BASIC Boot Camp for Understanding Benefits & Work

1. BASIC Boot Camp for Understanding Benefits & Work Presented by: Supported Employment Consultation & Training (SECT) Center 1100 Broadway Anderson, IN 46012 www.sectcenter.org U:\My Music\03 Boogie Woogie Bugle Boy (Form Company B).mp3 (Benefits Boot Camp)- SECT

2. Fall In! Your in Boot Camp now!!! Sergeants: Payne & Suffrin A.K.A. Dennis Born & Denise Norris as your Boot Camp Commanders (Benefits Boot Camp)- SECT

3. The purpose of your “BASIC” Training • To give a brief overview of eligibility requirements for Title II and Title XVI Social Security and Medicaid programs. • To provide tools for calculating the impact of work income on Social Security and Medicaid. • Identify 2009 entitlement changes. • To identify educational resources available to individuals, case managers, and families. (Benefits Boot Camp)- SECT

4. How Does Work Affect Benefits? “…subjects reject competitive employment …in view of the fact that the working person loses money from his/her pension check and risks losing the disability pension altogether if work continues for long. Warner and Polak, Community Mental Health Journal, Vol. 31, No. 5, Oct. 1995 67% of unemployed individuals with disabilities indicate the reason they are not working because the increase income from work may cause a loss or decrease in healthcare benefits. Indiana Medicaid Action Coalition, Healthcare Barriers to Employment Survey, 2000 (Benefits Boot Camp)- SECT

5. Social Security Administration: Two Disability Programs: • Title XVI • SUPPLEMENTAL SECURITY INCOME (SSI) • Title II • SOCIAL SECURITY DISABILITY INSURANCE (SSDI)/SOCIAL SECURITY DISABLED ADULT CHILD (SSDAC) (Benefits Boot Camp)- SECT

6. Obtaining SS Information: Obtain Completed SSA Consent Forms for Release of a Benefits Planning Query (BPQY) to an Authorized 3rd Party (Benefits Boot Camp)- SECT

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9. SSI: A federal program that provides monthly payments to persons with disabilities on a needs basis • Eligibility • Have little or no unearned income • Be considered medically disabled • Initially not be working or working and earning less than the Substantial Gainful Activity (SGA) level ($940 in 2008) $980 in 2009 • Have limited countable resources ($2,000 for an individual and $3,000 for an eligible couple in 2009) • 2009 Federal Benefit Rate (FBR) • $674 (individual)/ $637 in 2008 • $1,011.00 (eligible couple)/ $956 in 2008 (Benefits Boot Camp)- SECT

10. SSI & Work Incentives: • EXCLUSIONS • General • Excludes first $20 of income • Applies to unearned or earned income • Earned • Excludes first $65 of earned income • Excludes one-half (1/2) of remaining gross earnings (Benefits Boot Camp)- SECT

11. SSI & Work Incentives • PLAN FOR ACHIEVING SELF-SUPPORT • STUDENT EARNED INCOME EXCLUSION • Property Essential to Self-Support (PESS) (Benefits Boot Camp)- SECT

12. Other SSI Work Incentives • 1619 a & b Status Public Law 99-643 - will not lose SSI eligibility due to exceeding SGA • Reinstatement of Eligibility Without a New Application • Section 301: Continued Payment under a Vocational Rehabilitation Program (Benefits Boot Camp)- SECT

13. Both SSI & SSDI Work Incentives • IMPAIRMENT RELATED WORK EXPENSE SSI (Benefits Boot Camp)- SECT

14. SSDI/SSDAC An earned entitlement that enables former workers, who due to a disability are unable to work, to receive monthly cash benefits and Medicare insurance • Eligibility (SSDI) • Have worked and paid Social Security taxes • Be considered medically disabled • Not be working, or working and earning less than the Substantial Gainful Activity (SGA) level ($980 in 2009/ $940 in 2008) • Eligibility (SSDAC) • Be a dependent of an insured worker who is disabled, retired, or deceased • Under age 18, or 18 years of age or older and who has become totally and seriously disabled before age 22 • Not be working, or working and earning less than the Substantial Gainful Activity (SGA) level ($980 in 2009/ $940 in 2008) (Benefits Boot Camp)- SECT

15. SSDI/SSDAC & Work • Trial Work Period • Allows an individual to continue to receive their check regardless of the amount of money they earn • $700 in 2009/ $670 in 2008 • 9 months - do not need to be consecutive – in a 60 month rolling period • Extended Period of Eligibility • Protects an individual’s eligibility but not his/her check • 36 consecutive months • Earnings over SGA will affect check (Benefits Boot Camp)- SECT

16. Other SSDI Work Incentives • Impairment Related Work Expense • Allows an individual to deduct the cost of certain items/services from their gross wages in order to keep earnings below SGA • Subsidy & Special Conditions • Section 301: Continued Payment under a Vocational Rehabilitation Program (Benefits Boot Camp)- SECT

17. Medicaid A federal/state funded medical assistance program administered by the Indiana Family and Social Services Administration (FSSA) (Benefits Boot Camp)- SECT

