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. What are Work Incentives? Special rules used to encourage an individual to work.

5. On Supplemental Security Income (SSI), work incentives increase the amount of the SSI payment. • On Social Security Disability Insurance (SSDI), work incentives let SSDI cash payment continue when earnings are above the Substantial Gainful Activity level.

6. Substantial Gainful Activity Level (SGA) • The amount of monthly earned income SSA uses to help define disability • $940 ($1570 if blind) in 2008

7. Federal Benefit Rate (FBR) • The maximum monthly SSI payment • $637 in 2008

8. “THE SSI FORMULA” Gross Earnings: Minus General Exclusion: Minus Earned Income Exclusion: Divided by 2: Countable Earnings 2007 Federal Benefit Rate (FBR): Minus countable earnings: SSI PAYMENT: $615 - 20 $595 - 65 $530 ÷ 2 $265 $637 - 265 $372

9. SSDI Work Incentives • Work incentives can reduce earned income by the amount of the deduction for people earning over SGA. Example: $1000 earned income (over SGA) • 80 IRWE $920 countable earned income (under SGA)

10. Work Incentives • Ticket to Work (Both) • Trial Work Period (SSDI) • Extended Period of Eligibility (SSDI) • Expedited Reinstatement (Both) • Impairment Related Work Expense (IRWE) (Both) • Subsidy (SSDI) • Plan for Achieving Self Support (PASS) (Both) • Earned Income Exclusion (SSI) • Blind Work Expense (SSI) • Student Earned Income Exclusion (SSI) • 1619(b) (SSI) • Extended Medicare (SSDI) • MA-EPD

11. Ticket to Work • Increases client’s choice in obtaining the employment support services, vocational rehabilitation services, and other and other services needed to get and keep a job • www.yourtickettowork.com

12. Impairment Related Work Expense (IRWE) • Allows certain expenses, necessary to go to work, to be disregarded from individual’s earned income. • An IRWE expense must be: • paid for by the individual; • related to serious medical condition; & necessary in order to work • approved by SSA

13. Trial Work Period (TWP) • 9 months when a person can test their ability to work and not affect their SSDI • TWP month = earnings over $670 in 2008 • SSDI payment continues during TWP, no matter how high earnings • After TWP, if earnings remain under SGA ($940 in 2008) SSDI continues

14. Plan for Achieving Self-Support (PASS) Income or resources set aside for a set amount of time to achieve a specific vocational goal • Examples of possible PASS goals include: Education Equipment Transportation • Funds set aside are not counted when calculating the SSI payment

15. Health Care with SSI • Medical Assistance • 1619(b) • Allows Medical Assistance (MA) coverage to continue after the individual’s earned income becomes too high to allow a SSI cash payment.

16. 1619 (b) continued • To qualify for 1619(b) the individual must: • have been eligible for an SSI cash payment for at least one month; • still be disabled; • meet non-disability requirements; & • need and use MA • 1619(b) can continue until person reaches MN’s 1619(b) threshold of $44,799 per year or assets exceed limit

17. Healthcare with SSDI • Medicare – after 24 months on SSDI • Extended Medicare – people who work their way off SSDI continue to receive Medicare for at least 93 months after the end of the Trial Work Period • Medical Assistance for Employed Persons with Disabilities (MA-EPD)

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

19. 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

20. 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

21. Individuals who can’t be certified by SSA due only to earnings over SGA ($940/month in 2008) 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.

22. 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

23. 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

24. 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

25. 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.

26. 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

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

28. 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

29. 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

30. 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

31. 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

32. 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.

33. 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

34. 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

35. 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”

36. 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

37. 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

39. 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”

40. Goal: Assist people with disabilities to return to work; to increase work effort; or to work off benefits. Method: Answer, “What will happen to my benefits if I work?” 1-800-976-6728 651-632-5113 Work Incentives Connection

41. Benefits Analysis (BA) • Comprehensive look at how all benefits • are affected by work. • Includes: • Benefits verification/information finding • Identification of work incentives • Development of examples of different levels of earnings----individual’s goals • Exploration of health care options • Comparison of finances before & after working • Benefit management help & follow-up

42. Anne: Not Working SSDI $575.00 SSI $ 68.00 MSA $ 81.00 MA Yes Medicare Yes Food Support $ 10.00 Subsidized Housing -$207.00 Available Income $527.00

43. Anne: Earning $650 per month vs. not working Earning $650/mo. $650.00 -$ 97.50 $575.00 $ 0.00 $ 0.00 Yes Yes $10.00 -$373.00 $764.50 Not Working $0.00 $0.00 $575.00 $68.00 $81.00 Yes Yes $10.00 -$207.00 $527.00 Wages: Minus 15% taxes SSDI: SSI: MSA: MA: Medicare: Food Support: Subsidized Housing: Available Income: $237.50 - A 45% increase in available income

44. Anne: Earning even more! Not Working $0.00 $0.00 $575.00 $68.00 $81.00 Yes Yes $10.00 - $207.00 $527.00 $650/mo$650.00 - $97.50 $575.00 $0.00 $0.00 Yes Yes $10.00 - $373.00 $764.50 $875/mo$875.00 - $131.00 $575.00 $0.00 $0.00 Yes Yes $10.00 - $446.00 $883.00 Wages: Minus 15% taxes: SSDI: SSI: MSA: MA: Medicare: Food Support: Subsidized Hsng.: Available Inc.: $356.00 - A 67.5% increase in available income!

45. Coming Spring 2009…

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

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

48. 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