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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 Office of Rehabilitation Services. What do all the SSS’s Mean???. SSA=.
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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 Office of Rehabilitation Services.
What do all the SSS’s Mean??? SSA= SOCIAL SECURITY ADMINISTRATION SSDI= SOCIAL SECURITY DISABILITY INSURANCE SSI= SUPPLEMENTAL SECURITY INCOME
SSDI BENEFICIARIES RECEIVE MEDICARE 24 MONTHS AFTER DATE OF ENTITLEMENT.
In RI, SSI RECIPIENTS AUTOMATICALLY RECEIVE MEDICAID WHEN THEY BECOME ELIGIBLE FOR SSI BENEFITS. THERE IS NO WAITING PERIOD.
Just a Reminder… • 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. • You may no longer be eligible for the work incentives discussed below.
Major SSDI Work Incentives: Provided that your impairment continues, 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 2010, months when you earn gross wages of $720 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), they will pay you a full SSDI payment for that month and for the following 2 months. • 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.
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 2010, gross earnings averaging over $1000/month generally demonstrate SGA if your impairment is anything other than blindness. (Amount changes each year.) • If you are blind, earnings averaging over $1640 per month (in 2010) generally demonstrate SGA. • Other factors may be taken into consideration when SSA is making an SGA decision, however.
Work Incentives That Affect SGA Impairment Related Work Expenses (IRWE) SSA will deduct the cost of certain disability-related items and services that you need to work from your “gross earnings” when they are deciding if your work demonstrates the performance of Substantial Gainful Activity.
Possible IRWE’S that Social Security may Approve: Plus many more………….
Work Incentives That Affect SGA • SSA considers the existence of subsidies and special conditions when they make an SGA decision. They try to determine the real value of your work. • A “Subsidy” is support provided by your employer that may result in your receiving more pay than the actual value of the services you perform. • “Special Conditions” refers to support provided by someone other than your employer.
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.)
SSDI Work IncentivesContinued… • Expedited Reinstatement of Benefits–If your cash payments ended because of your work and earnings, and 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.
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 Income: Wages earned from employment or self employment Unearned Income: Any other income such as SSDI, Pensions, TDI, Unemployment Benefits, Interest or Dividends, Gifts from Grandma etc…
Major SSI Work Incentives • General Income Exclusion (GIE) - $20 exclusion is applied first to unearned income, if any. (If little or no unearned income, the $20, or remainder of $20, is deducted from earned income along with EIE). • Earned Income Exclusion (EIE) - $65 and half of remaining earned income received in a month is deducted from gross earned income. • Student Earned Income Exclusion (SEIE) - if under age 22 and regularly attending school, may exclude $1,640 per month up to a maximum of $6,600 per year (2010 figures; adjusted each year)
Major SSI Work Incentives cont… • 1619(a) – Once you begin receiving SSI, 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” - $37,828 in RI in 2010. ( 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. • BlindWorkExpense (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. • 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.
Earning wages… means your SSI check decreases or stops BUT… your totalincome for the month increases
Sample SSI Formula for Individuals With SSI and Wages Only (No IRWE) Gross Monthly Wages Income Exclusions Remainder (divided by 2) Countable earnings: Maximum SSI Rate for 2010 Minus Countable Earned Income Adjusted SSI Payment • $500.00 • 85.00 $415.00 $207.50 $713.92 • 207.50 • $506.42 TOTAL MONTHLY INCOME = $1,006.42
Not Working If you do not work, your SSI payment will be $713.92 or less, unless you are in assisted living. $713.92 (SSI Maximum in RI in 2010)
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. $500.00 -$ 85.00 $415.00 - 100.00 $315.00 $157.50 $713.92 $157.50 $556.42 (divided by 2) Your total monthly income would be $1056.42 in this example.
Unearned Income (SSDI) $200.00 Minus general income Exclusion -$20.00 Countable Unearned Income $180.00 Gross monthly earned Income $500.00 Minus earned income exclusion -$ 65.00 Remainder $435.00 / 2 Countable Earned Inc. $217.50 Countable Unearned Inc. $180.00 Countable Earned Inc. +$217.50 Total Countable Inc. $397.50 Maximum SSI (2009) $713.92 Minus Countable Inc. -$397.50 Adjusted SSI payment$316.42 Your total income for month would be $1016.42! Sample SSI Formula For Individual With Unearned Income And Wages.
What is a Ticket to Work? • It is an employment program. • It is a free and voluntary service. • Most beneficiaries between the ages of18 through 64 are eligible for a ticket. • It allows individuals expanded opportunities to obtain the services and supports that they need 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 who want to enter or re-enter the workforce. • The ultimate goal of the program is to reduce reliance on Social Security disability benefits and to promote increased self-sufficiency for beneficiaries with disabilities through work.
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 • The state Vocational Rehabilitation Agency – the Office of Rehabilitation Services (ORS).
Where Can I Find Contact InformationFor ORS Or EN’s Serving RI? • Visit www.yourtickettowork.com for a list of EN’s serving RI. or • Contact Maximus at 1-866-968-7842 and request Ticket to Work information and a current list of EN’s. TDD users call 1-866-833-2976.
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.
How Do I Choose A Provider OfVocational 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, you will place your Ticket in “in use status”. Then 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.
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 continuingdisability review (CDR) as long as you are working toward your employment goal andmeeting the SSA Timely Progress Provision.
Why Is This Important? • If a medical review is done and Social Security decides that you are no longer disabled because you have medically improved, your cash payments and yourhealth insurance may stop, and you may not be entitled to important work incentives such as the Trial Work Period, Extended Medicare Coverage, or 1619(b).
When Will This Protection End? • This protection will continue while you are making “timely progress” toward achieving self-sufficiency. • This means that you must achieve certain work/educational goals during each 12-month period. • (See handout describing Timely Progress requirements.)
Why Should I Work? The reasons for wanting to work are different for everyone, 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 $$$$$$$.
