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

October, 20086

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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, 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, 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, Impairment Related Work Expenses (IRWEs) Related to medically established impairment Necessary to Work Reasonable Expense Proof of out of pocket payment

October, Examples of IRWE Medications Attendant care services Medical devices Work-related assistive devices Modifications to vehicle/residence Some transportation costs Job Coaching

October, How Does IRWE Work? Assume: Wages=$1500 month SSDI=$1200 month $1500 (Gross wages *Note- SGA) (Beneficiary pays for IRWE-job coach) $ 950 (Remainder) = Countable for SSDI $1200 (SSDI ck)+1500 wages = TOTAL INCOME: $2700 Check is payable!

October, 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, How Does Subsidy Work? Assume: Wages=$1000 month SSDI=$1200 month $1000 (Gross wages *Note- SGA) (Beneficiary pays for IRWE-job coach) (Subsidy=50%) $ 350 = Countable for SSDI $1200 (SSDI ck)+1000 wages = TOTAL INCOME: $2200 Check is payable!

19 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

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, 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, 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:

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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

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 AWIC, WIL WIPA Disability Rights Florida or (TDD) Disabilityrightsflorida. PASS Cadre Maximus YOURTICKET or (TDD) 30

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Marlene Ulisky North Florida Area Work Incentives Coordinator Ext If you have the courage to begin, you have the courage to succeed. David Viscott $$