Understanding How Work Affects SSI/SSDI Benefits Developed by the Work Incentives Planning and...

Understanding How Understanding How Work Affects SSI/SSDI Work Affects SSI/SSDI

BenefitsBenefits

Developed by the Work

Incentives Planning

and Assistance (WIPA)

Project. WIPA is a

cooperative agreement

between the Social

Security Administration and

the RI Department of

Human Services/Office of

Rehabilitation Services.

What do all the SSS’s Mean???

SSA=

SSDI=

SSI=

SOCIAL SECURITY ADMINISTRATION

SUPPLEMENTAL SECURITY INCOME

SOCIAL SECURITY DISABILITY INSURANCE

What Kind of BenefitsWhat Kind of Benefitsdo you Receive?do you Receive?

Title II

SSDI BenefitsYou are disabled and

have insured status as a former worker.

Must have worked in SSA covered employment.

CDB BenefitsYou were disabled before age 22 and are receivingbenefits on the record ofa parent who is retired, disabled, or deceased.

DWB

You are a qualifying widow/

widower and were found

disabled before the end of a

certain period prescribed by

law. (Not payable

before age 50)

SSDI BENEFICIARIES RECEIVE MEDICARE 24 MONTHS AFTER DATE OF ENTITLEMENT.

What Kind of Benefits do What Kind of Benefits do you Receive?...you Receive?...

SSIYOU MAY RECEIVE THESE BENEFITS

IF:

You are aged ordisabled.

You have little or no other income.

Your resources

do not exceed

$2,000, Individual

$3,000, Couple

In RI, SSI RECIPIENTS AUTOMATICALLY RECEIVE MEDICAID WHEN THEY BECOME ELIGIBLE FOR SSI BENEFITS. THERE IS NO WAITING

PERIOD.

Be aware that ...Be aware that ...

Work is not the only thing that may cause benefits Work is not the only thing that may cause benefits to endto end

Social Security may do a medical review and Social Security may do a medical review and decide that you have medically improved. If so, decide that you have medically improved. If so, both your cash payments and your health both your cash payments and your health insurance may stopinsurance may stop

What is Substantial Gainful What is Substantial Gainful Activity (SGA)?Activity (SGA)?

Substantial Gainful Activity (SGA)Substantial Gainful Activity (SGA) - a term SSA uses - a term SSA uses to describe a certain level of work and earningsto describe a certain level of work and earnings

Work is “substantial” if it involves doing certain Work is “substantial” if it involves doing certain physical or mental activities, or a combination of the physical or mental activities, or a combination of the twotwo

““Gainful” work activity is work performed for pay or Gainful” work activity is work performed for pay or profit, of a nature generally performed for pay or profit, of a nature generally performed for pay or profit, or work intended for profit, whether or not a profit, or work intended for profit, whether or not a profit is realizedprofit is realized

SGA Guideline Level:SGA Guideline Level:

In 2009, countable earnings averaging over In 2009, countable earnings averaging over $980/month generally demonstrate SGA if your $980/month generally demonstrate SGA if your impairment is anything other than blindness. impairment is anything other than blindness. (Amount changes each year.)(Amount changes each year.)

If you are blind, countable earnings averaging over If you are blind, countable earnings averaging over $1640 per month (in 2009) generally demonstrate $1640 per month (in 2009) generally demonstrate SGASGA

Factors other than earnings may be taken into Factors other than earnings may be taken into consideration when SSA is making an SGA consideration when SSA is making an SGA decision, howeverdecision, however

Work Incentives That Work Incentives That Affect SGAAffect SGA

Impairment Related Work Expenses Impairment Related Work Expenses (IRWE)(IRWE)

SSA will deduct the cost of certain disability-related SSA will deduct the cost of certain disability-related items and services that you need to work from your items and services that you need to work from your

earnings when they are deciding if your countable earnings when they are deciding if your countable earnings demonstrate the performance of earnings demonstrate the performance of Substantial Gainful Activity.Substantial Gainful Activity.

Possible IRWE’S that Social Security may Approve:

Plus many more………….

