Making Work Part of the Plan

1. Making Work Part of the Plan Work Incentives for People with Disabilities

2. The unemployment rate for people with disabilities is approximately 10 times higher than the national average. What keeps people with disabilities from working? The Landscape

3. Attitudes… Fears… Misconceptions… • Family, friends, employers, society “People with disabilities can’t work” “I’ll lose my benefits if I work.”

4. Myths and Facts Working and Social Security Benefits SSDI and SSI

5. Social Security’s disability standard Physical or mental condition must be documented with medical records Unable to earn over Substantial Gainful Activity (SGA) = $980 (2009) Condition expected to last one year or result in death

6. Two different programs, many different names! Social Security Disability Insurance • SSDI • RSDI • SSD • Disability • “Social Security” Supplemental Security Income • SSI • Disability • “Social Security” Some people get both!

7. Social Security Disability Insurance • Insurance based program funded by employment tax contributions (FICA, now OASDI) • Amount of monthly payment depends on the amount of work done and taxes paid. • Individual eligible for these benefits: • Has past work history • Has paid FICA taxes • May collect benefits on parents record (DAC) • Meets definition of disability

8. Supplemental Security Income • Needs-based program • Funded by general revenue tax dollars • Maximum payment for a single person with no other income is $674 per month in 2009 • Individual eligible for these benefits: • Does not need to have prior work history • Must meet both income and asset limits • Meets definition of disability

9. Reasons to work • More income • Gain independence • Improve health • Learn new skills • Meet new people

10. Thinking about working creates questions What do I have to report to my benefits providers? Am I going to keep my healthcare? What if I have to stop working? Will I lose my cash benefits?

11. MYTH: Social Security will kick me off benefits if I work FACT: • Social Security has work rules, called Work Incentives, designed to encourage people to work. • Work Incentives available will depend on which benefit a person is receiving. • Lots of people work & keep their benefits.

12. Extended Period of Eligibility 36 months SGA becomes important Work Incentives On and off benefits Beyond EPE SGA Work Incentives Expedited Reinstatement Trial Work Period 9 months Earn any amount Still receive SSDI SSDI time periods timeline SGA = Substantial Gainful Activity ($980 per month) There are options and safety nets in every time period!

13. Working may reduce the amount of the SSI benefit a person receives, but Most people are still ahead financially when they work. Changes to SSI benefits can be confusing – benefits can change every month… People can call the Connection for help. MYTH: I will have less money if I work FACT:

14. MYTH: If I work I will lose my healthcare FACT: • There are healthcare options: • For SSI –MA at no cost. If someone works enough to give up their SSI check (1619b), they can still keep MA until earnings are over $46,694 in 2009. • For SSDI – When working rather than MA w/ a spenddown folks can use Medical Assistance for Employed Persons with Disabilities (MA-EPD). Pay a small premium vs. a large spenddown.

15. MYTH: Social Security knows when I work because I am paying taxes FACT: • Taxes go to the IRS, not Social Security. • It is the client’s responsibility to report earnings. • Report the starts and stops of jobs, changes in earnings, and other information requested. • Keep paystubs in a safe place.

16. MYTH: Working will mess up allof my benefits. FACT: • Benefits can and do change when people work, most people have more money when they work. • Don’t go by what happened to someone else’s benefits---every benefit picture is different based on individual factors. • Knowing which rules to follow is key. • Call the Connection for the facts about working and benefits.

17. MN Work Incentives Connection Provide clear, accurate information about impact of work on government benefits Services include: • Phone hotline for info and referral • Problem solving and advocacy for complex benefit issues • Outreach • Benefits Analysis Twin Cities Metro: 651-632-5113 Greater MN: 1-800-976-6728

18. $340.75 - A 60% increase in available income! Matt working – more money? Not Working $0.00 $0.00 $575.00 $119.00 $81.00 Yes Yes $16.00 -$222.00 $569.00 $875/mo$875.00 - $131.25 $575.00 $0.00 $0.00 Yes Yes $16.00 - $425.00 $909.75 $650/mo$650.00 - $97.50 $575.00 $0.00 $0.00 Yes Yes $16.00 -$362.00 $781.50 Wages: Minus 15% taxes: SSDI: SSI: MSA: MA: Medicare: Food Support: Subsidized Hsng.: Available Inc.:

19. Things to know • There are safety nets and work incentives available to encourage people to work. • Programs interact with each other. • Program rules can be complicated. • The Connection is a resource available to help individuals, families and professionals understand the effect of earnings on benefit programs.

20. Do you have questions We have answers!

21. MA-EPDA work incentive/health care program Medical Assistance for Employed Persons with Disabilities

22. Pre-Test • What is the upper income limit for MA-EPD? • What is one thing that makes MA-EPD different than standard MA? • What is the MA-EPD age limit?

