PowerPoint - Interwork Institute

Report
SSI Work
Incentives:
Make Disability
Benefits Work for
You!
Karla
Bell,Incentives:
Program Manager
SSI Work
Make
CHIIP/SDSU
Interwork
Disability Benefits
Work for
Institute
You!
Getting Started
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Overview
 Myths
about SSI and Work
 Social
Security Disability Benefits Overview
 How
earned income affects SSI
 Ways
to maximize SSI benefits
 Keeping
 Tools
Medi-Cal and IHSS while working
and Resources for benefits and
employment planning
Myths
If I go back to work:
I’ll
lose my cash benefits
I’ll
lose my Medi-Cal and IHSS
If
my disability worsens and I
can’t continue to work, I won’t
be able to get back on benefits
SSI? SSDI? What’s What?
Social Security Disability
Supplemental Security
Insurance (SSDI) or Title II Income (SSI) or Title XVI
Must meet SSA disability criteria
Insurance Program
Needs Based
FICA contributions/work
history
Paid from Title II Trust Fund
Resource Limits: $2,000 for
individual; $3,000 for couple
Paid from tax fund
5 month waiting period
No waiting period
Monthly payment depends
Payment fluctuates with
on average lifetime earnings income, state supplements,
etc
Medicare: 2 year waiting
period
Medicaid (Medi-Cal):
Immediate eligibility
2012 California SSI
payment rates
2012 California SSI Monthly Payment Rates
 $854.40 (Individual-own household)
 $625.17 (Individual-household of another)
 $938.40 (Individual-no cooking facilities)
 $909.40 (Blind individual)
 $680.17 (Blind-household of another)
 $1444.20 (Couple)
 $1591.20 (Blind Couple)
Rates effective January 2012
SSI Resource Limit:
 $2000 (individual)
 $3000 (couple)
How do I find out
what benefits I
receive?

Benefits Planning Query (BPQY)
 A brief report with details about your SSI and/or SSDI
benefits, health coverage and work and earnings history
 Request from your local Social Security Office
 Call the Social Security Administration (SSA) at: 800-7721213 (voice); 800-325-0778 (TTY)
 Learn more about the BPQY on Disability Benefits 101:
http://ca.db101.org/news/news_1685.htm
 A Community Work Incentives Coordinator (WIPA projects)
will request a BPQY for you as part of benefits counseling
SSI Work
Incentives

Going to work can increase overall income

Your SSI payment amount is adjusted when a person has other
sources of income (earnings, SSDI, etc.)

Work Incentives allow income to be excluded in order to maximize
the SSI amount when a person is returning to work

To use most work incentives:
 Tell Social Security that you have gone to work or
 Report changes in your earnings

Some work incentives require you to ask Social Security to
determine if you can use them
How Earnings Affect
SSI Payments

Social Security counts less than half of your earned income

Social Security uses gross earnings (before taxes) to decide how
much to subtract from SSI check

The first $85 of earnings is not counted ($20 General Income
Exclusion and $65 Earned Income Exclusion)

After subtracting these amounts from gross earnings, Social
Security divides the remaining earnings by two

The remainder, called “countable income”, is then subtracted
from the amount of the original SSI check

The amount left over is the person’s adjusted SSI payment
How Amount of Adjusted SSI Check is calculated:
Step One:
$885.00 Gross Monthly Earnings from Work
-$20.00 General Income Exclusion
-$65.00 Earned Income Exclusion
÷2
=$400.00 Countable Earned Income
Step Two:
$854.40 SSI Payment (California 2012 rate)
-$400.00 Countable Earned Income
=$454.40 Adjusted SSI Payment While
Working
Available Income
$885.00 Gross Monthly Earnings from Work
+$454.40 Adjusted SSI Payment
=$1339.4 Total Spendable Monthly Income
0
Compared to $854.40/month
without income from work
Using Work Incentives
to Maximize Benefits
 Impairment
 Blind
Work Expenses (BWEs)
 Student
 Plan
Related Work Expenses (IRWEs)
Earned Income Exclusion (SEIE)
to Achieve Self-Support (PASS)
Impairment Related
Work Expenses
(IRWE)
Documented expenses for services or items that are
related to one's disability, needed in order to work
and are paid out of pocket and not reimbursed
 The cost may be pro-rated over a 12-month period for
nonrecurring expenses
 Examples:







Personal assistance services
Assistive Technology
Prescription drug co-payments
Costs related to service animals
Supplements or expendable medical supplies
No fixed list-negotiate IRWEs with Social Security
Example: IRWE
and SSI

Jack is 24 years old and lives in his own apartment

He receives $854.40/month from SSI

He begins a new job that pays him $1000 in gross monthly earnings

He has a physical disability and he cannot use available public
transportation and cannot drive himself

He pays a driver to transport him to his job

He also pays out of pocket for medical supplies and supplements

These services and items cost him $300/month and qualify as
IRWEs
How Jack’s Adjusted SSI Check is calculated:
Step One:
$1000.00 Gross Monthly Earnings from Work
-$85.00 General & Earned Income Exclusions
-$300.00 IRWEs
-$615.00 Remaining Earnings
Step Two:
$615.00 Remaining Earnings
÷2
=$307.50 Countable Earned Income
How Jack’s Adjusted SSI Check is calculated:
Step Three:
$854.40 SSI Payment (California 2012 rate)
-$307.50 Countable Earned Income
=$546.90 Adjusted SSI Payment While Working
Step Four:
$546.90 Adjusted SSI Payment
+1000.00 Work Earnings
-$300.00 IRWE
=$1246.90 Total Available Income
Blind Work
Expenses (BWE)

For SSI beneficiaries whose primary diagnosis is blindness

Allows the exclusion of any work related items that are paid
out of pocket and not reimbursed

BWEs do not need to be related to blindness or any
impairment

Examples: Service animal expenses, fees, State, Federal &
local taxes, visual & sensory aids, driver services,
transportation to and from work, childcare, meals consumed
at work, union dues, uniforms, reader services, vehicle
modification, mandatory pension contributions, training to use
an impairment-related item, translation of materials into
Braille
Example: BWE
and SSI

Jill is 30 years old, blind and lives in her own apartment

She receives $909.40/month from SSI

She begins a new job that pays her $1800 in gross monthly
earnings

She can deduct the cost of transportation to work regardless
of whether her blindness required any specialized
arrangement

Costs related to blindness are also included so she can
deduct expenses for adaptive computer software or service
dog expenses

She also can deduct income taxes, union dues and meals at
work

Her expenses cost her $500/month and qualify as BWEs
How Jill’s Adjusted SSI Check is calculated:
Step One:
$1800.00 Gross Monthly Earnings from Work
-$85.00 General & Earned Income Exclusions
÷2
$857.50 Remaining Earnings
Step Two:
$857.50 Remaining Earnings
-$500.00 BWE
=$357.50 Countable Earned Income
How Jill’s Adjusted SSI Check is calculated:
Step Three:
$909.40 SSI Payment (California 2012 rate)
-$357.50 Countable Earned Income
=$551.90 Adjusted SSI Payment While Working
Step Four:
$551.90 Adjusted SSI Payment
+1800.00 Work Earnings
-$500.00 BWE
=$1851.90 Total Available Income
IRWE & BWE

All Blind and Impairment Related Work
Expenses must be verified by your local
Social Security field office

Provide them with original receipts or
canceled checks of the expenses

Social Security will determine if the expense
may be deducted

Request in writing in order to use appeal
rights (if necessary)
Student Earned
Income Exclusion
(SEIE)
 SEIE
allows young people who are in school to test their
ability to work without any reduction in their SSI check
 For
SSI recipients under the age of 22 and regularly
attending school, college or training to prepare for a
paying job
 Social
Security can exclude up to $1640 of earned
income per month from the student’s countable earnings
when calculating their SSI payment
 2012 monthly exclusion will be $1,700/month
 Maximum
yearly exclusion:
 $6600 in 2011
 $6840 in 2012
Student Earned
Income Exclusion
(SEIE)
 “Regularly
attending school” means taking one or
more courses of study and attending classes:
 In
college or university for at least 8 hours a week
 In
grades 7-12 for at least 12 hours a week
 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)
 May
be approved for less time if it is due to a
reason beyond student’s control, such as illness
Student Earned
Income Exclusion
(SEIE)
 School
enrollment can be verified with an ID
Card, tuition receipt, or other evidence
 Social
Security can contact the school to verify
attendance
 It
is recommended that student status is
clearly indicated in writing when notifying
Social Security of employment
 SEIE
should be applied automatically when
earnings and student status are reported
Example: SEIE
and SSI