Work Incentives That Work Incentives That Affect SGAAffect SGA

SSA considers SSA considers subsidies and special subsidies and special conditionsconditions to determine if the real value of to determine if the real value of your work is SGAyour work is SGA

A A “Subsidy”“Subsidy” is support provided by your is support provided by your employer that may result in your receiving employer that may result in your receiving more pay than the actual value of the work more pay than the actual value of the work you perform you perform

““Special Conditions”Special Conditions” refers to support refers to support provided by someone other than your provided by someone other than your employeremployer

Major SSDI Work Major SSDI Work Incentives:Incentives:

Provided that your impairment continues,Provided that your impairment continues, you will be entitled to the following:you will be entitled to the following:

Trial Work Period (TWP) -Trial Work Period (TWP) - you will receive full SSDI payments for you will receive full SSDI payments for at leastat least 9 months, regardless of how high your earnings might be. In 2009, months 9 months, regardless of how high your earnings might be. In 2009, months when you earn gross wages of $700 or more will be counted as Trial Work when you earn gross wages of $700 or more will be counted as Trial Work months. (This amount is adjusted each year.)months. (This amount is adjusted each year.)

Grace Period (GP)Grace Period (GP) - when Social Security decides that - when Social Security decides that your work is at a level they call Substantial Gainful Activity (SGA), 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 thethey will pay you a full SSDI payment for that month and for the following 2 months before stopping your benefitsfollowing 2 months before stopping your benefits

Extended Period of Eligibility (EPE) -Extended Period of Eligibility (EPE) - a period of 36 consecutive months a period of 36 consecutive months following the TWP when, if you qualify, SSA may restart your SSDI benefits following the TWP when, if you qualify, SSA may restart your SSDI benefits without a new application, disability determination, or waiting period. You without a new application, disability determination, or waiting period. You qualify to have your benefits restarted if your earnings or work activity fall qualify to have your benefits restarted if your earnings or work activity fall below SGA and you continue to have a disabling conditionbelow SGA and you continue to have a disabling condition

During Extended Period During Extended Period of Eligibility:of Eligibility:

If earnings are If earnings are below below Substantial Gainful Substantial Gainful Activity (SGA) level Activity (SGA) level

If earnings are If earnings are at or above at or above Substantial Gainful Substantial Gainful Activity (SGA) level Activity (SGA) level

EntitledEntitled to SSDI cash to SSDI cash paymentpayment

Not entitledNot entitled to SSDI to SSDI Cash PaymentCash Payment

EXCEPTION – EXCEPTION – Entitled to SSDI payments during 3 month Grace Entitled to SSDI payments during 3 month Grace Period (G.P.) (G.P. occurs 1st time after TWP that you perform Period (G.P.) (G.P. occurs 1st time after TWP that you perform SGA.)SGA.)

Year 2009 Jan Feb Mar April May June July Aug Sept Oct Nov Dec

Gr Wages 500 500 600 910 865 925 0 0 0 850 850 850

Ben Status PT PT PTTWP 1

PTTWP 2

PTTWP 3

PT PT PT PTTWP 4

PTTWP 5

PTTWP 6

PT

Yr 2010 Jan Feb Mar April May June July Aug Sept Oct Nov Dec

Wages 1000 1000 1000 0 0 0 0 1800 1500 1500 0 500

Ben StatusTWP 7

PTTWP 8

PTTWP 9

PTEPE 1

PTEPE 2

PTEPE 3

PTEPE 4

PTEPE 5 GP - PT

EPE 6 GP - PT

EPE 7 GP - PT

EPE 8 PT

EPE 9 PT


Wages 0 0 0 0 0 0 0 0 0 0 0 0

Ben StatusEPE 10

PTEPE 11

PTEPE 12

PTEPE 13

PTEPE 14

PTEPE 15

PTEPE 16

PTEPE 17

PTEPE 18

PTEPE 19

PTEPE 20

PTEPE 21

PT

YR 2012 Jan Feb Mar April May June July Aug Sept Oct Nov Dec

Wages 1400 1300 780 1400 1300 0 450 670 1350 800 1500 950

Ben StatusEPE 22 NO PT

EPE 23 NO PT

EPE 24 PT

EPE 25 NO PT

EPE 26 NO PT

EPE 27 PT

EPE 28 PT

EPE 29 PT

EPE 30 NO PT

EPE 31 PT

EPE 32 NO PT

EPE 33 PT


Wages 1280 1400 700 0 700 1600

Ben StatusEPE 34 NO PT

EPE 35 NO PT

EPE 36 PT PT PT NP

Trial Work Period TWP Mo. Used (Allowed 9 within 60 Months)

