Disability Employment Initiative (DEI)

1. Disability Employment Initiative (DEI) Ticket to Work Boot Camp: Foundational Knowledge - 2 SSA Work Incentives and Other State & Federal Work Incentive Programs Hosted/Facilitated by: Miranda Kennedy, NDI Technical Assistance Team Member Presented by: Elizabeth Jennings NDI Technical Assistance Team Member March 8, 2012

2. Disability Employment Initiative (DEI) 2 DEI Projects at the state level and/or local level participating LWIBs are required to become Employment Networks (EN) under Social Security Administration’s (SSA) Ticket to Work Program (TtW). Training and Technical Assistance to DEI Projects in attaining Employment Network status and implementing effective EN operations is provided under U.S. DOLETA contract with NDI Consulting, Inc. and the National Disability Institute (NDI). Evaluation of the impact of the DEI Projects implementation and outcomes as Employment Network will be provided under U.S. DOL ODEP contract with Social Dynamics. 2

3. Upon completion of this webinar, DEI Project staff will: Understand the basic components of SSA’s two disability benefit programs; SSDI and SSI Recognize coordinating work incentives and how they are designed to increase an individual's work effort Have basic information about complimentary non-SSA incentives that SSA beneficiaries can and should utilize SSA’s Work Incentives Learning Objectives 3

4. SSA Work Incentives Agenda • Critical Information about SSDI • Critical Information about SSI • Other Incentives and Programs

5. Critical Information about SSDI: • Overview/Knowing rules before attempting work • Substantial Gainful Activity • Work Incentives • Continued Medicare • Good record keeping

6. Critical Information about SSI: • Overview/Basic Calculations • Resource limits • Work Incentives • Continued Medicaid (1619b) • Good record keeping

7. Other State Work Incentives & Programs: • Medicaid Buy-In Program • HUD Programs • Earned Income Tax Credit • Other Financial Stability programs

8. Overview • The Social Security Administration has two programs to support individuals with disabilities with an inability to work at a substantial level. • Social Security Disability Insurance (SSDI) • Supplemental Security Income (SSI) • Many people with disabilities who receive SSDI and/or SSI, want to work or return to work but are unsure what will happen to their benefits when they do. • The SSA has special work incentives available that make it possible for individuals to test their ability to work and continue to receive some or all of their cash and health benefits.

9. SSA Eligibility Individuals must prove 2 things to be eligible for SSDI or SSI: • Prove that they have a documented medical disability that will last 12 months or longer or result in death. • Meet SSA’s definition of disability: The inability to engage in Substantial Gainful Activity (SGA, which is paid work) by reason of any documented medical impairment (physical or mental) that will lasts 12 months or longer and/or result in death. Individuals who are blind do not have to prove that they are unable to work. They only have to prove that they meet SSA’s level of blindness.

10. Substantial Gainful Activity (SGA) SGA is a basic test used by SSA to establish disability status SGA is the performance of significant mental and/or physical duties for profit. It is usually determined to be gross earnings (before taxes) of an amount of money that is set January 1 of each calendar year based on the National Average Wage Index. To meet this test a person must not be working, or if working, earning less than the SGA level amount. 2012 SGA for non-blind individuals = $1010/month 2012 SGA for blind individuals = $1690/month

11. What is SSDI? • SSDI is a Title II Benefit. • SSDI benefits are based on a person’s work history looking at length of time and amount of money earned in F.I.C.A.. SSDI check amount will vary from person to person. • DAC –Disabled Adult Children • Disability Prior to Age 22 & Never Legally Married • Insufficient FICA or higher parent amount • Parent is deceased, disabled or retired • Possible continuation of Medicaid • Medical Insurance – MEDICARE

12. Important to Note • 5 Month Waiting Period for cash benefits • 24 months waiting period for Medicare • No Asset limit • Individual must have 12 months consecutive-initial eligibility • SSDI is obsessed with SGA

