SSI-SSDI Work Incentives - Washington Access Fund · Receive a Social Security disability-based...

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The webinar will begin shortly.

Welcome!

2 Plan to Work !  Who we are:

! Community Work Incentives Coordinators !  Experts on federal, state, and local benefits in relation to

employment goals ! A community resource to beneficiaries and service providers

!  What we do: !  Provide free and confidential benefits planning services to

individuals who are on a disability-based benefit from Social Security and who have questions about employment

!  Provide both general assistance with understanding benefits and work incentives, and long-term individualized services

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Plan to Work: Who we Serve

!  To qualify for services an individual must: !  Receive a Social Security disability-based benefit (SSI or

SSDI) "  Or be a client of the Washington Access Fund "  Or a client of Spokane County DDD

!  Be between the ages of 14 and Full Retirement Age !  Live in the state of Washington ! Have work-related questions

We also serve service providers, advocates, agencies, friends, and family members!

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Social Security Disability Benefits

!  There are two types of benefits: SSI and SSDI !  Individuals can receive both types at the same time ! Benefits are entirely different

" They respond differently to employment, unearned income, resources, living arrangements, etc

" They have different health insurance and different benefit amounts

" There are different timelines associated with each

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SSI vs. SSDI

!  Need-based and means-tested

!  Maximum amount for an individual of $710 (2013)

!  Medicaid !  Impacted by all income or

in-kind support !  Benefit amount varies

depending on other income

!  Based on previous work history

!  Benefit amount varies !  Medicare !  Only impacted by

employment !  Receive entire benefit or

no benefit– no middle ground

SSI SSDI

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Work Incentive Comparison Chart

!  Trial Work Period !  Extended Period of Eligibility !  Impairment Related Work

Expense !  Subsidies !  Unsuccessful Work Attempt !  Unincurred Business Expenses !  Continuation of Medicare !  Section 301 !  Expedited Reinstatement !  Ticket to Work !  Medicaid Buy-In

!  Student Earned Income Exclusion !  Impairment Related Work Expense !  Blind Work Expense !  1619 (a) !  1619 (b) !  Property Essential For Self Support !  Plan for Achieving Self-Support !  Section 301 !  Reinstatement without new

application !  Expedited Reinstatement !  Ticket to Work !  Medicaid Buy-In

SSDI SSI

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Work Incentives provide the safety net so you can: •  Try different jobs •  Be trained •  Build skills •  Gain confidence •  Start a new career

Working While Receiving SSDI: Utilizing Work Incentives

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SSDI

!  Requires previous work credits through FICA ! Can also be from a parent�s work record (DAC/CDB) or a

deceased spouse (DWB) !  5-month waiting period for cash benefits !  Medicare

!  Starts 24 months after entitlement !  Part A is free, Parts B and D may have premiums

!  No asset limit !  Continuing disability reviews every 3, 5, or 7 years !  Substantial Gainful Activity rules

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Substantial Gainful Activity (SGA)

!  SGA is a basic test used by SSA to establish disability status

!  SGA is the performance of significant mental and/or physical duties for profit.

!  It is usually determined to be gross earnings (before taxes) above a specific yearly threshold !  2013 SGA for non-blind individuals = $1040/month !  2013 SGA for blind individuals = $1740/month

!  SGA involves an ongoing pattern of work behavior – not an isolated month or two

!  If you�re above SGA, your check may be paused or terminated, unless you have work incentives to use

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Time-Limited Phases

Social Security offers two work incentive Phases that offer safety nets beyond the SGA rules:

Phase 1: Trial Work Period

Phase 2: Extended Period

of Eligibility

Phase 3: Cessation and Grace Period

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Phase 1: Trial Work Period (TWP)

A 9-month phase that allows you to work and receive your cash benefit, no matter how much you�re earning.