Extended Period of Eligibility EPE Mo. Paid (36 Mo. After TWP)

Grace Period GP Mo. Paid

NP Month when there is no payment

SSA Uses Gross Wages

SSDI Work IncentivesSSDI Work IncentivesContinued…Continued…

Expedited Reinstatement of BenefitsExpedited Reinstatement of Benefits – If cash – If cash payments end after the EPE because of your work at payments end after the EPE because of your work at SGA level, but you must stop working at SGA level SGA level, but you must stop working at SGA level within 5 years of the month your benefits were within 5 years of the month your benefits were terminated, SSA may be able to start your payments terminated, SSA may be able to start your payments again again

Continuation of Medicare CoverageContinuation of Medicare Coverage – Most – Most individuals with disabilities who work will continue individuals with disabilities who work will continue to receive at least 93 consecutive months of to receive at least 93 consecutive months of premium - free Medicare Part A after the Trial Work premium - free Medicare Part A after the Trial Work Period. They may also continue to have Medicare Period. They may also continue to have Medicare Parts B and D during this time period if enrolledParts B and D during this time period if enrolled

MovingMoving on to SSIon to SSI . . . . . .

SSI: Before SSI: Before and and

After Age 18After Age 18 Some children may receive SSI benefitsSome children may receive SSI benefits

At age 18, they must undergo a medical review to At age 18, they must undergo a medical review to determine if they meet the adult disability standarddetermine if they meet the adult disability standard

There is no guarantee that an individual will continue There is no guarantee that an individual will continue to be eligible for SSI benefits simply because he or to be eligible for SSI benefits simply because he or she received SSI as a childshe received SSI as a child

EarnedEarned

Income:Income: Wages earned from Wages earned from

employment or self employment or self employmentemployment

UnearnedUnearned Income:Income: Any other income such Any other income such

as SSDI, Pensions, TDI, as SSDI, Pensions, TDI, Unemployment Benefits, Unemployment Benefits, Interest or Dividends, Interest or Dividends, Gifts from Grandma etc…Gifts from Grandma etc…

Major SSI Work IncentivesMajor SSI Work IncentivesWhen figuring your income, we do not

count all of your earnings:

General Income Exclusion (GIE) - We do not count General Income Exclusion (GIE) - We do not count $20 of any unearned income you have a month. If $20 of any unearned income you have a month. If little or no unearned income, the $20, or remainder of little or no unearned income, the $20, or remainder of $20, is deducted from earned income along with EIE$20, is deducted from earned income along with EIE

Earned Income Exclusion (EIE) – We do not count $65 Earned Income Exclusion (EIE) – We do not count $65 of your earnings in a month plus half of remaining of your earnings in a month plus half of remaining earned income received in a monthearned income received in a month

Student Earned Income Exclusion (SEIE) - if under Student Earned Income Exclusion (SEIE) - if under age 22 and regularly attending school, we may age 22 and regularly attending school, we may exclude $1,640 per month up to a maximum of $6,600 exclude $1,640 per month up to a maximum of $6,600 per year (2009 figures; adjusted each year)per year (2009 figures; adjusted each year)

Major SSI Work Incentives Major SSI Work Incentives cont…cont…

1619(a) – Once you begin receiving SSI, if you are 1619(a) – Once you begin receiving SSI, if you are still disabled you may continue to receive SSI still disabled you may continue to receive SSI payments while you work, even if your earnings are payments while you work, even if your earnings are at the SGA levelat the SGA level

1619(b) or (continued Medicaid while working) – 1619(b) or (continued Medicaid while working) – After you return to work, your Medicaid may After you return to work, your Medicaid may continue if your wages (or your wages in continue if your wages (or your wages in combination with other income) become too high for combination with other income) become too high for you to receive an SSI cash payment. Certain you to receive an SSI cash payment. Certain conditions applyconditions apply

