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Maryland Benefits Counseling Network

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Presentation on theme: "Maryland Benefits Counseling Network"— Presentation transcript:

1 Maryland Benefits Counseling Network
Making Employment Work: Creating Financial Independence Through Work Incentives Lauren Horner Program Director Maryland Benefits Counseling Network

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3 Housekeeping - Evaluations/Assessment
Please complete your evaluations before leaving today! You will receive an with the link and password to complete your training assessment. You will be given 2 attempts to score at least 80% in order to pass. CEUs/COPs will be mailed to the address provided after a passing score is obtained. Be sure to dedicate time for your assessment. If you leave the assessment page once started, you will NOT be able to log back in where you left off and will need to start all over again.

4 Why is Work Important? Employment allows beneficiaries to move towards financial independence. Employment helps in the recovery process, increasing self-respect, dignity and self-worth Employment creates contributing members of society. Improving the economy and community as a whole. Employment offers the opportunity to develop new skills and to grow a successful employment record.

5 What Benefits Questions Do You Hear?
How many hours can I work and not lose my SSA benefits? How will this job affect my SSA benefits? Will I lose my medical assistance if I work? What about my Medicare?? Can I get my benefits back if I can’t continue to work?

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7 FACT or FICTION? “I can keep my benefits as long as I am working part-time not full-time.” FICTION – Depends on the type of benefit received and the amount of someone’s actual earnings. “As soon as I start to work, I will lose my benefits.” FICTION – It is very possible to work and keep benefits. “I can work up to 20 hours per week and keep my benefits.” FICTION – Again, depends on the type of benefit received and the amount of someone’s actual earnings. “I can work for 9 months without my benefit changing.” FACT – For SSDI Beneficiaries! FICTION – For SSI beneficiaries!.

8 FACT or FICTION? “I don’t need to report my earnings; Social Security takes money from my paycheck and should know what I am making.” “My benefit cannot be changed or lost while I am in the Ticket to Work program.” FICTION – Social Security doesn’t know what you are earning each month unless you tell them. The taxes taken out are not a way of reporting. FICTION – Participation in the Ticket to Work program does not protect you from the rules on how working impacts benefits. “Working can help me be financially better off – even if I lose my cash benefit.” FACT – Most individuals have more money by working, even it they’ve lost their SS benefit! Work Incentives education and Benefits Counseling is key!

9 Why Benefits Education is Important
Myths and misconceptions about how working impacts benefits are overwhelming. Social Security is not a reliable source of accurate information. Integrating benefits education and benefits counseling early on has been linked to: Higher employment success rates Less employment turnover Higher earning rates.

10 Difference Between Medicaid & Medicare
A state-run program that provides hospital and medical coverage for people with low income and little or no resources. aka Medical Assistance (MA) Receive with SSI Managed Care and Fee-for-Service Will cover Medicare premiums Apply for Medicaid at DSS or online at mydhrbenefits.gov or marylandhealthconnection.gov Medicare Health insurance program for people age 65 or older, certain individual’s with disabilities and those who have permanent kidney failure or Lou Gehrig’s disease. Receive with Title II benefits There are 4 parts Part A – Hospital Coverage Part B – Medical Insurance Part C – Supplemental Medicare Advantage Part D – Prescription Apply for Medicare through SSA

11 Employed Individuals with Disabilities (EID)
State of Maryland’s Medicaid Buy-In Program Provides Medicaid for a fee to people with disabilities who work and would ordinarily have incomes and/or resources above limits for other Medicaid programs Recipients may be charged a small premium for enrollment (between $0-$55 per month)

12 Employed Individuals with Disabilities (EID)
Eligibility Requirements Must meet SSA’s disability definition (does not necessarily need to receive SSA disability benefits) Be between 18 – 64 years old Be working for pay (employed or self-employed) Meet income limits ($37,470 individual or $50,730 married) Have resources below $10,000 individual or $15,000 married Be a U.S. citizen or qualified alien To apply, submit a paper application to the Eligibility Determination Division (EDD):

13 Title II: SSDI, CDB, DWB A federal disability insurance program that provides benefits to individuals with disabilities who are insured by workers' contributions to the Social Security trust fund. Title II pays benefits to eligible individuals and certain members of his/her family if he/she worked long enough and paid Social Security taxes. There are 3 different types of Title II disability benefits that someone could receive.