13. SSDI Work Incentives and Wages • These are the list of programs under SSDI called Work Incentives: • Trial Work Period = $720/Month 2012 • Extended Period of Eligibility • Extended Medicare Coverage • Impairment Related Work Expenses • Section 301 • Special Condition/Subsidies • Expedited Reinstatement

14. Trial Work Period (TWP) • 9-month period, within 60 months, in which a person on SSDI can work and earn any amount of money without the earnings affecting their SSDI eligibility • Each month an SSDI recipient earns more than $720 counts as one month of the TWP (indicated 2012 amount) • These months do NOT need to be consecutive

15. Extended Period of Eligibility (EPE) • A period of extended eligibility that starts with the month after the TWP ends and continues for the next 36 months. • Months that countable earned income is less than the SGA level they receive their full SSDI check. • Months that countable earned income is more than the SGA level they do not receive a SSDI cash benefit. • When countable wages first exceed the SGA level (cessation month), Social Security will plan to stop the benefits - but will allow the person to receive a check for that month and for 2 more months as a “grace period” before stopping checks altogether

16. Impairment Related Work Expenses (IRWEs) • An IRWE exists when: • The individual with a disability pays for the item or service • The item or service is related to the person’s condition • The person would not be able to work if s/he did not spend the money and receive the item or service • Can apply to SSI or SSDI

17. Subsidies • A Subsidy Exists When the Employer: • Willingly pays more in wages than the value of services performed (Employer Subsidy); or • Receives full value only because some agency provides extra services to the employee (sometimes called Special Considerations) • For use with SSDI beneficiaries

19. Extended Medicare Eligibility(effective October 1, 2000) • An SSDI beneficiary is entitled to continued Medicare coverage after the trial work period and for up to an additional 93 months following the ninth trial work month. • During this entire period, hospital coverage is automatic and cost-free. outpatient coverage continues to be optional and subject to premium payment ($99.90/month in 2012 for all enrollees)

20. Options for Returning to Rolls • Re-Application • Expedited Reinstatement (EXR)

21. Expedited Reinstatement (EXR) • SSDI benefits shall be reinstated without a new application if the person: • Was eligible for SSDI; and • Lost SSDI due to performance of SGA • requests EXR within the consecutive 60-month period beginning with the month of entitlement termination • is disabled by the same as (or related to) the physical or mental disability that was the basis for their original claim • Is under a disability based on the application of the medical improvement review standards (MIRS) • is unable to perform SGA due to his or her medical condition

22. Expedited Reinstatement (cont.) • SSDI dependent’s benefits may be reinstated if the dependent satisfies all of the requirements for entitlement to the benefits • Provisional benefits may be received up to 6 months pending the reinstatement application • Once the individual receives EXR benefits for 24 months (called the Initial Reinstatement Period, or IRP), he or she will be eligible for a new Trial Work Period, Extended Period of Eligibility and Expedited Reinstatement period (This is a new period of disability)

23. What is SSI? Supplemental Security Income (SSI) is a Title XVI program. SSI is the payer of last resort. An individual must prove that they are financially eligible for SSI. Monthly income less than $698/month Assets less than $2000 Eligible couple = $1048/month and $3000 assets Federal Benefit Rate Maximum: 2012 equals $698 per month. Medical Insurance - Medicaid

24. Federal Benefit Rate (FBR) • Not everyone receives the full benefit amount • The rate of pay an individual is eligible for is based on: • Family composition (i.e. Living alone, with others, etc.) • Marital status • Deeming of income • Type of housing (i.e. congregate care) • In-Kind support and maintenance

25. SSI: Income At-A-Glance • Income:Anything received in cash or in kind that can be used to meet needs for food or shelter. • Two Types of Income: Earned Income and Unearned Income • Earned Income:Typically, gross wages - salaries, commissions, bonuses, self-employment; sheltered workshop earnings. • Unearned Income: All income that is not earned income. Unearned income is counted when it is actually or constructively received.

26. SSI: Resources At-A-Glance • Resources:Cash or other liquid assets or real or personal property that an individual owns and could convert to cash which can be used to provide for food or shelter. • The general rule is that an item received in a month is income and, unless spent, becomes a resource in the following month. • General resource limit in 2012 is $2,000 for an individual, $3,000 for an eligible couple (Note: This rate was established on 1/1/89).

