Ticket to Work Program

1. You Can Work and Keep Your Benefits: How Work Affects Social Security Disability Benefits, Medicaid, and Medicare Monroe SpencerMarilyn MorrisonvaACCSES Work Incentives Planning and Assistance (WIPA) Project

2. Ticket to Work Program The Social Security Administration (SSA) provides: • Access to free job seeking services. • Work Incentives Planning and Assistance (WIPA) Services. 102 projects nationwide originally. 2 Virginia projects. • Protection and advocacy (P&A) for the rights of individuals with disabilities.

3. Objective of this Presentation Introduce you to the ways that special rules can help you keep all, or the most important features of, your disability benefits while you work.

4. Commonly Asked Questions • How much can I make and still keep my benefits? • If I work, will I lose health benefits? • Is there a way I can keep more of my disability check while working? • When and what must I report to Social Security?

5. Supplemental Security Income (SSI) • A cash benefit that’s based on medical disability and financial need. • The maximum amount is $674. • You can get Medicaid. • Must have $2000 or less of resources.

6. Living Arrangement • If the person you live with provides your food and/or shelter, your SSI check might be $449/mo. • But if you pay room and board or live alone, you might receive the full $674/mo.

7. Medicaid • Pays for practically all medical expenses except dental. • Must have $2000 or less of resources.

8. Effect of Wages on Monthly SSI Payments • The SSA reduces your max SSI by a portion of your total countable income each month. • You always gain far more in wages than you lose in SSI payments. • No practical earnings limit.

9. Example: Wages Put More Money in Your Pockets Johnny's base SSI check is $674/month. He earned $785 in April at Wal-Mart. He reports his earnings to the Social Security office in May. His SSI check will be $324 in June. So before he started working, he lived off of $674/month. Now he lives off of $785 + $324 = $1109/month.

10. SSI Work Incentives … help the SSI recipient keep more in his/her SSI check while working. • Student Earned Income Exclusion • Impairment Related Work Expenses (IRWE) • Continuation of Medicaid Eligibility

11. Student Earned Income Exclusion (SEIE) • Regularly attending school or IEP. • Under age 22. • SSA does not count up to $1,640 of student’s monthly wages when they figure his/her SSI payment amount. The maximum yearly exclusion for 2011 is $6,600.

12. Impairment Related Work Expenses (IRWE) • Half of the money spent on these items does not count against the monthly SSI payment. • Attendant care services, certain transportation costs, medical devices, medications, residential modifications, and more.

13. Example: IRWE Increase the Amount of SSI Normally, $785 in wages reduces Johnny's SSI check to $324. But now Johnny can report that he spends $200/month on psychiatric counseling so he can maintain his job. So his SSI check will be reduced to $424/month instead of $324.

14. How the SSA Calculates MonthlySSI Check A B Gross Earned Income $1005 $1005 Student Earned Income Exclusion (SEIE) - $ 0 - $ 0 GIE (If not used previously) - $ 20 - $ 20 Earned Income Exclusion (EIE) - $ 65 - $ 65 Impairment-Related Work Expenses, if any - $ 0 - $ 100 Sub-total $ 920 $ 820 Divided by 2 $ 460 $ 410 Blind Work Expenses (if any) - $ - $ Total Countable Earned Income = $ 460 $ 410 PASS Deduction - $ 0 - $ 200 Total Countable Income = $ 460 $ 210 Base SSI Rate $ 674 $ 674 Total Countable Income -$ 460- $ 210 Adjusted SSI Payment = $ 214 $ 464

15. Continuation of Medicaid (1619b) An SSI check might be reduced to $0 by wages. But, Medicaid coverage can continue if you: • Are still disabled, • Need Medicaid in order to work, and • Have annual earnings not greater than the state threshold amount ($32,545 for 2011).

16. Continuation of Medicaid (1619b) The Bottom Line For all practical purposes, you will keep your Medicaid even if you get a very good-paying job.

17. I Social Security Disability Insurance (SSDI) • A cash benefit paid from individuals who have worked and paid into Federal Insured Contribution Act (F.I.C.A). • Monthly benefit check is paid in full or not at all. • You will get Medicare.

18. (In this presentation, the term SSDI is used to represent all three kinds of Title II disability benefits: SSDI, Childhood Disability Benefit (CDB), and Disabled Widow(er) Benefit. The benefits differ primarily in the earnings record upon which the benefit is paid. Wages affect all three types in the same way.)

19. Medicare • Federal medical assistance program for SSDI and retirement beneficiaries. • Must wait 24 months after eligibility for cash payments begins. • Part A: Hospitalization (No premium) Part B: Medical ($96/$96-115 prem.) Part D: Prescription Drug Plan (premium varies)

20. Medicaid • Some may qualify for income-based full Medicaid or limited Medicaid QMB. • Some may qualify for limited Medicaid coverage such as Medicaid SLMB or QI1 which only pay the Medicare premiums.