14 Title II: SSDI, CDB, DWB Social Security Disability Insurance (SSDI) - An individual is a former worker, has achieved “insured status” and has become disabled Childhood Disability Beneficiary (CDB) - An individual is a disabled adult child of a worker who has retired, became disabled, or who is deceased. The disabled adult child must: Be at least 18 years old Have become disabled before age 22 Be the child (or in some cases the grandchild) of a former worker who is eligible for Social Security retirement benefits or SSDI, or who is deceased Disabled Widows/Widowers (DWB) - An individual is a widow(er) age 50 or older that is disabled and has not remarried before age 60 All must meet Social Security’s definition of Disabled There is no resource limit for Title II benefits

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16 So What Happens to Title II Benefits When Someone Starts Working?!
For any month gross earnings are below a benchmark of $850, benefit is paid in full and no change occurs. Once earnings exceed the benchmark, a series of phases with different rules and work incentive protections apply: Phase 1 - Trial Work Period (TWP) Phase 2 - Extended Period of Eligibility (EPE) Phase 3 - Post EPE/Expedited Reinstatement (EXR)

17 Phase 1 – Trial Work Period (TWP)
Individuals are allowed 9 months to work with no limit on earnings. Any month gross earnings exceed $880 (benchmark) will count as 1 of the 9 TWP months. This means these 9 months DO NOT need to occur consecutively. During these 9 months the benefit amount is paid in full no matter how high the earnings. Once a total of 9 months have been used, the TWP has ended. Individuals only get 1 Trial Work Period!

18 TWP Scenario Evan has been entitled to SSDI for six years. He started to work for the first time in April of He had a couple of breaks in his earnings. Evan’s earnings and TWP usage looks like this: 2018 Jan. Feb. Mar. Apr. May Jun. July Aug. Sept. Oct. Nov. Dec. Earnings 900 619 600 905 901 1200 TWP No Yes Count 1 2 3 4 5

19 TWP Exercise Katie is entitled to SSDI benefits. In January 2018 she began working at a library earning $ per month. Katie worked at the library for 6 months and then stopped working. In October 2018 Katie began working again, this time at a local restaurant earning $1000 per month. She continues to work through December of 2019. Use a SSDI Tracking Form to illustrate Katie’s earnings and TWP usage.

20 Year  2018   Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings 900 1000 Benefit Status  1 TWP     2 TWP 3 TWP 4 TWP 5 TWP 6 TWP 7 TWP 8 TWP 9 Year  2019    Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings  1000 1000 Benefit Status       Year  2020     Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings       Benefit Status Year 2021   Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings       Benefit Status

21 Phase II – Extended Period of Eligibility (EPE)
Immediately following the 9th TWP month new rules apply! Social Security will now compare monthly gross earnings to a monthly earnings limit known as Substantial Gainful Activity or SGA. In 2019, SGA is $1,220 gross earnings per month (non blind); or $2,040 gross per month (blind). For each month earnings are below the SGA limit, benefit payment is made in full. Benefit payments are also made during the first month earnings are above the SGA limit (after the TWP) and the two months immediately following (these are called the Grace Period). Then payments are stopped or ‘suspended’. So what if work stops or earnings are reduced??!...

22 Phase II – Extended Period of Eligibility (EPE)
Immediately following the TWP, a work incentive safety net called the Extended Period of Eligibility (EPE) begins. The EPE is a safety net that enables benefit payments to start again very easily if work stops or earnings are reduced below the SGA limit. Benefit payments can be restarted by contacting SSA, reporting the change, and providing proof. The EPE begins immediately following the 9th TWP month and lasts for 36 consecutive months (3 years) whether or not the individual is working during that time. During the EPE, benefit payments can start and stop repeatedly based on changes in earnings above and below SGA.

23 EPE Exercise In January 2020, Katie increases her hours at work and is now earning $1300 per month. In May she cuts her hours and is back to earning $1000 per month through December 2020. Use a SSDI Tracking Form to illustrate the following: When Katie’s EPE started and stopped; When Katie’s 3 Grace Period months were used; Indicate what months she should receive her benefit check.