#  Months do not have to be consecutive

#  In order to use a TWP month, you must earn a minimum of $750 a month (2013) or work 80 hrs/month in Self-Employment

#  Once you use all 9 months within a 60-month window, you move into Phase 2

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Phase 2: Extended Period of Eligibility (EPE)

A 36-month period that allows you to maintain your SSDI eligibility even if your check is paused

!  Begins in the month following the Trial Work Period, whether you are working or not

!  Cash benefit continues for all months earnings are below SGA !  Any month earnings are above SGA, your cash benefit is

paused, but you remain eligible for your check !  You do not have to reapply if your earnings fall below SGA–

just notify Social Security about the change in earnings

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Tools SSA Uses to Make an SGA Decision

!  Can reduce the amount of earnings used to calculate SGA !  Only apply during Phase 2 (Extended Period of Eligibility)

and after (not during the Trial Work Period) !  Must be accompanied by proof !  There are many work incentives that may apply to your

situation:

$ Impairment Related Work Expense $ Subsidies $ Special Condition $ Unsuccessful Work Attempt $ Income Averaging $ Unincurred Business Expenses

$ Unpaid Help $ Continuation of Medicare $ Section 301 $ Expedited Reinstatement $ Ticket to Work $ Medicaid Buy-In

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Impairment Related Work Expense (IRWEs)

! Out-of-pocket costs for items needed to work are excluded from SGA

! Can be one-time expenses or repeating expenses ! Must be correlated with SSA diagnosis or for a

medical condition being treated by a physician. " Medication, assistive devices, service animal costs

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Subsidy

Extra support or services provided by your employer !  Social Security excludes the value (either a dollar

amount or a percentage) of the supports provided from SGA

!  Examples: ! Fewer/easier duties ! Frequent rest breaks !  Irregular hours ! Extra help/supervision

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Special Conditions

Assistance provided by someone other than yourself or your employer

!  Only count the wages that are based on your own productivity– the value of the assistance is excluded from SGA ! Job coach ! Medical devices ! Assistive technology

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Other Work Incentives

!  If you’ve been working at or above SGA for less than six months and have a significant break in work activity due to your disability OR

!  If your monthly wages fluctuate from month to month, sometimes going above the SGA threshold amount . . .

Talk to a benefits planner to get accurate work incentive information about your

specific situation!

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Phase 3: Cessation Month and Grace Period

!  The cessation month is important because it is the first month in which SSA determines a person to be officially engaging in SGA.

!  The cessation month may occur during or after the EPE. Title II disability payments are due in the cessation and the next two �grace period months�

!  Beneficiaries who never engage in SGA never use this work incentive phase

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Expedited Reinstatement (ExR)

Individuals who become ineligible for SSDI benefits due to work at the SGA level may request to reinstate benefits without filing a new application.

!  You must be unable to work and earn SGA because of the same or similar medical condition

!  You must file the request for reinstatement with Social Security within 60 months from the month your benefits are terminated.

!  SSA will provide up to six months of provisional benefits (including Medicare) while a case is being reviewed.

!  Note: Individuals always have the option of re-applying for benefits

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What Happens to My Medicare if I Go Back to Work? !  If you are a Medicare beneficiary, if you continue to

have a disability as defined by the Social Security Administration, and you return to work, you can keep your Medicare coverage for at least 93 months after you return to work.

!  During this Extended Period of Medicare Coverage (EPMC), you will continue to receive Part A (premium-free hospital insurance) and Part B (elected medical insurance coverage with a monthly premium), and Medicare prescription drug coverage if applicable.

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Other Ways to Access Healthcare

Healthcare for Workers with Disabilities (HWD) is a Medicaid Buy-In Program, and covers your Medicare Part B and Part D premiums

Eligibility: !  Between 14 and retirement age !  Meet federal disability requirements !  Are employed !  Have monthly net income at or below 220% of the

federal poverty level Monthly premium is never more than 7.5% of your total

income

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Work Incentives provide the safety net so you can: •  Try different jobs •  Be trained •  Build skills •  Gain confidence •  Start a new career

Working While Receiving SSI: Utilizing Work Incentives

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How earnings affect SSI payments

!  First $20 of income (earned or unearned) is excluded !  First $65 of earned income is excluded !  SSA only counts ½ of remaining earned income

! Example: You earn $850 a month in wages and have no other income " $850-$20-$65 = $765 " $765/2 = $382.50

! SSA will deduct $382.50 from your SSI check, so you will end up with an SSI check of $327.50

! Your total monthly income will be $1,177.50! Remember, after the first $20 income exclusion, unearned

income is counted dollar for dollar!