23. MA-EPD Eligibility at a glance • Age 16 to 64 • Certified disabled • Employed • Pay taxes • Meet $20,000 asset limit • Pay premium • NO upper income limit

24. MA-EPD Eligibility • Individuals must be at least 16 but less than 65 years old • Individuals must be certified disabled by either the Social Security Administration or the State Medical Review Team (SMRT) • Continued on next slide

25. Individuals who can’t be certified by SSA due only to earnings over SGA ($980/month in 2009) may be certified disabled through SMRT. • Individuals on extended Medicare continue to be certified disabled by SSA even though their cash benefits have ended. Refer to SMRT prior to Medicare coverage ending.

26. MA-EPD Eligibility • Individuals must be employed • To be considered employed, a person must have average gross monthly wages or countable self-employment earnings of more than ?? $65

27. Earned Income • Enrollees must receive earned income each month, unless: • They change jobs and receive no pay check for 1 month because of different pay periods • They are on a temporary medical or job loss leave • Continued on next slide

28. Safety Nets • 4-Month Medical Leave: Enrollees may have an interruption of employment due to a physician verified medical condition for up to 4 months. • 4-Month Job Loss Leave: Enrollees who lose their job, through no fault of their own, may remain on MA-EPD for up to 4 months while looking for another job. • Continued on next slide

29. There is no limit on the number of leaves a person can use, as long as they return to work in between. • A job loss leave can be used immediately following a medical leave. • A medical leave cannot be used immediately following a job loss leave.

30. Calculating Earned Income • For retro months, use actual gross wages or countable self-employment income received in that month • Determine countable self-employment income by deducting allowable costs of doing business from gross receipts. • For current and future months, use the average anticipated earned income (MAXIS: FIAT EBUD) • Continued on next slide

31. Earned Income Verification • Acceptable earned income verifications include: • pay stubs • employer statement (DHS-2146) • tax forms or business records • Continued on next slide

32. Examples of acceptable self-employment business records include: • Detailed, hand written or computer generate records of gross receipts and expenses • Business quarterly report • Signed statement from the business’s accountant verifying projected business income or expenses

33. Taxes • To be considered employment, Medicare and Social Security taxes must be paid or withheld from earnings • Proof of state or federal income tax being paid is not required. • Continued on next slide

34. Acceptable Medicare and Social Security tax withholding/payment include: • Wages • Pay stubs • Written Employer Statement (DHS-2146) • Self-employment: • Quarterly Schedule ES or Schedule SE • Annual federal income tax return • Business records • Continued on next slide

35. Generally, quarterly estimated tax payments are required by the IRS only if taxes of $1,000 or more are owed. • If the client does not file quarterly, accept the annual federal tax return from the previous year • If the client hasn’t been in business long enough to file taxes or has not filed taxes in the past, accept business records until the review due following the next filing deadline

36. Assets • Individuals must have assets of less than $20,000 • Exclude standard MA assets plus retirement accounts, medical expense accounts set up through an employer and all spousal assets. • People on MA-EPD who lose employment for any reason retain the MA-EPD asset limit and rules for up to 12 months.

37. Premiums • Individuals must pay a premium of $35 or more, based on their income and household size • People with unearned income must pay ½ % of their unearned income. • Both are calculated on MAXIS/EBUD • Continued on next slide

38. Counties bill and collect initial premiums • Eligibility cannot be approved until premium is paid • Applicants can choose which month(s) they want eligibility and pay only those months • Counties must work the “overdue premiums” report each month • Continued on next slide

39. Clients with overdue premiums will show on the report until they’ve paid all past due premiums • Over due MA-EPD premiums do not affect eligibility for other programs • Notify DHS Special Recovery of new, changing or discontinued premiums via MAXIS email “MADE”

40. Ongoing premiums can be paid by mail, in person, by auto-withdrawal, or online at http://payments.dhs.state.mn.us/selectthepaymenttype.asp • MA-EPD premium estimator online at: www.dhs.state.mn.us/maepdpremium

41. Remember… • Do not switch people eligible for 1619(b) to MA-EPD • Counties must reimburse Medicare Part B premiums for MA-EPD enrollees with income below 200% FPG who are not eligible for QMB/SLMB

42. Post-Test • What is the upper income limit for MA-EPD? • What is one thing that makes MA-EPD different than standard MA? • What is the MA-EPD age limit?

43. MA-EPD Contacts MA-EPD Information Line651-431-4300 Disability Linkage Line 1-866-333-2466 Beth Grube Brian Jorgensen 651-431-2412 651-431-4241 Beth.grube@state.mn.usBrian.jorgensen@state.mn.us MAXIS email “QS” MAXIS email “KCM”

44. Coming Soon…

45. An interactive web site designed for people with disabilities, and those who help them.

46. Information – on disability benefit programs • Tools – to show the connection between work and benefits • Tailored Plans – for moving forward • System – to get the help you need

47. If you want more information about DB101, want to participate in testing, or have any input or ideas to help DB101 succeed, please contact Lesli.Kerkhoff@state.mn.us