24 Year 2018 Jan Feb March April May June July Aug Sept Oct Nov Dec
Countable Earnings 900 1000 Benefit Status  1 TWP     2 TWP 3 TWP 4 TWP 5 TWP 6 TWP 7 TWP 8 TWP 9 Year  2019    Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings  1000 1000 Benefit Status EPE Starts       Year  2020 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings   1300    1300 1000 Benefit Status       Grace     Grace Grace No benefit Benefit Paid Year 2021 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings       Benefit Status EPE Ends

25 Phase III – Post Extended Period of Eligibility
Once the EPE ends… An individual will continue to receive benefit payments in full for each month earnings are below the SGA limit. Benefits are ‘terminated’ the first month earnings exceed the SGA limit. If benefits are terminated because of earnings above SGA, and the individual later stops working or reduces earnings below the SGA limit, they must either… Make a special request that benefits be reinstated through a work incentive known as Expedited Reinstatement or EXR (if eligible), or Complete a new application for benefits.

26 Phase III – Post Extended Period of Eligibility
A request for Expedited Reinstatement of benefits can only be made if the following criteria are met… The individual stopped receiving benefits because of SGA level earnings from work, The individual is now unable to work or perform substantial gainful activity, This individual is disabled because of an impairment(s) that is the same as or related to the impairment(s) that allowed benefits earlier, and They make the request within 5 years from the month benefits were terminated. Individual can receive up to 6 months of provision benefit payments while an EXR decision is being made. If the above EXR criteria are not met, individuals may receive benefits again but must complete a new application.

27 Extended Period of Eligibility
Review – Title II Work Incentives Phases Phase I Trial Work Period 9 months of earnings over TWP threshold (not necessarily consecutive) Individual can earn any amount from work and will receive cash benefit payments during this time Earnings still need to be reported to SSA Phase II Extended Period of Eligibility 36 consecutive months starting immediately after TWP ends Cash payments made for months of earnings below SGA Cash payments suspended for months of earnings above SGA Phase III Post EPE-EXR Benefit continues for months of earnings below SGA. Benefit will be terminated if earnings are above SGA Individual can apply for reinstatement of benefits through EXR or can re-apply.

28 Possible Work Incentive Deductions
Some individuals may be eligible for other work incentives. Subsidies & Special Conditions Impairment Related Work Expenses (IRWEs) If either or both of these work incentives apply, Social Security will only count a portion of the individuals earnings when deciding if earnings are above or below the SGA limit. The amount of earnings that are counted are known as ‘countable earnings’. This means some individuals could have gross earnings above SGA and still qualify to receive benefit payments!

29 Subsidies/Special Conditions
Special circumstances that indicate a worker is not actually earning the full wages he or she is being paid. A dollar value for this circumstance is determined and then subtracted from the individual’s monthly gross wages to calculate Countable Earnings. Examples of Subsidies are: Reduced productivity. Performing fewer work duties than co-workers. Receiving extra supervision from employer or a job coach. May use form SSA-3033 to document this work incentive.

30 Subsidy Exercise Jane is starting a new job in an insurance office and will be earning $1300 per month. As an accommodation to her impairments, Jane’s employer has made some exceptions to her job description. Jane will only be required to complete 70% of the standard job description for her position. Jane completed her TWP already. Calculate Jane’s countable earnings. Will she continue to receive her benefit?

31 Subsidy Exercise Jane is earning $1300 per month but is only required to complete 70% of her job duties. What is the amount of her subsidy? Jane has a 30% subsidy. What is the amount of Jane’s countable earnings? $910 (or 70% of $1300). Will Jane continue to receive her SSDI benefit? Yes!

32 Impairment Related Work Expense (IRWE)
IRWE’s must be work related, necessitated by the worker’s disability, and paid for by the worker. Examples of IRWE’s are: Vehicle modification. Assistive devices (including repair, maintenance, and training to use them). Job coaching. Attendant services. Therapies. Transportation necessitated by disability (e.g. wheelchair van service). Medications, medical services and supplies. Must provide SSA with copies of receipts for IRWEs.

33 IRWE Exercise Brian will soon begin working full-time earning $1250 per month. He is unable to take public transportation because of his disability, therefore, Brian pays his neighbor $150 per month to drive him to and from work. He also pays $20 per month in medication co-payments. Brian has completed his TWP and is in his EPE. Calculate Brian’s countable earnings. Will Brian continue to receive his benefit?

34 IRWE Exercise What is Brian’s total IRWE amount?
$170 per month ($150 transportation + $20 medication copays) What is the amount of Brian’s countable earnings? $1,080 ($1250 earnings - $170 IRWEs) Will Brian continue to receive his SSDI check? Yes!

