 July 2001 Page 2 0f 2

9 9 (Benefits Boot Camp)- SECT SSI: A federal program that provides monthly payments to persons with disabilities on a needs basis Eligibility oHave little or no unearned income oBe considered medically disabled oInitially not be working or working and earning less than the Substantial Gainful Activity (SGA) level ($940 in 2008) $980 in 2009 oHave limited countable resources ($2,000 for an individual and $3,000 for an eligible couple in 2009) 2009 Federal Benefit Rate (FBR) o$674 (individual)/ $637 in 2008 o$1, (eligible couple)/ $956 in 2008

10 10 (Benefits Boot Camp)- SECT SSI & Work Incentives: EXCLUSIONS General o Excludes first $20 of income o Applies to unearned or earned income Earned o Excludes first $65 of earned income o Excludes one-half (1/2) of remaining gross earnings

11 11 (Benefits Boot Camp)- SECT SSI & Work Incentives PLAN FOR ACHIEVING SELF-SUPPORT STUDENT EARNED INCOME EXCLUSION Property Essential to Self-Support (PESS)

12 12 (Benefits Boot Camp)- SECT Other SSI Work Incentives 1619 a & b Status Public Law will not lose SSI eligibility due to exceeding SGA Reinstatement of Eligibility Without a New Application Section 301: Continued Payment under a Vocational Rehabilitation Program

13 13 (Benefits Boot Camp)- SECT Both SSI & SSDI Work Incentives IMPAIRMENT RELATED WORK EXPENSE SSI

14 14 (Benefits Boot Camp)- SECT SSDI/SSDAC An earned entitlement that enables former workers, who due to a disability are unable to work, to receive monthly cash benefits and Medicare insurance Eligibility (SSDI) oHave worked and paid Social Security taxes oBe considered medically disabled oNot be working, or working and earning less than the Substantial Gainful Activity (SGA) level ($980 in 2009/ $940 in 2008) Eligibility (SSDAC) oBe a dependent of an insured worker who is disabled, retired, or deceased oUnder age 18, or 18 years of age or older and who has become totally and seriously disabled before age 22 oNot be working, or working and earning less than the Substantial Gainful Activity (SGA) level ($980 in 2009/ $940 in 2008)

15 15 (Benefits Boot Camp)- SECT SSDI/SSDAC & Work Trial Work Period o Allows an individual to continue to receive their check regardless of the amount of money they earn $700 in 2009/ $670 in months - do not need to be consecutive – in a 60 month rolling period Extended Period of Eligibility o Protects an individual’s eligibility but not his/her check o 36 consecutive months o Earnings over SGA will affect check

16 16 (Benefits Boot Camp)- SECT Other SSDI Work Incentives Impairment Related Work Expense o Allows an individual to deduct the cost of certain items/services from their gross wages in order to keep earnings below SGA Subsidy & Special Conditions Section 301: Continued Payment under a Vocational Rehabilitation Program

17 17 (Benefits Boot Camp)- SECT Medicaid A federal/state funded medical assistance program administered by the Indiana Family and Social Services Administration (FSSA)

18 18 (Benefits Boot Camp)- SECT Medicaid Eligibility Must be substantially impaired per the definition of disability in State law: A physical or mental impairment, disease, or loss Appears reasonably certain to last twelve (12) months or more Substantially impairs the person’s ability to perform labor or services or to engage in useful occupation Determination of disability is based on the individual’s age, education, work experience, and functional limitations Must meet certain income and resource limits: 2009 Income Standard is $674 (individual) and $1, (couple) * will most likely follow SSA guidelines for resource limits are $1,500 (individual) and $2,250 (couple) Must be a resident of Indiana

19 19 (Benefits Boot Camp)- SECT Medicaid & Work Spend-down o Enables recipients to qualify for some Medicaid when their income exceeds the Medicaid Monthly Income Standard

20 20 (Benefits Boot Camp)- SECT Medicaid & Work 1619 Status “the big gun!!!” o1619 (a) Must receive SSI & Medicaid Protects an individual’s Medicaid eligibility without a spend-down when earning exceed SGA o1619 (b) Must receive SSI & Medicaid Protects an individual’s Medicaid eligibility without a spend-down when his/her SSI check is reduced to zero (0) due to earnings

