Understanding How Work Affects SSI/SSDI Benefits Developed by the Work Incentives Planning and Assistance (WIPA) Project. WIPA is a cooperative agreement between the Social Security Administration and the RI Department of Human Services/Office of Rehabilitation Services.

What do all the SSS’s Mean??? SSA= SSDI= SSI= SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME SOCIAL SECURITY DISABILITY INSURANCE

What Kind of Benefits do you Receive? Title II SSDI Benefits You are disabled and have insured status as a former worker. Must have worked in SSA covered employment. CDB Benefits You were disabled before age 22 and are receiving benefits on the record of a parent who is retired, disabled, or deceased. DWB You are a qualifying widow/ widower and were found disabled before the end of a certain period prescribed by law. (Not payable before age 50)

SSDI BENEFICIARIES RECEIVE MEDICARE 24 MONTHS AFTER DATE OF ENTITLEMENT.

What Kind of Benefits do you Receive?... SSI YOU MAY RECEIVE THESE BENEFITS IF: You are aged or disabled. You have little or no other income. Your resources do not exceed $2,000, Individual $3,000, Couple

In RI, SSI RECIPIENTS AUTOMATICALLY RECEIVE MEDICAID WHEN THEY BECOME ELIGIBLE FOR SSI BENEFITS. THERE IS NO WAITING PERIOD.

Be aware that...  Work is not the only thing that may cause benefits to end  Social Security may do a medical review and decide that you have medically improved. If so, both your cash payments and your health insurance may stop

What is Substantial Gainful Activity (SGA)?  Substantial Gainful Activity (SGA) - a term SSA uses to describe a certain level of work and earnings  Work is “substantial” if it involves doing certain physical or mental activities, or a combination of the two  “Gainful” work activity is work performed for pay or profit, of a nature generally performed for pay or profit, or work intended for profit, whether or not a profit is realized

SGA Guideline Level:  In 2009, countable earnings averaging over $980/month generally demonstrate SGA if your impairment is anything other than blindness. (Amount changes each year.)  If you are blind, countable earnings averaging over $1640 per month (in 2009) generally demonstrate SGA  Factors other than earnings may be taken into consideration when SSA is making an SGA decision, however

Work Incentives That Affect SGA Impairment Related Work Expenses Impairment Related Work Expenses (IRWE) (IRWE) SSA will deduct the cost of certain disability-related items and services that you need to work from your SSA will deduct the cost of certain disability-related items and services that you need to work from your earnings when they are deciding if your countable earnings demonstrate the performance of Substantial Gainful Activity. earnings when they are deciding if your countable earnings demonstrate the performance of Substantial Gainful Activity.

Possible IRWE’S that Social Security may Approve: Plus many more………….

Work Incentives That Affect SGA  SSA considers subsidies and special conditions to determine if the real value of your work is SGA  A “Subsidy” is support provided by your employer that may result in your receiving more pay than the actual value of the work you perform  “Special Conditions” refers to support provided by someone other than your employer

Major SSDI Work Incentives: Major SSDI Work Incentives: Provided that your impairment continues, Provided that your impairment continues, you will be entitled to the following: you will be entitled to the following:  Trial Work Period (TWP) - you will receive full SSDI payments for at least 9 months, regardless of how high your earnings might be. In 2009, months when you earn gross wages of $700 or more will be counted as Trial Work months. (This amount is adjusted each year.)  Grace Period (GP) - when Social Security decides that your work is at a level they call Substantial Gainful Activity (SGA), your work is at a level they call Substantial Gainful Activity (SGA), they will pay you a full SSDI payment for that month and for the they will pay you a full SSDI payment for that month and for the following 2 months before stopping your benefits following 2 months before stopping your benefits  Extended Period of Eligibility (EPE) - a period of 36 consecutive months following the TWP when, if you qualify, SSA may restart your SSDI benefits without a new application, disability determination, or waiting period. You qualify to have your benefits restarted if your earnings or work activity fall below SGA and you continue to have a disabling condition

During Extended Period of Eligibility: If earnings are below Substantial Gainful Activity (SGA) level If earnings are at or above Substantial Gainful Activity (SGA) level Entitled to SSDI cash payment Not entitled to SSDI Cash Payment EXCEPTION – Entitled to SSDI payments during 3 month Grace Period (G.P.) (G.P. occurs 1st time after TWP that you perform SGA.)