35 Work Incentive Reminders
Remember… Subsidies and Special Conditions can only apply if reported to Social Security! If not reported, they don’t exist. Subsidies and IRWEs only apply after the TWP has ended.

36 A Few Things To Note Social Security always considers GROSS (pre-tax) earnings. Remember, some individuals may have already worked through some or all of these Phases from past work!!! It’s important to ask about previous work. DON’T assume everyone is starting from the beginning. Advocating for Benefits Counseling is important! Every Title II beneficiary is entitled to these work incentive Phases to protect benefits, however, if Social Security determines an individual has “medically improved” as the result of a medical review, he/she may lose benefits. Medical reviews happen routinely for everyone, regardless of work.

37 MD-BCN Online Tools Social Security Disability and Work Calculator -
Blank TWP-EPE Chart -

38 So if my cash benefit payments stop, what about Medicare?

39 Extended Period of Medicare Coverage (EPMC)
If an individual loses Title II due to earnings above SGA, he/she can retain Medicare coverage for at least 93 months (7 years and 9 months) after the end of the Trial Work Period. *Important to Note: Medicare premiums are typically deducted from an individual’s monthly benefit. It is important that individuals know they will be billed directly for their Medicare premiums (usually quarterly) once they are no longer receiving a benefit. But if they qualify for Medicaid through EID, their Medicare premiums will be covered!

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41 Supplemental Security Income (SSI)
SSI falls under the Title XVI benefit program. Provides supplemental income to adults with low income who are age 65 or older or are blind or have a disability. Needs based program for which the individual must have limited resources and income to qualify. Eligible individuals also receive Medicaid

42 SSI Eligibility Criteria
Resource Limits Individual resource limit: no more than $2000 Married couple (two SSI–eligible persons residing together) resource limit: no more than $3000 SSA does not count the following resources: An individual’s home he/she lives in and the land it is on; Life insurance policies with a face value of $1,500 or less; One car (usually); Burial plots for the individual and members of his/her immediate family; and Up to $1,500 in burial funds for the individual and his/her spouse. Special Needs Trust Fund ABLE Accounts General Criteria Individuals who meet SSA's disability criteria, or blind criteria or are over 65 and meet income and resource limit guidelines Be a US citizen or qualified alien Income Limits To initially qualify, an individual cannot perform “Substantial Gainful Activity” (SGA). An individual may be performing SGA if she/he earns more than $1220/month gross wages (or $2040/month gross wages if the individual is blind). The SGA limit does not apply once approved for SSI. An individual's “countable income” cannot be greater than $771/month (for 2019)

43 SSI Eligibility - Financial Requirements
The maximum amount of SSI any one person can be eligible for is known as the Federal Benefit Rate (FBR). In 2019 the Federal Benefit Rate for an individual is $771 per month. The amount of SSI an individual qualifies for depends on the amount of other income he or she receives. SSA looks at 2 different categories of income when calculating SSI payment amounts: Countable Unearned Income Countable Earned Income

44 SSI Eligibility – A Few Exceptions
It is important to note that some individuals may not be eligible for the maximum SSI payment amount even if they themselves have no other income. An individual’s maximum benefit rate could be reduced if he or she is married to a spouse who has income, OR (‘deeming’ applies) under age 18, living with his/her parents, and the parent(s) has income, OR not paying the full cost of his/her food and shelter costs (i.e. not charged rent or receives help with his/her living expenses (an ‘In Kind Support and Maintenance (ISM) reduction applies).

45 Countable Unearned Income
Unearned income is most income except that from wages, salary, or self-employment. For example: Veterans Benefits, Unemployment, Worker’s Compensation benefits, other Social Security benefits (Title II), etc. To calculate countable unearned income: Subtract a General Income Exclusion (GIE) of $20 from the amount of unearned income.