Lola is 20-years old and she lives with her parents

Starting in January 2012, she will be a full time student at her
local community college

Because she still lives at home and is not paying rent, she
receives a monthly SSI check of $625.17

Starting in April of 2012, she will be working ten hours a week
at the rate of $15/hour as a peer mentor at her local
independent living center

Her gross monthly income from work is $645.00

Because she is a student, she can use the SEIE, which allows
her to exclude her earnings up to $1700 per month (up to a
total of $6840 per year) from her countable income for SSI
Example – SEIE and SSI Calculation:
Step One:
$645.00 Gross Monthly Earnings from Work
-$645.00 SEIE
$0.00 Total Countable Earnings
Step Two:
$625.17 SSI Payment (California 2012 rate)
-$0.00 Countable Earnings
$625.17 Adjusted SSI Payment
Step Three:
$625.17 Adjusted SSI Payment
+$645.00 Work Earnings
=$1270.17 Total Income
SEIE Yearly
Exclusion
 Maximum
yearly exclusion is $6840 in
2012
 If
Lola earns $645.00/month, and works 9
months (April-December) she could
exclude the entire $5805.00 total earnings
 Can
remain in effect even when you are on
summer break as long as you resume
school when school reopens
Plan to Achieve SelfSupport (PASS)
 A written
plan that allows recipients of SSI to set aside
income and/or resources for a specified period of time
to be used to achieve a chosen occupational goal
 SSI
recipients are eligible
 PASS may allow SSI eligibility for SSDI beneficiaries
 A way
that SSA assists people with disabilities in their
own efforts to join or re-enter the workforce
 Examples
of PASS expenses: training, transportation,
equipment and tools, child care, assistive technology,
job coach, business start up funds, vehicle
modifications, professional attire
28
Plan to Achieve SelfSupport (PASS)

You must have some form of countable income and/or
resources to set aside in the PASS
 Funds set aside in a PASS are not counted as income when
determining SSI payment
 Funds set aside don’t count toward SSI resource limits

A PASS is intended to encourage SSI recipients to eventually
become self-supporting (i.e. occupational goal will lead to a
significant reduction in SSI)

To learn more watch our archived PASS webinar:
http://interwork.sdsu.edu/chiip/training.php?page=webinars
29
Example: PASS
and SSI

Keiko receives $854.40/month in SSI

She is earning $550.00/month working part-time at a local coffee house

She attends college full-time and she has been using the Student Earned
Income Exclusion, but she is turning 22 next month

Her goal is to become a licensed practical nurse which includes state
certification testing

She has been saving money to buy a car and she has almost $1,800 in her
savings account, but she knows that she cannot save much more without
losing her SSI

She would like to write a PASS for:
 School and employment expenses
 To buy a used car since there is no public transportation available to or
from any local hospitals or nursing homes
Example—SSI and PASS Calculation:
$550.00 Gross Monthly Earnings from Work
-$85.00 General & Earned Income Exclusions
$465.00 Remaining Earnings
÷2
$232.50 Countable Earned Income
-$232.50 Contributed to PASS
$0.00 Adjusted Countable Income
Example—SSI and PASS Calculation:
$854.40 SSI Payment (California 2012 rate)
-$0.00 Countable Income
=$854.40 Adjusted SSI Payment
Available Income
$854.40 Adjusted SSI Payment
+$550.00 Earnings from Work
-$232.50 Contributed towards PASS
$1,171.90 Total Available Income
Benefits of a PASS
Plan

Often notice no difference in available income with or without a
PASS (depending on amount set aside)

Ownership of items purchased

Personal investment in employment goals

Ability to supplement services from other agencies; cover costs
that other agencies cannot

Viable option for self-employment goals

Offers alternative or supplement to traditional Department of
Rehabilitation services

Allows for self-directed employment plan
Keeping Medi-Cal and
IHSS While Working
Section
1619(b)
Medi-Cal
Program
Working Disabled
SSI and Medi-Cal:
1619(b)

1619(b) is a work incentive that allows working SSI recipients to keep
FREE Medi-Cal (No Share-of-Cost)

Medi-Cal retained when SSI payment is reduced to $0.00 per month due
to earned income