Year 2009JanFebMarAprilMayJuneJulyAugSeptOctNovDec Gr Wages Ben Status PT TWP 1 PT TWP 2 PT TWP 3 PTPT TWP 4 PT TWP 5 PT TWP 6 PT Yr 2010JanFebMarAprilMayJuneJulyAugSeptOctNovDec Wages Ben Status TWP 7 PT TWP 8 PT TWP 9 PT EPE 1 PT EPE 2 PT EPE 3 PT EPE 4 PT EPE 5 GP - PT EPE 6 GP - PT EPE 7 GP - PT EPE 8 PT EPE 9 PT Yr 2011JanFebMarAprilMayJuneJulyAugSeptOctNovDec Wages Ben Status EPE 10 PT EPE 11 PT EPE 12 PT EPE 13 PT EPE 14 PT EPE 15 PT EPE 16 PT EPE 17 PT EPE 18 PT EPE 19 PT EPE 20 PT EPE 21 PT YR 2012JanFebMarAprilMayJuneJulyAugSeptOctNovDec Wages Ben Status EPE 22 NO PT EPE 23 NO PT EPE 24 PT EPE 25 NO PT EPE 26 NO PT EPE 27 PT EPE 28 PT EPE 29 PT EPE 30 NO PT EPE 31 PT EPE 32 NO PT EPE 33 PT Yr 2013JanFebMarAprilMayJuneJulyAugSeptOctNovDec Wages Ben Status EPE 34 NO PT EPE 35 NO PT EPE 36 PTPT NP Trial Work PeriodTWPMo. Used (Allowed 9 within 60 Months) Extended Period of EligibilityEPEMo. Paid (36 Mo. After TWP) Grace PeriodGPMo. Paid NPMonth when there is no payment SSA Uses Gross Wages

SSDI Work Incentives Continued…  Expedited Reinstatement of Benefits – If cash payments end after the EPE because of your work at SGA level, but you must stop working at SGA level within 5 years of the month your benefits were terminated, SSA may be able to start your payments again  Continuation of Medicare Coverage – Most individuals with disabilities who work will continue to receive at least 93 consecutive months of premium - free Medicare Part A after the Trial Work Period. They may also continue to have Medicare Parts B and D during this time period if enrolled

Moving on to SSI...

SSI: Before and After Age 18  Some children may receive SSI benefits  At age 18, they must undergo a medical review to determine if they meet the adult disability standard  There is no guarantee that an individual will continue to be eligible for SSI benefits simply because he or she received SSI as a child

Earned Earned Income: Income:  Wages earned from employment or self employment Unearned Unearned Income: Income:  Any other income such as SSDI, Pensions, TDI, Unemployment Benefits, Interest or Dividends, Gifts from Grandma etc…

Major SSI Work Incentives Major SSI Work Incentives When figuring your income, we do not count all of your earnings :  General Income Exclusion (GIE) - We do not count $20 of any unearned income you have a month. If little or no unearned income, the $20, or remainder of $20, is deducted from earned income along with EIE  Earned Income Exclusion (EIE) – We do not count $65 of your earnings in a month plus half of remaining earned income received in a month  Student Earned Income Exclusion (SEIE) - if under age 22 and regularly attending school, we may exclude $1,640 per month up to a maximum of $6,600 per year (2009 figures; adjusted each year)