46 General Income Exclusion (GIE) - $20
Step Calculations Unearned Income General Income Exclusion (GIE) - $20 Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Countable Earned Income Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income Base SSI Rate: $771 $771 Adjusted SSI Payment

47 Unearned Income - Exercise
Shelby is currently receiving the maximum SSI benefit of $771 each month. Next month she will start receiving an SSDI benefit of $450. Help Shelby by advising her of the effect her SSDI income will have on her SSI benefit amount and calculate her new SSI monthly payment. Use a SSI Calculation Sheet to calculate Shelby’s new SSI Payment

48 General Income Exclusion (GIE) - $20
Step Calculations Unearned Income $450 General Income Exclusion (GIE) - $20 Countable Unearned Income = $430 Gross Earned Income Student Earned Income Exclusion -0 Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Countable Earned Income =0 Total Countable Unearned Income $430 Total Countable Earned Income + 0 PASS Deduction Total Countable Income =$430 Base SSI Rate: $771 $771 -430 Adjusted SSI Payment =$341

49 Unearned Income – Exercise Review
Shelby’s new SSI payment would be $341 per month. Her SSI has been reduced. Is her total monthly income now less? No, her total monthly income is more! With $450 SSDI and $341 SSI, Shelby’s total monthly income is $791 per month.

50 Countable Earned Income
Like unearned income, earned income from work will reduce the amount of SSI an individual is eligible for but not dollar for dollar! SSI is only reduced by the amount of countable earned income. How is Countable Earned Income is calculated? Subtracting from gross earnings the General Income Exclusion (GIE) of $20 (as long as it was not already subtracted from unearned income); then Subtracting an Earned Income Exclusion (EIE) of $65; then Dividing the remaining amount in half. In addition to the GEI and EIE, other special work incentive exclusions may apply (we will discuss these more later on). SSI recipients are ALWAYS better off financially by working!!

51 Scenario – Countable Earned Income
You are a job coach and your client, Patrick, is considering accepting a job as a store clerk. He wants to know how working will impact his SSI amount. Patrick is excited about the possibility of working but concerned that he will lose too much of a benefit he needs. Patrick tells you: He is currently receiving the maximum SSI payment of $771 per month, and He would earn $1200 per month from work.

52 Step Calculations Unearned Income General Income Exclusion (GIE) - Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Total Countable Earned Income Total Countable Unearned Income + PASS Deduction Total Countable Income Base SSI Rate Adjusted SSI Payment 1200 1200 20 1180 65 1115 1115 557.50 557.50 557.50 557.50 771 557.50 213.50

53 Countable Earned Income Scenario Results
What is Patrick’s new SSI benefit amount? $ per month Patrick’s SSI benefit was reduced. Is he better off financially by working?? YES! While working, Patrick would have $ per month in income versus $771 per month while not working.

54 Earned Income - Exercise
Rebecca is currently receiving the maximum SSI benefit amount each month of $771 per month. Next week she will start a job and will be earning $1050 a month. Use a SSI Calculation Sheet to calculate Rebecca’s new SSI Payment once she starts working.

55 Step Calculations Unearned Income General Income Exclusion (GIE) - Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Total Countable Earned Income Total Countable Unearned Income + PASS Deduction Total Countable Income Base SSI Rate Adjusted SSI Payment 1050 1050 20 1030 65 965 965 482.50 482.50 482.50 482.50 771 482.50 288.50

56 Earned Income – Exercise Results
What will Rebecca’s new SSI payment be? $ per month Rebecca’s SSI benefit decreased. Is she better off financially by working? YES!! While working, Rebecca has $ per month in income versus the $771 per month she would have while not working.

57 SSI Work Incentives There are three key work incentives for which SSI recipients may qualify to help them receive or retain higher cash benefits: Impairment Related Work Expenses (IRWEs) Blind Work Expenses (BWEs) Student Earned Income Exclusion (SEIE) There is also another work incentive called a Plan for Achieving Self-Support (PASS) which is a tool to help reduce an individual’s long term reliance on cash benefits.

58 Impairment Related Work Expenses (IRWEs)
IRWEs are defined the same for SSI as for the Title II program IRWE amounts are deducted from gross earnings within the SSI benefit calculation and enable a person to keep more of their SSI while working IRWEs must be reported and approved by SSA in order to be counted. Individual must provide SSA with copies of IRWE receipts every month.

59 General Income Exclusion (GIE)
Step Calculations Unearned Income General Income Exclusion (GIE) Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Total Countable Earned Income Total Countable Unearned Income + PASS Deduction Total Countable Income Base SSI Rate Adjusted SSI Payment

60 IRWE Exercises You are a job coach and your client, Samantha is a person with a physical disability. She has been offered a part-time job working from home. In order for her to work from home she will need specialized equipment. Samantha will be incurring the cost of the needed equipment and the training to use it. She wants to know if working will be financially beneficial given these out of pocket expenses and the impact to her SSI. Samantha tells you she will be earning $900 per month. She will incur expense of $125 per month for the specialized equipment. Use a SSI Calculation Sheet to calculate Samantha’s new SSI payment.