21 21 (Benefits Boot Camp)- SECT Medicaid & Work Medicaid for Employees with Disabilities (MED Works) oEligibility Meet state definition of disability Between ages of 16 and 65 Be engaged in a substantial and reasonable work effort Have monthly income that exceeds the spend-down income standard o2009 Income Limit = $3,159 (as of 3/1/09) o2009 Resource Limits $2,000 (single) $3,000 (couple) oMonthly premiums Must pay premium based on gross monthly income Zero (0) premium for single persons earning less than $1,353 or married couples earning less than $1,821 (as of 3/1/09)

22 22 (Benefits Boot Camp)- SECT Example: Joe receives $ SSDI each month. He obtains a job as an Auto Technician working 20 hours a week. He earns $7.00 an hour. Note: Gross Monthly Earned Income: Hours X $ X 4.3 (weeks) = GMEI (20 X 7 X 4.3 = $602.00)

23 23 (Benefits Boot Camp)- SECT 2009 MED Works Premiums Gross monthly Income as a percent of FPG <150%150%≤175% >175%≤200% >200%≤250%>250%≤300%>300%≤350% >350% Single Gross Monthly income $0-$1,353$1,354-$1,580$1,581-$1,8050$1,806-$2,257$2,258-$2,708$2,709-$3,159$3,160.+ Monthly Premium $0$48$69$107$134$161$187 Married Gross Monthly income $0-$1,821$1,822-$2,125$2,126-$24292$2,430-$3,036$3,0374-$3,643$3,644-$4250$4,251+ Monthly Premium $0$65$93$145$182$218$254 Please note: Gross monthly income must be at or below the high dollar figure within a given percentage range. For example, in a family size of one, an individual must earn $1, (gross monthly) or less to qualify for MED Works with no premium. If that same individual earns $1,276.01, earnings would be rounded up to the next income level of $1,277.00, resulting in a $48 monthly premium. Note: To figure out the premium add gross earned income with unearned income to equal gross monthly income. Example:$ gross earned income (wages) unearned income $ total gross monthly incomepremium cost: $ 48.00

24 24 (Benefits Boot Camp)- SECT Medicare A federally funded health insurance program for individuals: Aged 65 or older Have end-stage renal disease Receiving SSDI/SSDAC benefits

25 25 (Benefits Boot Camp)- SECT Medicare & Work Receive at least 93 months of premium-free hospital insurance (Part A) after Trial Work Period even with earnings over Substantial Gainful Work Activity. Medicare could continue if you never work over Substantial Gainful Activity. Medicare Buy-Back oPurchase Medicare If it’s stopped due to work oOptions Part A & Part B Part A only

26 26 (Benefits Boot Camp)- SECT Other Entitlement Work Incentives The Indiana Food Stamp Program Section 8 Housing

27 27 (Benefits Boot Camp)- SECT Acronyms BPQYBenefits Planning Query BWEBlind Work Expense CDRContinuing Disability Review DDSDisability Determination Services EPEExtended Period of Eligibility FBRFederal Benefit Rate FPGFederal Poverty Guideline IRWEImpairment-Related Work Expense MADMedicaid for the Disabled – Full Coverage MADW Medicaid for the Disabled – Working Individual MADIMedicaid for the Disabled – Medically Improved PASS Plan for Achieving Self-Support PESS Property Essential to Self-Support PMPPrimary Medical Provider SGASubstantial Gainful Activity SSASocial Security Administration SSDAC Social Security Disabled Adult/Child SSDISocial Security Disability Insurance (Title II) SSISupplemental Security Income (Title XVI) TWPTrial Work Period UWAUnsuccessful Work Attempt WIPAWork Incentives Planning and Assistance BPAOBenefits Planning, Assistance, & Outreach

28 28 (Benefits Boot Camp)- SECT Contact Information The Supported Employment Consultation and Training (SECT) Center 1100 Broadway Anderson, IN Dennis Born, S.E.C.T. Director Denise Norris Trainer/Consultant Community Work Incentive Coordinator


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