Major SSI Work Incentives cont…  1619(a) – Once you begin receiving SSI, if you are still disabled you may continue to receive SSI payments while you work, even if your earnings are at the SGA level  1619(b) or (continued Medicaid while working) – After you return to work, your Medicaid may continue if your wages (or your wages in combination with other income) become too high for you to receive an SSI cash payment. Certain conditions apply In most cases, your wages must be below a certain “threshold amount” - $36,604 in RI in ( Figure is adjusted annually.) In certain situations, individualized thresholds may be calculated In most cases, your wages must be below a certain “threshold amount” - $36,604 in RI in ( Figure is adjusted annually.) In certain situations, individualized thresholds may be calculated

Major SSI Work Incentives cont…  Impairment Related Work Expense (IRWE) – your out-of pocket and non-reimbursable expenses for items or services which are related to your disability and which you need to work. IRWE figure in the SSI payment calculation and may result in a higher SSI payment  Blind Work Expense (BWE) - expenses incurred by blind individuals while obtaining earned income. These expenses need not be related to blindness. They play a part in the SSI calculation and may result in a higher SSI payment

Major SSI Work Incentives cont… Expedited Reinstatement of Benefits If your SSI payments ended because of your earnings, Social Security may be able to restart them if you must stop working because of the same or a related disability within five years. If your SSI payments ended because of your earnings, Social Security may be able to restart them if you must stop working because of the same or a related disability within five years.

Major SSI Work Incentives con’t  Plan for Achieving Self – Support (PASS): A plan that allows you to set you to set aside income or resources to help you reach your work goal(s) A plan that allows you to set you to set aside income or resources to help you reach your work goal(s) The goal of a PASS is to earn enough money to significantly reduce or end your dependence on SSI/SSDI cash paymentsThe goal of a PASS is to earn enough money to significantly reduce or end your dependence on SSI/SSDI cash payments A PASS involves an application process and it must be approved by Social SecurityA PASS involves an application process and it must be approved by Social Security PASS funds may be used for education or job training, to help you start a business, or to purchase items or services needed to reach your job goalPASS funds may be used for education or job training, to help you start a business, or to purchase items or services needed to reach your job goal Using a PASS may help you keep your SSI, get a higher SSI payment, or become eligible for SSI (In RI you will also have Medicaid while using a PASS)Using a PASS may help you keep your SSI, get a higher SSI payment, or become eligible for SSI (In RI you will also have Medicaid while using a PASS)

Earning wages… means your SSI check decreases or stops BUT… your total income for the month increases

Sample SSI Formula for Individuals With SSI and Wages Only (No IRWE) Gross Monthly Wages Income Exclusions ($20 + $65) Remainder (divided by 2 equals) Countable earnings: Maximum SSI Rate for 2009 Minus Countable Earned Income Adjusted SSI Payment $ $415.00$207.50$ $ TOTAL MONTHLY INCOME = $1,006.42

Not Working If you do not work, your SSI payment will be $ or less, unless you are in assisted living. $ (SSI Maximum in RI in 2009)

Sample SSI Formula For Individual With Wages And IRWE’s  Gross monthly wages  Income Exclusions  Remainder  minus IRWE  Remainder  Countable Earnings  Maximum SSI Rate for 2009  Minus Countable Earned Inc Adjusted SSI Payment  Notice that SSI payment is $50 higher than in previous example due to IRWE. Your total monthly income would be $ in this example. $ $ $ $ $ $713.92$157.50$ (divided by 2)

Sample SSI Formula For Individual With Unearned Income And Wages. Unearned Income (SSDI) $ Minus general income Exclusion -$20.00 Countable Unearned Income $ Gross monthly earned Income $ Minus earned income exclusion -$ Remainder $ / 2 Countable Earned Inc. $ Countable Unearned Inc. $ Countable Earned Inc. +$ Total Countable Inc. $ Maximum SSI (2009) $ Minus Countable Inc. -$ Adjusted SSI payment $ Your total income for month would be $ ! Your total income for month would be $ !