18. Medicaid Eligibility • Must be substantially impaired per the definition of disability in State law: • A physical or mental impairment, disease, or loss • Appears reasonably certain to last twelve (12) months or more • Substantially impairs the person’s ability to perform labor or services or to engage in useful occupation • Determination of disability is based on the individual’s age, education, work experience, and functional limitations • Must meet certain income and resource limits: • 2009 Income Standard is $674 (individual) and $1,011.00 (couple) * will most likely follow SSA guidelines for 2009 • 2009 resource limits are $1,500 (individual) and $2,250 (couple) • Must be a resident of Indiana (Benefits Boot Camp)- SECT

19. Medicaid & Work • Spend-down • Enables recipients to qualify for some Medicaid when their income exceeds the Medicaid Monthly Income Standard (Benefits Boot Camp)- SECT

20. Medicaid & Work • 1619 Status “the big gun!!!” • 1619 (a) • Must receive SSI & Medicaid • Protects an individual’s Medicaid eligibility without a spend-down when earning exceed SGA • 1619 (b) • Must receive SSI & Medicaid • Protects an individual’s Medicaid eligibility without a spend-down when his/her SSI check is reduced to zero (0) due to earnings (Benefits Boot Camp)- SECT

21. Medicaid & Work Medicaid for Employees with Disabilities (MED Works) • Eligibility • Meet state definition of disability • Between ages of 16 and 65 • Be engaged in a substantial and reasonable work effort • Have monthly income that exceeds the spend-down income standard • 2009 Income Limit = $3,159 (as of 3/1/09) • 2009 Resource Limits • $2,000 (single) • $3,000 (couple) • Monthly premiums • Must pay premium based on gross monthly income • Zero (0) premium for single persons earning less than $1,353 or married couples earning less than $1,821 (as of 3/1/09) (Benefits Boot Camp)- SECT

22. Example: Joe receives $850.00 SSDI each month. He obtains a job as an Auto Technician working 20 hours a week. He earns $7.00 an hour.Note: Gross Monthly Earned Income: Hours X $ X 4.3 (weeks) = GMEI (20 X 7 X 4.3 = $602.00) 850.00 850.00 834.50 834.50 602.00 834.50 537.00 211.50 268.50 834.50 268.50 1103.00 1103.00 480.00 (Benefits Boot Camp)- SECT

23. 2009 MED Works Premiums Please note: Gross monthly income must be at or below the high dollar figure within a given percentage range. For example, in a family size of one, an individual must earn $1,276.00 (gross monthly) or less to qualify for MED Works with no premium. If that same individual earns $1,276.01, earnings would be rounded up to the next income level of $1,277.00, resulting in a $48 monthly premium. Note: To figure out the premium add gross earned income with unearned income to equal gross monthly income. Example: $ 602.00 gross earned income (wages) + 850.00 unearned income $1452.00 total gross monthly income premium cost: $ 48.00 (Benefits Boot Camp)- SECT

24. Medicare A federally funded health insurance program for individuals: • Aged 65 or older • Have end-stage renal disease • Receiving SSDI/SSDAC benefits (Benefits Boot Camp)- SECT

25. Medicare & Work • Receive at least 93 months of premium-free hospital insurance (Part A) after Trial Work Period even with earnings over Substantial Gainful Work Activity. • Medicare could continue if you never work over Substantial Gainful Activity. • Medicare Buy-Back • Purchase Medicare If it’s stopped due to work • Options • Part A & Part B • Part A only (Benefits Boot Camp)- SECT

26. Other Entitlement Work Incentives • The Indiana Food Stamp Program • Section 8 Housing (Benefits Boot Camp)- SECT

27. Acronyms BPQY Benefits Planning Query BWE Blind Work Expense CDR Continuing Disability Review DDS Disability Determination Services EPE Extended Period of Eligibility FBR Federal Benefit Rate FPG Federal Poverty Guideline IRWE Impairment-Related Work Expense MAD Medicaid for the Disabled – Full Coverage MADW Medicaid for the Disabled – Working Individual MADI Medicaid for the Disabled – Medically Improved PASS Plan for Achieving Self-Support PESS Property Essential to Self-Support PMP Primary Medical Provider SGA Substantial Gainful Activity SSA Social Security Administration SSDAC Social Security Disabled Adult/Child SSDI Social Security Disability Insurance (Title II) SSI Supplemental Security Income (Title XVI) TWP Trial Work Period UWA Unsuccessful Work Attempt WIPA Work Incentives Planning and Assistance BPAO Benefits Planning, Assistance, & Outreach (Benefits Boot Camp)- SECT

28. Contact Information The Supported Employment Consultation and Training (SECT) Center 1100 Broadway Anderson, IN 46012 www.sectcenter.org Dennis Born, S.E.C.T. Director Denise Norris Trainer/Consultant Community Work Incentive Coordinator 765.641.8382 765.635.4439 bornd@cfmh.org Dn2028@cfmh.org (Benefits Boot Camp)- SECT