27. SSI Work Incentives and Wages • SSI Work Incentives enhance economics and can protect Medicaid • Student Earned Income Exclusion • Impairment Related Work Expense (IRWE) • Blind Work Expense • Plan For Achieving Self-Support (PASS) • Property Essential for Self-Support (PESS) • 1619a • 1619b • Section 301 • Special Condition/Subsidies • Expedited Reinstatement

28. SSI Work Incentives and Wages • Sample of a SSI wage Formula: $1085 gross Wages -20 General Exclusion -65 Earned Income Exclusion Wages = $1085.00 $1000 New Countable Wage New SSI = 198.00 $1283.00 $1000 ÷ 2 = $500 New Countable Wage $698 Federal Benefit Rate for SSI 2012 - 500 Countable Wage $198 New SSI

29. Student Earned Income Exclusion (SEIE) • Student Earned Income Exclusion (SEIE) - The SEIE allows an individual who is under age 22 and regularly attending school to have earnings excluded from income as shown below: • For Year 2012, Monthly Exclusion is $1700, Maximum exclusion for calendar year is $6,840 • Effective 4/01/05 To qualify for this exclusion, an individual must be: • under age 22; and • a student regularly attending school per SI 00501.020D.

30. Impairment Related Work Expenses (IRWE) IRWE reduces gross income due to disability-related out of pocket expenses that allow a person to earn income, even if those items or services are needed for non-work activities. The expenses must be directly related to supporting the disability Cost must be paid out of person’s pocket and not covered by other funding sources Expense must be paid in a month wages are earned Expense must be reasonable

31. Plan to Achieve Self-Support (PASS) • The purpose of PASS is to allow SSI recipients to set aside income and/or resources to be used to assist in achieving specific work goals. • A PASS can be used to assist in the costs of education, starting a business or purchasing support services that will result in the reduction / cessation of benefits. • By utilizing PASS, an SSI recipient’s can help to off-set the costs associated with the return to gainful employment by reducing countable income and potentially increasing the amount of SSI cash benefits due.

32. Plan For Achieving Self-Support (PASS) The PASS plan must: Have a specific work goal Have a specific time frame for reaching the goal Show what money and any other contributions will be used to reach the work goal Show how any money set aside in savings will be kept separate from other funds Show how the money and resources will be saved and, later, spent Be submitted in writing and approved by Social Security’s PASS Cadre Include a Business Plan if the PASS is for self-employment Be reviewed periodically to assure compliance Increase an individual’s ability to be self-supporting by decreasing the amount they receive in cash benefits from Social Security www.passonline.org

33. SSI & Section 1619(b) Medicaid • Protects Medicaid when SSI Cash Benefits is Zero: • The person must lose eligibility for SSI cash benefits due to excess earnings • Person must be otherwise eligible for SSI • Person must need Medicaid to Work • Earnings must be below State’s Earned Income Threshold:www.ssa.gov/disabilityresearch/wi/1619b.htm#threshold

35. Options for Returning to Rolls • Re-Application • Expedited Reinstatement (EXR)

36. Good Record Keeping • Open SSA mail immediately • Keep EVERYTHING SSA sends • Make copies of EVERYTHING sent to SSA • Report new work activity to the local SSA Office • Provide wage data to SSA regularly by providing a copy of pay check stubs • Wage data may be FAXED, hand delivered, or mailed • Be sure to write your S.S. # on pay check stubs, and your name if not already printed on check stubs

37. Work Incentives Planning Assistance Program (WIPA) • The Work Incentives Planning Assistance Program is a grant funded program sponsored by the Social Security Administration • Community Work Incentive Coordinators (CWIC) receive training approved by SSA, and are certified under this program to provide accurate advisement to Social Security beneficiaries

38. Intention of WIPA Program • To assist people who want to know how work will affect benefits • To learn about Work Incentives through SSA • To learn about additional resources available to assist in the return to work • Referrals to other resources http://www.ssa.gov/work/wipafactsheet.html