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Impairment Related Work Expense (IRWEs)

!  Out-of-pocket costs for items needed to work are deducted from earnings before the earnings are halved !  Example: You earn $850 a month in wages and have $200 in

Impairment-Related Work Expenses "  $850-$20-$65 = $765 "  $765 - $200 for an IRWE = $565/2 = $282.50 "  SSA will deduct $282.50 from your SSI check, so you will end up with an

SSI check of $427.50 "  Your total monthly income will be $1,277.50!

!  Can be one-time expenses or repeating expenses !  Must be correlated with SSA diagnosis or for a medical

condition being treated by a physician. ! Medication, assistive devices, service animal costs

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Student Earned Income Exclusion (SEIE)

If you are receiving SSI benefits, are under age 22, and regularly attending school, SSA will not count up to $1,730 of earned income (wages) per month while attending school and working, up to the maximum yearly exclusion of $ 6,960 (2013) SSA�s definition of �regularly attending school� is: ! You take one or more courses of study and attend classes:

!  In a college or university for at least 8 hours a week; or !  In grades 7 – 12 for at least 12 hours a week; or !  In a training course to prepare for employment for at least 12 hours a week (15 hours a week

if the course involves shop practice), or !  For less time indicated above for reasons beyond the student�s control, such as illness.

# Note: if you are home schooled because of a disability, you may be considered �regularly attending school� by:

!  Studying a course or courses given by a school (grades 7 – 12), college, university or government agency; or

!  Having a home visitor or tutor who directs the study.

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Medicaid and Returning to Work

#  If your earnings are so high that your SSI check stops you can still receive Medicaid if you #  Remain disabled # Have assets under $2000 ($3000/couple) # Need Medicaid # Have annual earnings below the State Threshold– $29,269

(2013)

*An individualized threshold amount may be available if your medical costs are high.

27 Ticket to Work

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What is a Ticket to Work?

A voluntary program for people who want help reaching employment goals that allows you to access free-of-charge services from Employment Networks Participating in the Ticket program provides:

! Greater choice through an increased network of Vocational Service Providers

!  Suspension of the Continuing Disability Review when actively using their Ticket

!  The National Program Manager for SSA is MAXIMUS !  1-866-968-7842 / 866-833-2967 (TTY/TDD) !  http://www.chooseworkttw.net/

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Using Your Ticket

!  Assign Ticket to an Employment Network !  They work for you: interview Employment Networks to find the

best fit !  Employment Networks:

!  Accept your Ticket to work !  Provide services to help you remove barriers to employment !  Help you reach your employment goals

!  Employment Networks can be: !  Private companies !  Public organizations !  State Vocational Rehabilitation agency !  Employment agencies, schools, etc.

!  Under contract with Social Security

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Other Resources in your Return to Work

!  Division of Vocational Rehabilitation (DVR)—helps individuals move toward employment goals through targeted services

!  WorkSource—helps individuals find work through job readiness classes and job listings

!  Benefits Planners—help individuals plan ahead for employment goals and benefit needs

!  Disability Rights Washington—helps individuals with legal questions related to disabilities

!  Independent Living Centers—help individuals with advocacy related to disabilities

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Asset Development and SSDI

!  There is NO asset limit for SSDI! !  There are asset development programs for individuals

on a limited income such as: !  Individual Development Account (IDA) – Matched savings

accounts to help you save for an expense related to employment

! Home Buyer Assistance Programs ! Something Else? Maybe EITC?

*Keep in mind - if you receive additional benefits other

than SSDI your assets may impact your eligibility!

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Partnering with Plan to work

What we can do for you: ! Be the experts on federal, state, and local benefits for

you

! Work alongside you in planning ahead for your future

! Be a resource and a hub of information to collaborate with family members, friends, and service providers

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How to Contact Us

www.PlantoWork.org Toll-free statewide hotline: 1-866-497-9443/1-877-676-4754 (TTY) Emma: (509)209-2602 emmah@community-minded.org