61 Step Calculations Unearned Income General Income Exclusion (GIE) - Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Total Countable Earned Income Total Countable Unearned Income + PASS Deduction Total Countable Income Base SSI Rate Adjusted SSI Payment 900 900 20 880 65 815 125 690 345 345 345 345 771 345 426

62 IRWE Exercise Results What would Samantha’s new SSI payment be?
$426 per month Samantha’s SSI benefit decreased and she is paying out of pocket for work expense. Is she financially better off by working? YES!! Samantha’s income is $1201 while working ($900 from work + $426 SSI - $125 expenses) versus $771 while not working If Samantha did not report her IRWEs, her SSI payment would only be $

63 Blind Work Expense (BWEs)
A BWE must be incurred due to work and paid for by the individual. BWE’s are not time limited. Examples of BWE’s are: Guide dog expenses. Transportation. Work-related training. Assistive technology. Medical services and medications. Federal, State, and Local income taxes withheld. Social Security and Medicare taxes withheld. Mandatory pension contributions. Work-related equipment. Childcare. Meals consumed at work.

64 General Income Exclusion (GIE)
Step Calculations Unearned Income General Income Exclusion (GIE) Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Total Countable Earned Income Total Countable Unearned Income + PASS Deduction Total Countable Income Base SSI Rate Adjusted SSI Payment

65 Student Earned Income Exclusion (SEIE)
The SEIE allows SSI recipients who are under age 22 and “regularly attending school” to exclude earned income up to $1870 per month with a maximum of $7550 per calendar year (for 2019). Regularly attending school means taking at least one course of study and attending classes: In grades 7-12 for twelve hours per week. In college/university for eight hours per week. In training courses to prepare for employment 12 hours per week (15 hours per week if course involves shop practice). For less time than indicated above for reasons beyond control, such as illness.

66 General Income Exclusion (GIE)
Step Calculations Unearned Income General Income Exclusion (GIE) Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Total Countable Earned Income Total Countable Unearned Income + PASS Deduction Total Countable Income Base SSI Rate Adjusted SSI Payment

67 SEIE Exercise You are an employment specialist and your client, Antonio, is 20 years old and a full time student. He receives $771 per month in SSI. He meets the criteria for the Student Earned Income Exclusion (SEIE). Antonio starts working part-time at the college library making $700 per month. Use a SSI Calculation Sheet to calculate Antonio's new SSI payment.

68 700 700 771 771 Unearned Income General Income Exclusion (GIE) -
Step Calculations Unearned Income General Income Exclusion (GIE) - Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Total Countable Earned Income Total Countable Unearned Income + PASS Deduction Total Countable Income Base SSI Rate (check for VTR or PMV) Adjusted SSI Payment 700 700 771 771

69 SEIE Exercise Results What would Antonio’s new SSI payment be?
$771 per month Because he is under age 22 and a full-time student, he is eligible to use the SEIE. Antonio can exclude all $700 of his earnings each month because his earnings are less than the SEIE max of $1870. If Antonio did not request that SSA apply the SEIE, what would his SSI payment be? $ per month

70 Plan for Achieving Self-Support (PASS)
A work incentive that enables qualified individuals to set aside income or resources to pay for expenses related to services and/or equipment needed to reach a work goal. Any money saved or used for approved PASS expenses is excluded as income when SSA does an SSI calculation. A PASS can help someone to keep more of their SSI benefit when it would otherwise be reduced because of other income. Must be approved by the Social Security Administration. A PASS is time limited – the length is based on the individual’s goal. If the individual changes his or her work goal, then he or she may apply for another PASS. No lifetime limit on the number of PASS’s an individual is able to receive; only that each one be used to achieve different work goal. Subsequent PASS’s are more difficult to get approved, so it is best to plan for only one.

71 General Income Exclusion (GIE)
Step Calculations Unearned Income General Income Exclusion (GIE) Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Total Countable Earned Income Total Countable Unearned Income + PASS Deduction Total Countable Income Base SSI Rate Adjusted SSI Payment

72 MD-BCN Online Tools Supplemental Security Income Payments Calculator –

73 So if my SSI payments stop,
what about Medicaid?

74 Continued Medicaid Coverage 1619(b)
If an individual loses his/her SSI cash benefit due to earned income, he/she can retain his/her Medicaid through 1619(b). To qualify for 1619(b), a person must: Have been eligible for an SSI cash payment for at least one month; Still meet the disability and non-disability requirements; Need Medicaid in order to work, and Have gross earned income which is either below a predetermined state threshold level or below an individualized threshold. Maryland Threshold for 2018 is $40,869 per year. Only earnings are counted towards the threshold.

