Why do people going to work while receiving SSDI/SSI benefits? 2

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• Wouldn’t have to worry about

reapplying for benefits if the job doesn’t work out

• Had resources to help understand work incentives and has CHOICE in how work affects benefits?

• Could purchase needed services?

October, 2008 4

October, 2008 6

7

Can you get both?

DISABILITY

SSD

Based on someone's work – an Insurance Program

SSI

Low income

Low assets

APD04/11/23

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.

APDAPD04/11/23

• 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

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October, 2008 12

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, 2008 13

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, 2008 14

Impairment Related Work Impairment Related Work Expenses (IRWEs)Expenses (IRWEs)

Related to medically established impairment

Necessary to Work Reasonable Expense Proof of out of pocket

payment

October, 2008 15

Examples of IRWEExamples of IRWE Medications Attendant care services Medical devices Work-related assistive

devices Modifications to

vehicle/residence Some transportation costs Job Coaching

October, 2008 16

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, 2008 17

SUBSIDY & SPECIAL CONDITIONS

Subsidy = Support provided by EmployerSpecial Conditions = Support by others

• More pay than Value of work performed• Dollar value attached to extra help,

supervision, etc.• Job Coaching

October, 2008 18

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!

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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

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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)

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October, 2008 23

• 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

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• Work Reviews

• Medical reviews• Medical CDR Protection – That’s

the Ticket!

October, 2008 25

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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www.yourtickettowork.com

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

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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

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Resources

Social Security Administration1-800-772-1213AWIC, WILwww.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

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Marlene UliskyNorth Florida AreaWork Incentives Coordinator1-866-296-4879 Ext 16801

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If you have the courage to begin, you have the courage to succeed.”David Viscott

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