21. I Substantial Gainful Activity (SGA) • Determines whether you are eligible for continued monthly SSDI payments while you work. • The performance of paid work in which a month’s countable income is $1000 or more for the disabled and $1,640 for the blind.

22. SSDI Work Incentives … help some SSDI beneficiaries keep their SSDI checks even if they are earning $1000 or more per month.

23. Selected SSDI Work Incentives • Trial Work Period • Extended Period of Eligibility • Impairment Related Work Expenses (IRWE) • Subsidies and Special Conditions

24. Trial Work Period (TWP) • Complete protection ofyour full disability check no matter how much you earn during this period. • This period ends when you have accumulated 9 service months. • A service month in 2011 is earnings of $720 or more.

25. Extended Period of Eligibility (EPE) • A 36-month period, following the TWP, in which you are eligible for your SSDI check when you earn less than SGA and not eligible when you earn at or above SGA. • This give you month-to-month protection of your SSDI check.

26. Three-Month Grace Period But, the first time that you do perform SGA after your TWP ends, you’ll still be eligible for your disability check for that month plus the next two consecutive months.

27. Impairment Related Work Expenses (IRWE) • None of the money you spend for these items counts against the SGA amount. • Attendant care services, certain transportation costs, medical devices, medications, residential modifications, and more.

28. Example of TWP, EPE, and IRWE Irene gets $915/mo. in SSDI. Her first job since her benefits began pays her $1200/mo. in a floral shop. SGA is $1000/mo. She keeps her full SSDI check throughout her TWP. She reports $150/mo. in medications and $75/mo. in counseling expenses for a total of $225 IRWE. Therefore only $975 of her wages counts against SGA during her EPE. She keeps SSDI.

29. Subsidy • Your employer might say that you work at a lower productivity rate but you’re paid at the same rate as your co-workers. • If the SSA and your employer document this employment situation, only a percentage of your wages will count against SGA.

30. Example of Subsidy • SGA is $1000/mo. Alice earns $1300/mo. after the TWP. Ordinarily she would lose her SSDI check. But her documented productivity rate is 70%. • The SSA only counts $910 (70% of $1300) each month against SGA. She keeps her SSDI check.

31. Expedited Reinstatement • Even if you earn so much money each month that you eventually lose your SSDI checks for good, you still might be able to get your benefits back if your disability causes you to stop performing SGA. • You will receive temporary benefits while the SSA determines your eligibility.

32. Expedited Reinstatement • If you want your benefits back after you stop performing SGA for any other reason (like lay-off), you will have to reapply for benefits to get them back.

33. Something New!MEDICAID WORKS Some SSI or SSDI beneficiaries may want to earn or save too much to become or remain Medicaid eligible. Now they may be able to buy Medicaid in Virginia. See your DSS worker to apply or CWIC for details.

34. MEDICAID WORKS … lets you keep full Medicaid coverage while earning up to $44,340/year and saving up to $32,545. You might have to pay a small monthly premium.

35. Plan to Achieve Self-Support • An approved PASS helps you pay for items or services you need to achieve a job goal. • In an approved PASS, Social Security makes you eligible for SSI or increases your monthly SSI check to match or nearly match what you set aside in savings.

36. Plan to Achieve Self-Support Examples of job goals: • Paying for vocational training or college. • Purchasing job coaching. • Starting your own business. • Buying tools to become a carpenter. • Becoming a school teacher.

37. Example: PASS increases the SSI check Omar’s base SSI check is $674/mo. He’s paid $885/mo. as a grocery bagger reducing his SSI check to $275/mo. But Omar wants to be a doctor’s office worker. He gets an approved PASS to pay for medical terminology and billing courses. In the PASS, he will set aside $400/mo. for tuition, books, and fees. His SSI check will be increased to $674/mo.

38. Example: PASS qualifies you for SSI Tameka gets $944 in SSDI and no health insurance. She wants to start her own pet care business . She gets an approved PASS to pay for pet care courses, equipment, and business licenses. In the PASS, she will set aside $300/mo. The approved PASS makes her eligible for a small $50 SSI check and full Medicaid until her business gets off the ground.

39. To Avoid Overpayments, you should …. • Report employment to Social Security. • Set up a simple filing system. • Submit pay stubs and IRWE receipts once every month (including the month you stop working). SSI call-in number: 866-772-0953. • Contact your CWIC.

40. CWIC Contacts vaACCSES WIPA Project, Call toll-free 1-877-822-2777 Endependence Center WIPA Project, Toll-free 1-866-323-1088 See your WIPA Project handout for the CWIC nearest you.

41. Other Contacts The Virginia Office for Protection and Advocacy (VOPA), at 804-225-2042 or www.vopa.state.va.us