Embed Size (px)
Citation preview
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
11
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!
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, 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
24
• 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:
27
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
28
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 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
31
Marlene UliskyNorth Florida AreaWork Incentives Coordinator1-866-296-4879 Ext 16801
33
If you have the courage to begin, you have the courage to succeed.”David Viscott
$$