In most cases, your wages must be below a certain In most cases, your wages must be below a certain “threshold amount” - $36,604 in RI in 2009. ( Figure “threshold amount” - $36,604 in RI in 2009. ( Figure is adjusted annually.) In certain situations, is adjusted annually.) In certain situations, individualized thresholds may be calculatedindividualized thresholds may be calculated


Impairment Related Work Expense (IRWE) – your out-of Impairment Related Work Expense (IRWE) – your out-of pocket and non-reimbursable expenses for items or pocket and non-reimbursable expenses for items or services which are related to your disability and which you services which are related to your disability and which you need to work. IRWE figure in the SSI payment calculation need to work. IRWE figure in the SSI payment calculation and may result in a higher SSI paymentand may result in a higher SSI payment

BlindBlind WorkWork Expense (BWE) Expense (BWE) -- expenses incurred by blind expenses incurred by blind individuals while obtaining earned income. These individuals while obtaining earned income. These expenses need not be related to blindness. They play a expenses need not be related to blindness. They play a part in the SSI calculation and may result in a higher SSI part in the SSI calculation and may result in a higher SSI paymentpayment


Expedited Reinstatement of BenefitsExpedited Reinstatement of Benefits

If your SSI payments ended because of If your SSI payments ended because of your earnings, Social Security may be your earnings, Social Security may be able to restart them if you must stop able to restart them if you must stop working because of the same or a working because of the same or a related disability within five years.related disability within five years.

Major SSI Work Incentives con’tMajor SSI Work Incentives con’t

Plan for Achieving Self – Support (PASS): Plan for Achieving Self – Support (PASS): A plan that allows you to set you to set aside income A plan that allows you to set you to set aside income

or resources to help you reach your work goal(s)or resources to help you reach your work goal(s)• The goal of a PASS is to earn enough money to significantly The goal of a PASS is to earn enough money to significantly

reduce or end your dependence on SSI/SSDI cash paymentsreduce or end your dependence on SSI/SSDI cash payments• A PASS involves an application process and it must be A PASS involves an application process and it must be

approved by Social Securityapproved by Social Security• PASS funds may be used for education or job training, to PASS funds may be used for education or job training, to

help you start a business, or to purchase items or services help you start a business, or to purchase items or services needed to reach your job goalneeded to reach your job goal

• Using a PASS may help you keep your SSI, get a higher SSI Using a PASS may help you keep your SSI, get a higher SSI payment, or become eligible for SSI (In RI you will also have payment, or become eligible for SSI (In RI you will also have Medicaid while using a PASS)Medicaid while using a PASS)

Earning wages…

means your SSI check

decreases or stops

BUT… your total income for the month

increases

Sample SSI Formula for Sample SSI Formula for Individuals With SSI and Wages Individuals With SSI and Wages

Only (No IRWE)Only (No IRWE)Gross Monthly WagesGross Monthly Wages

Income Exclusions ($20 + $65) Income Exclusions ($20 + $65) Remainder (divided by 2 equals) Remainder (divided by 2 equals)

Countable earnings:Countable earnings:

Maximum SSI Rate for 2009 Maximum SSI Rate for 2009 Minus Countable Earned Income Minus Countable Earned Income Adjusted SSI PaymentAdjusted SSI Payment

$500.00$500.00-85.0085.00

$415.00$415.00

$207.50$207.50

$713.92$713.92-207.50207.50

$506.42$506.42

TOTAL MONTHLY INCOME = $1,006.42TOTAL 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 2009)

Sample SSI Formula For Individual Sample SSI Formula For Individual

With Wages And IRWE’sWith Wages And IRWE’s Gross monthly wagesGross monthly wages Income ExclusionsIncome Exclusions RemainderRemainder minus IRWEminus IRWE RemainderRemainder Countable EarningsCountable Earnings

Maximum SSI Rate for 2009Maximum SSI Rate for 2009 Minus Countable Earned Inc Minus Countable Earned Inc

Adjusted SSI PaymentAdjusted SSI Payment Notice that SSI payment is Notice that SSI payment is

$50 higher than in previous $50 higher than in previous example due to IRWE. example due to IRWE.

Your total monthly income would be $1056.42 in this example.