The Ticket to Work Program

What is Ticket to Work?  It is an employment support program  It is a free and voluntary service  Most beneficiaries age 18 and older, who have not reached age 65 are eligible for a ticket  It allows individuals expanded opportunities to obtain the services and supports that they need obtain the services and supports that they need to work and to achieve their employment goals to work and to achieve their employment goals

What Is The Goal Of The Ticket Program?  The Ticket to Work program expands the choices available to SSA beneficiaries with disabilities available to SSA beneficiaries with disabilities who want to enter or re-enter the workforce who want to enter or re-enter the workforce  The ultimate goal of the program is to support the work goals of beneficiaries with disabilities and help them gain financial independence from reliance on Social Security disability benefits to the extent possible 

Where Can The Ticket Be Used?  The Ticket program allows participants to choose from several providers of vocational services called Employment Networks (EN’s)  EN’s are organizations or agencies that have agreed to work with SSA to provide employment services to beneficiaries with disabilities and/or and/or  The state Vocational Rehabilitation Agency – the Office of Rehabilitation Services (ORS)

Where Can I Find Contact Information For ORS Or EN’s Serving RI?  Visit for a list of EN’s serving RI or or  Contact Maximus at and request Ticket to Work information and a current list of EN’s. Ticket to Work information and a current list of EN’s. TDD users call TDD users call

What Kinds of Employment Services May be Offered?  May help with developing a resume  May teach interviewing skills  May do interest or aptitude testing  May assist with education or training  May provide job coaches  May offer job development services Services differ from one organization to the next. However a variety of services may be available, such as:

How Do I Choose A Provider Of Vocational Rehabilitation Services?  Think about the services that you may need in order to work  Call or visit several EN’s and ORS  Ask them specific questions about how they will help you  Talk to others who have used their services  Choose the provider that best fits your needs

What Happens Next?  When a beneficiary and a provider agree to work together, you will develop a written plan outlining the services and supports that will be provided to help you achieve your vocational goal  If you choose to work with an EN, you will “assign” your Ticket to that EN  If you choose to work with ORS, they will decide whether to accept your ticket assignment or place your Ticket in “in use status”. If your ticket is placed in “in use status” you may “assign” it to an EN after you become employed for ongoing support services after ORS closes your case

What If The Vocational Provider Does Not Help Me?  If the services do not meet your needs, you may choose to reassign the Ticket to another provider  You may “retrieve” a Ticket or take it out of assignment at any time for any reason  You must notify the Operations Support Manager, Maximus, in writing  If you are ending your work with an ORS state VR agency, you must also ask them to close your case

Why Should I Use My Ticket?  You will obtain valuable Vocational services at no cost to you  While using your Ticket, SSA may postpone your medical continuing disability review (CDR) as long as you are working toward your employment goal and meeting the SSA Timely Progress Provision

Why Is It Important To Have Medical CDRs Postponed?  If a medical review is done, Social Security may decide that you are no longer disabled because you have medically improved. Your cash payments and your health insurance may stop, and you may lose the employment support services and other help you were receiving towards your work goals

How Long Will My Medical CDRs Be Postponed?  Medical CDRs will be postponed as long as you are using your Ticket and making the you are using your Ticket and making the expected progress toward achieving self- expected progress toward achieving self- sufficiency sufficiency  This means that you must achieve certain work/educational goals during each work/educational goals during each 12-month period 12-month period  (See handout describing Timely Progress requirements.) requirements.)

Should I Work? The decision to work despite a disabling condition is individual and personal. The reasons for wanting to work are individual and personal too, but often include: The decision to work despite a disabling condition is individual and personal. The reasons for wanting to work are individual and personal too, but often include:  an increase in self-esteem  a decrease in feelings of depression  more social interaction  the chance to use knowledge/skills  and of course, more $$$$$$$

DISCLAIMER: The current presentation is based on 2009 rates. Many of the Social Security Rates change on an annual basis, usually in January. Updates will be made as new figures become available. Thanks for your time!