PowerPoint - Interwork Institute

SSI Work
Make Disability
Benefits Work for
Program Manager
SSI Work
Disability Benefits
Work for
Getting Started
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 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
If I go back to work:
lose my cash benefits
lose my Medi-Cal and IHSS
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
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,
Medicare: 2 year waiting
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
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:
 A Community Work Incentives Coordinator (WIPA projects)
will request a BPQY for you as part of benefits counseling
SSI Work
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
=$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
Available Income
$885.00 Gross Monthly Earnings from Work
+$454.40 Adjusted SSI Payment
=$1339.4 Total Spendable Monthly Income
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
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
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
=$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
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
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
She can deduct the cost of transportation to work regardless
of whether her blindness required any specialized
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
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
$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
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
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
 “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
 School
enrollment can be verified with an ID
Card, tuition receipt, or other evidence
 Social
Security can contact the school to verify
 It
is recommended that student status is
clearly indicated in writing when notifying
Social Security of employment
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
 Maximum
yearly exclusion is $6840 in
 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
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
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:
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
$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
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
Working Disabled
SSI and Medi-Cal:
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
 $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
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
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
Area Work Incentives Coordinators
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
 1619(b)
- SSI cash benefits can start again
if you stop working or your earnings
decrease (Reinstatement)
 Expedited
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
 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
These tools, rules and skills can result in timely and improved
customer service with benefit programs
Disability Benefits 101
SSA Red Book-Guide to Work Incentives
Work Incentives Planning and Assistance (WIPA) Projects
Free benefits counseling by Community Work Incentives
Coordinators (CWIC)
For SSI, and SSDI recipients ages 18-64
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
Disability Rights California
 Protection and Advocacy for Beneficiaries of Social Security
 Assistance with appeals, overpayments, problems with
Employment Networks, workplace discrimination
TTY 800-719-5798
Plan to Achieve Self-Support
Find your PASS Cadre:
PASS Plan form:
The Work Site
You are welcome to contact
Karla Bell at:
[email protected]
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