Free Medi-Cal coverage continues until earnings reach a threshold
amount:
 $36,423.00 (non-blind)
 $37,743.00 (blind)
 These are 2012 amounts for California

People with high medical costs or publicly funded attendants (i.e. IHSS)
can earn even more (Individualized Threshold)

Benefits can start again if you stop working or your earnings decrease
(Reinstatement)
1619(b)
Qualifications
To qualify:

Have been eligible for an SSI cash payment for at least
1 month;

Would be eligible for cash payment except for earnings;

Still be disabled or blind;

Still meet all other eligibility rules, including the
resources test;

Need Medi-Cal in order to work;

Have gross earned income that is insufficient to replace
SSI, Medi-Cal, and any publicly funded attendant care
(IHSS)
1619(b):
Individualized
Threshold

Individualized Threshold: threshold can be adjusted on a case-by-case basis

Higher Individualized Threshold if:



Blind Work Expenses (BWE)

Impairment Related Work Expenses (IRWE)

Plan to Achieve Self-Support (PASS Plan)

Publicly Funded Personal Attendant (i.e. In-Home Supportive Services)

Medical Expenses above State Average
Social Security’s Programs Operation Manual reference:

SI 02302.050 Individualized Threshold Calculation

https://secure.ssa.gov/apps10/poms.nsf/lnx/0502302050
Area Work Incentives Coordinators

http://www.ssa.gov/sf/awic.htm
Medi-Cal Working
Disabled Program

The Medi-Cal Working Disabled Program allows individuals to
earn up to $55,476/year and keep their Medi-Cal!
 Eligible couples can earn up to $74,580/year
 Even higher wages are allowed with IRWEs

Affordable monthly premiums to access Medi-Cal and IHSS
without a share-of-cost
 $20-$250 for individuals
 $30-$375 for couples

IRS approved Retirement Plans allowed and not counted towards
asset limit

Save your earned income in a separate identifiable account with
no cap
Getting Back on
Benefits
 1619(b)
- SSI cash benefits can start again
if you stop working or your earnings
decrease (Reinstatement)
 Expedited
5
Reinstatement (EXR):
year period after SSI benefits and payments
stop due to work and earnings
 If a beneficiary stops working their benefits can
be reinstated without having to file a new
application
 Up to 6 months provisional benefits payable
during EXR decision making process
 Medical decision needed
Benefits Planning Tools,
Skills and Resources
for Results

The Benefits Binder: your notebook and log of phone calls,
office visits, and names of service staff you contact. File original
paycheck stubs, government letters and receipts here.

Reporting Requirements: Who is responsible, when? If you
have a payee, the payee is responsible to report changes to
Social Security. If not, it’s the beneficiary. Report income and
other life changes timely

Know your appeal rights. A Notice of Action explains them.

Utilize Benefits Planning Tools and Resources: Disability
Benefits 101 website (www.db101.org), and local benefits
planners.
These tools, rules and skills can result in timely and improved
customer service with benefit programs
Resources

Disability Benefits 101
www.disabilitybenefits101.org

SSA Red Book-Guide to Work Incentives
www.ssa.gov/redbook

Work Incentives Planning and Assistance (WIPA) Projects

Free benefits counseling by Community Work Incentives
Coordinators (CWIC)

For SSI, and SSDI recipients ages 18-64
https://secure.ssa.gov/apps10/oesp/providers.nsf/bystate
Resources
Area Work Incentives Coordinators (AWIC)
 Social Security’s work incentives experts
 Help SSI and SSDI beneficiaries who are having trouble getting
accurate information and application of work incentives at local
SSA offices
www.ssa.gov/sf/awic.htm
Disability Rights California
 Protection and Advocacy for Beneficiaries of Social Security
(PABSS)
 Assistance with appeals, overpayments, problems with
Employment Networks, workplace discrimination
http://www.disabilityrightsca.org/
800-776-5746
TTY 800-719-5798
Resources
Plan to Achieve Self-Support
Find your PASS Cadre:
www.socialsecurity.gov/disabilityresearch/wi/passcadr
e.htm
PASS Plan form:
www.socialsecurity.gov/online/ssa-545.html
The Work Site
www.ssa.gov/work
Questions
You are welcome to contact
Karla Bell at:
619-594-5381
[email protected]
www.talentknowsnolimits.info
www.tknlyouth.org
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Credits
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available for this webinar:
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survey:
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