$500.00$500.00-$ 85.00-$ 85.00$415.00$415.00- - 100.00100.00

$315.00 $315.00

$157.50$157.50

$713.92$713.92

$157.50$157.50

$556.42 $556.42

(divided by 2)(divided by 2)

Sample SSI Formula For Individual Sample SSI Formula For Individual With Unearned Income And With Unearned Income And

Wages.Wages.Unearned Unearned Income (SSDI) $200.00Income (SSDI) $200.00Minus general incomeMinus general incomeExclusion -Exclusion -$20.00$20.00Countable Unearned Countable Unearned Income $180.00Income $180.00

Gross monthly earnedGross monthly earnedIncome $500.00Income $500.00Minus earned incomeMinus earned incomeexclusion -$ exclusion -$ 65.0065.00Remainder $435.00 / 2Remainder $435.00 / 2Countable Earned Inc. $217.50 Countable Earned Inc. $217.50

Countable Unearned Inc. $180.00Countable Unearned Inc. $180.00Countable Earned Inc. +Countable Earned Inc. +$217.50$217.50Total Countable Inc. $397.50Total Countable Inc. $397.50

Maximum SSI (2009) $713.92Maximum SSI (2009) $713.92Minus Countable Inc. Minus Countable Inc. -$397.50-$397.50Adjusted SSI paymentAdjusted SSI payment $316.42$316.42

Your total income for month Your total income for month would be would be $1016.42$1016.42!!

The Ticket to Work ProgramThe Ticket to Work Program

What is Ticket to Work?What is Ticket to Work?

It is an employment support programIt is an employment support program

It is a free and voluntary serviceIt is a free and voluntary service

Most beneficiaries age 18 and older, who have not Most beneficiaries age 18 and older, who have not reached age 65 are eligible for a ticketreached age 65 are eligible for a ticket

It allows individuals expanded opportunities toIt allows individuals expanded opportunities to

obtain the services and supports that they needobtain the services and supports that they need to work and to achieve their employment goalsto work and to achieve their employment goals

What Is The Goal Of The What Is The Goal Of The Ticket Program?Ticket Program?

The Ticket to Work program expands the choicesThe Ticket to Work program expands the choices available to SSA beneficiaries with disabilities available to SSA beneficiaries with disabilities who want to enter or re-enter the workforcewho want to enter or re-enter the workforce

The ultimate goal of the program is to support the The ultimate goal of the program is to support the work goals of beneficiaries with disabilities and help work goals of beneficiaries with disabilities and help them gain financial independence from reliance on them gain financial independence from reliance on Social Security disability benefits to the extent Social Security disability benefits to the extent possiblepossible

Where Can The Ticket Be Where Can The Ticket Be Used?Used?

The Ticket program allows participants to choose The Ticket program allows participants to choose from several providers of vocational services called from several providers of vocational services called Employment Networks (EN’s)Employment Networks (EN’s)

EN’s are organizations or agencies that have agreed EN’s are organizations or agencies that have agreed to work with SSA to provide employment services to to work with SSA to provide employment services to beneficiaries with disabilitiesbeneficiaries with disabilities

and/orand/or The state Vocational Rehabilitation Agency – the The state Vocational Rehabilitation Agency – the

Office of Rehabilitation Services (ORS) Office of Rehabilitation Services (ORS)

Where Can I Find Contact Where Can I Find Contact InformationInformation

For ORS Or EN’s Serving RI?For ORS Or EN’s Serving RI?

Visit Visit www.yourtickettowork.comwww.yourtickettowork.com for a list of EN’s for a list of EN’s serving RIserving RI

oror

Contact Maximus at 1-866-968-7842 and request Contact Maximus at 1-866-968-7842 and request Ticket to Work information and a current list of EN’s. Ticket to Work information and a current list of EN’s. TDD users call 1-866-833-2976TDD users call 1-866-833-2976

What Kinds of Employment What Kinds of Employment Services May be Offered? Services May be Offered?

May help with developing a resumeMay help with developing a resume

May teach interviewing skillsMay teach interviewing skills

May do interest or aptitude testingMay do interest or aptitude testing

May assist with education or trainingMay assist with education or training

May provide job coachesMay provide job coaches

May offer job development servicesMay offer job development services

Services differ from one organization to the next. Services differ from one organization to the next. However a variety of services may be available, However a variety of services may be available,

such as:such as:

How Do I Choose A Provider How Do I Choose A Provider OfOf

Vocational Rehabilitation Vocational Rehabilitation Services?Services?