39. Protection and Advocacy of Beneficiaries of Social Security (PABSS) • Protects the rights of beneficiaries of SSDI and SSI • Check out any complaint against an employment network or other service provider helping an individual return to work • Give information and advice about vocational rehabilitation and employment • Explain SSA’s work incentives • Provide consultation and legal representation to protect the rights of any one wanting to return to work • Assist with problems concerning work plans under the Ticket to Work Program http://www.ssa.gov/work/PandA.html

40. Other State Work Incentives & Programs: • Medicaid Buy-In Program • HUD Programs • Earned Income Tax Credit • Other Financial Stability programs

41. Why Consider Other Programs? • SSA has provided a sense of financial stability. • Ticket to Work is about Self-Sufficiency so building the Financial Stability of the Ticket Holder should be part of the plan • Letting go of SSA is more easily palatable with a plan for financial stability • View the DEI archived training to learn more about financial stability and asset building programs.

42. Medicaid Buy-In • Medicaid Buy-In programs allow states to expand Medicaid coverage to workers with disabilities who are not typically eligible for Medicaid due to their income/assets. • States design their Medicaid Buy-In program (within certain parameters) to meet their State’s unique needs, resources, and objectives. • To be eligible for the Buy-In program, an individual must have a disability (as defined by the Social Security Administration), have earned income, and meet any other financial eligibility requirements established by their state. Check with Your State Medicaid office to learn more about Buy-In

43. HUD Programs • HUD offers many (over 25) programs to support individuals in transitioning to work. www.huduser.org/publications/pdf/w2w.pdf • Programs vary by Public Housing Authority (PHA) • Important to Note: Earned Income Disregard

44. HUD Earned Income Disregard • First 12 Months of Employment = 100 Percent disregard of New Wages • Second 12 Months of Employment 50 Percent disregard of New Wages www.nls.org/ssassi/hud-earned-income.pdf

45. Earned Income Tax Credit • The Earned Income Tax Credit (EITC) is a credit for people who earn low-to-moderate incomes. EITC can reduce your taxes, and can mean a refund. In simple terms, working families and individuals may keep more of what they work for.

46. 2011 Tax Year EITC Earned Income and adjusted gross income (AGI) must be less than: • $43,998 ($49,078 married filing jointly) with three or more qualifying children • $40,964 ($46,044 married filing jointly) with two qualifying children • $36,052 ($41,132 married filing jointly) with one qualifying child • $13,660 ($18,740 married filing jointly) with no qualifying children Tax Year 2011 maximum credit: • $5,751 with three or more qualifying children • $5,112 with two qualifying children • $3,094 with one qualifying child • $464 with no qualifying children • Investment income must be $3,150 or less for the year. *For more information on whether a child qualifies you for the EITC, see IRS Publication 596, Chapter 2.

47. VITA – Volunteer Income Tax Assistance File For Free!!! • The VITA Program offers free tax help to low- to moderate-income (generally, $49,000 and below) people who cannot prepare their own tax returns. Certified volunteers sponsored by various organizations receive training to help prepare basic tax returns in communities across the country. VITA sites are generally located at community and neighborhood centers, libraries, schools, shopping malls, and other convenient locations. Most locations also offer free electronic filing. To locate the nearest VITA site, call  1-800-829-1040.

48. Other Financial Stability Programs • Financial Education • Affordable Financial Services • Favorable Tax Provisions • Family Self-Sufficiency Program • Individual Development Accounts (IDAs)

49. Today we Learned…. The basic components of SSA’s two disability benefit programs; SSDI and SSI Work incentives that allow an individual to return to work while maintaining some or all of their cash benefit How these work incentives support the ticket to Work program The importance of using other programs to build the financial security of the individual as they build their work effort and let go of some or all of the SSA benefit.

50. Questions? A: Submit it to the host in writing via the Chat or Q&A Box to the right, or…B: Click on the “raise hand” icon to have your line un-muted and ask your question/make your comment.