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76 Concurrent Beneficiaries
Concurrent describes individuals who are eligible for disability benefits under both the SSI and Title II programs. Concurrent beneficiaries can use all work incentives available to SSI and Title II beneficiaries. When you advise a concurrent beneficiary on the impact of work, you must consider BOTH the impact to the Title II and SSI benefits.

77 Concurrent Beneficiaries – Exercise
You are a job developer working with Herman. Herman has $220 in SSDI and $550 per month in SSI. Herman is offered a job earning $1000 per month and wants to know how this will impact his benefits. This is his first job since he started receiving benefits. Calculate Herman’s new SSI payment. Will Herman’s new job impact his SSDI benefit?

78 Step Calculations Unearned Income General Income Exclusion (GIE) - Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion Remainder GIE (if not used above) Earned Income Exclusion (EIE) Impairment Related Work Expense (IRWE) Divide by 2 Blind Work Expenses (BWE) Total Countable Earned Income Total Countable Unearned Income + PASS Deduction Total Countable Income Base SSI Rate Adjusted SSI Payment 220 20 200 1000 1000 1000 65 935 935 467.50 467.50 99.90 Part B 200 467.50 667.50 771 667.50 103.50

79 Concurrent Beneficiaries – Exercise Results
What is Herman’s new SSI payment? $103.50 How will Herman’s SSDI benefit be impacted? Herman’s SSDI payments will continue. Herman will being using TWP months because his earnings are over the TWP threshold. Is Herman financially better off by working? YES!! Herman has income of $1220 per month while working versus $791 per month while not working. Will Herman keep his health insurance? Yes, he will keep both Medicaid & Medicare.

80 What is the Ticket to Work Program
The Social Security Administration (SSA) started the Ticket to Work program to help people who get Social Security disability benefits get the services they need to find a job and to stay employed. SSA has set up agreements with hundreds of community programs around the country so that people can find these services in their communities. Most often, the services are career guidance, job placement, job coaching and/or benefits counseling Social Security calls these agencies “employment networks” and ENs. The beneficiary “assigns” a ticket to an EN. In turn, the EN provides needed services at no charge. SSA has contracted with a company called Maximus to administer the Ticket to Work program.

81 What is a Ticket Anyone who is receiving Social Security Disability benefits has a Ticket to Work. You do not need an actual “ticket.” However, this is what a ticket to work looks like. Social Security mails it in the award letter.

82 Goals of the Ticket to Work Program
Increase the number of beneficiaries entering the work force Reduce beneficiary dependency on cash benefits

83 How does that help a beneficiary?
The beneficiary gets no-cost employment support services When a Ticket is assigned to an employment network, SSA will not conduct a continuing disability review (as long as Timely Progress is met). Some agencies provide ongoing personalized benefits counseling about Social Security’s safety nets for cash benefits and medical coverage

84 What to Expect with an Assigned Ticket
The EN will work with the beneficiary to set up an Individualized Work Plan (IWP). The plan will include employment goals and the amount of money the beneficiary expects to earn. The EN will typically ask the beneficiary to provide information on wages earned.

85 Timely Progress Reviews
In order for the Ticket to stay “assigned” to an EN, Maximus will track a ticket holder’s progress Usually conducted at the end of every 12 month period the ticket is assigned or in use MAXIMUS checks the earnings of ticket holder If earnings meet SSA guidelines, no further action takes places If earnings don’t meet SSA guidelines, MAXIMUS contacts beneficiary

86 What If I Don’t Want to Participate?
The Ticket to Work program and Social Security’s work incentives are voluntary. There is no penalty if you decide not to participate.

87 Communicating with SSA
Recordkeeping Keep all correspondence from SSA Ask for receipt when providing documentation to SSA Always keep a copy of submitted documentation Know claims representative that is handling case

88 Reporting Earnings Every beneficiary who works needs to report their earnings to prevent overpayments from occurring! Earnings can be reported by the beneficiary or his/her Representative Payee. Reporting methods and recommendations differ depending on the type of benefit received. Regardless of how you report, you can sign up for or text message reporting reminders!