Think about the services that you may need in order Think about the services that you may need in order to workto work

Call or visit several EN’s and ORSCall or visit several EN’s and ORS Ask them specific questions about how they will Ask them specific questions about how they will

help youhelp you Talk to others who have used their servicesTalk to others who have used their services Choose the provider that best fits your needsChoose the provider that best fits your needs

What Happens Next?What Happens Next? When a beneficiary and a provider agree to work When a beneficiary and a provider agree to work

together, you will develop a written plan outlining together, you will develop a written plan outlining the services and supports that will be provided to the services and supports that will be provided to help you achieve your vocational goalhelp you achieve your vocational goal

If you choose to work with an EN, you willIf you choose to work with an EN, you will “assign” “assign” your Ticket to that ENyour Ticket to that EN

If you choose to work with ORS, they will decide If you choose to work with ORS, they will decide whether to accept your ticket assignment or place whether to accept your ticket assignment or place your Ticket in “in use status”. If your ticket is placed your Ticket in “in use status”. If your ticket is placed in “in use status” you may “assign” it to an EN after in “in use status” you may “assign” it to an EN after you become employed for ongoing support services you become employed for ongoing support services after ORS closes your caseafter ORS closes your case

What If The Vocational What If The Vocational Provider Does Not Help Me?Provider Does Not Help Me?

If the services do not meet your needs, you may If the services do not meet your needs, you may choose to reassign the Ticket to another providerchoose to reassign the Ticket to another provider

You may “retrieve” a Ticket or take it out of You may “retrieve” a Ticket or take it out of assignment at any time for any reasonassignment at any time for any reason

You must notify the Operations Support Manager, You must notify the Operations Support Manager, Maximus, in writingMaximus, in writing

If you are ending your work with an ORS state VR If you are ending your work with an ORS state VR agency, you must also ask them to close your caseagency, you must also ask them to close your case

Why Should I Use My Ticket?Why Should I Use My Ticket?

You will obtain valuable Vocational services at no You will obtain valuable Vocational services at no cost to youcost to you

While using your Ticket, SSA may postpone your While using your Ticket, SSA may postpone your

medical continuingmedical continuing disability review (CDR)disability review (CDR) as long as long as you are working toward your employment goal as you are working toward your employment goal andand meeting the SSA Timely Progress Provisionmeeting the SSA Timely Progress Provision

Why Is It Important To Why Is It Important To Have Medical CDRs Have Medical CDRs

Postponed?Postponed? If a medical review is done, Social Security may If a medical review is done, Social Security may

decide that you are no longer disabled because you decide that you are no longer disabled because you have medically improved. have medically improved. Your cash payments and Your cash payments and

youryour health insurance may stop, health insurance may stop, and you may lose and you may lose the employment support services and other help you the employment support services and other help you were receiving towards your work goalswere receiving towards your work goals

How Long Will My Medical How Long Will My Medical CDRs Be Postponed?CDRs Be Postponed?

Medical CDRs will be postponed as long as Medical CDRs will be postponed as long as you are using your Ticket and making the you are using your Ticket and making the expected progress toward achieving self-expected progress toward achieving self- sufficiencysufficiency

This means that you must achieve certainThis means that you must achieve certain work/educational goals during eachwork/educational goals during each 12-month period12-month period

(See handout describing Timely Progress(See handout describing Timely Progress requirements.)requirements.)

Should I Work?Should I Work?

The decision to work despite a disabling condition The decision to work despite a disabling condition is individual and personal. The reasons for wanting is individual and personal. The reasons for wanting to work are individual and personal too, but often to work are individual and personal too, but often include:include:

an increase in self-esteeman increase in self-esteem

a decrease in feelings of depressiona decrease in feelings of depression

more social interactionmore social interaction

the chance to use knowledge/skillsthe chance to use knowledge/skills

and of course, more $$$$$$$and of course, more $$$$$$$

DISCLAIMER:The current presentation is based on 2009 rates. Many of the Social

Security Rates change on an annual basis, usually in January. Updates will be made as new figures become available.

Thanks for your time!

Understanding How Work Affects SSI/SSDI Benefits Developed by the Work Incentives Planning and...

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