89 Reporting Earnings – Initial First Step
Step #1: Every Title II and SSI recipient should contact SSA right away once working to provide the following: Name of Employer Start Date Hourly Rate of Pay or Salary Average Number of Hours worked per week Employer Identification Number (EIN) – (can be obtained from a W-2 or by asking the employer) Step #2: Earnings should then be reported every month using one the available reporting options…

90 Reporting Earnings Options - SSI
Supplemental Security Income (SSI) - Earnings need to be reported monthly, by the 6th day of each month! Reporting options include: Entering paystub information through one’s mySSA Account; or Logging into the Mobile App; or Calling into the Automated Phone System ( ); or Submitting copies of paystubs by certified mail, fax, or in-person to local SSA offices (but not recommended).

91 Reporting Earnings Options - SSDI
Title II (SSDI, CDB, DWB) - Earnings should be reported monthly whenever possible! Reporting options include: Entering paystub information through one’s mySSA Account; or Submitting copies of paystubs by certified mail, fax, or in-person to local SSA offices (but not recommended).

92 Reporting Earnings – SSDI (cont.)
Title II (SSDI, CDB, DWB) – Individuals should use a Work Activity Report (form SSA-821) to report past work history and update SSA records. This form can also be used to report current or past subsidies and IRWEs. The Work Activity Report is the most important reporting tool for Title II beneficiaries! Work Activity Reports should be submitted at critical touchpoints that are best determined with a benefits counselor. Critical touchpoints might include the end of a TWP or start of above-SGA level earnings.

93 Reporting Earnings Options - Concurrent
Concurrent beneficiaries (receive both SSI & Title II) - Should report by logging into one’s mySSA Account monthly and entering paystub information.

94 Making Employment Work – Using this Information
You are not expected to provide intensive benefits counseling. You should use this information to: Break down barriers to employment regarding the fear of losing benefits; Dispel myths about how working impacts benefits; Educate individuals about work incentives; Encourage employment, Assist individuals in using this information to work towards financial independence.

95 Making Employment Work
To make employment work you should be able to identify the need for intensive benefits counseling services and refer appropriately. Most individuals don’t know about benefits counseling and will need support and advocacy to access the service. Once a Beneficiary becomes employed you should: Work with the beneficiary & a Benefits Counselor to develop and support a plan for self-management of benefits.

96 Accessing a Benefits Counselor
Division of Rehabilitation Services (DORS) consumers DORS can add Benefits Counseling Services to a consumer’s employment plan. Individuals and support persons should advocate for Benefits Counseling to be a part of the consumer’s employment plan from the beginning.

97 Accessing a Benefits Counselor
Benefits Counseling can be accessed via an Employment Network through the Ticket to Work Program. Not all ENs offer this service. Be sure to check. Maryland Employment Network (MD-EN) MD-EN is an Employment Network (EN) which provides Employment Services as well as Benefits Counseling Services to Marylanders. Phone: Website:

98 Accessing a Benefits Counselor
Work Incentives Planning and Assistance (WIPA) SSA funded project which offers free Benefits Counseling Services to individuals interested in work or already working. In most areas, services are provided only remotely. Drawback is that services are prioritized. Only individuals already working receive intensive BC services. Maryland-Work Incentives Network Phone: Website:

99 Questions

100 Thank You for your Participation!

101 Resources DORS (Division of Rehabilitation Services) – Has programs and services that help people with disabilities go to work or stay independent in their homes and communities Website: EID (Employed Individuals with Disabilities) – Has information on EID and how to apply. Website:   SSA (Social Security Administration) - website provides information and resources for individuals who are receiving Social Security benefits or want to find out more about receiving benefits. Website:

102 Resources The Red Book - A Guide to Work Incentives - serves as a general reference source about the employment-related provisions of Social Security Disability Insurance (SSDI) and the Supplemental Security Income (SSI) programs for educators, advocates, rehabilitation professionals and counselors who work with people with disabilities. Website: MAXIMUS - responsible for managing the Ticket to Work Program for SSA. Send out Timely Progress Review letters to beneficiaries. Website: PASS (Plan for Achieving Self-Support) Resources - the following websites provide general information, link to PASS form, tutorials and examples of a completed PASS. SSA’s PASS Website - Cornell University, Employment and Disability Institute - University of Montana Rural Institute -


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