Making
Work
Part of
the Plan
Work Incentives for People with
Disabilities
The Landscape
For people with disabilities…
the unemployment rate is roughly 10
times higher than the national average
What keeps people with disabilities from
working?
Attitudes…
Fears…
Misconceptions…
• Family, friends, employers and society
• People with disabilities can’t work
• People with disabilities will lose benefits
if they work – especially health care
Medical Assistance for Employed
Persons with Disabilities
MA-EPD
A work incentive/health care program
MA-EPD Eligibility at a glance
•
•
•
•
•
•
Age 16 to 64
Certified disabled
Employed
Pay taxes
Meet $20,000 asset limit
Pay premium
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
• Individuals who can’t be certified by SSA
due only to earnings over SGA ($900/month
in 2007) 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.
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
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
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
• 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.
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
• If six-month averaged earned income is
more than $65, the individual is eligible for
MA-EPD though the 6-month budget period
as long as all other eligibility factors are
met.
 E.g., Budget period November – April.
Projected earnings of $120 in November,
February, March and April but $60 in
December and January due to reduced hours
during holidays. Six-month averaged income
is $100/month, therefore, the client is eligible
for the entire budget period.
• If the 6-month averaged earned income is $65 or
less, determine earned income eligibility separately
for each month.
• E.g., Budget period May – October.
• Projected earnings of $90 in May, June and July.
• Client reports surgery scheduled in August
resulting in $0 earnings for August, September,
and October.
• Six-month averaged earned income would be
$45/month, which would make client ineligible for
entire budget period.
• Instead of averaging, look at each month
individually. (Client would be eligible for 4-month
medical leave for August, September and October.)
Earned Income Verification
• Acceptable earned income verifications
include:
• pay stubs
• employer statement (DHS-2146)
• tax forms or business records

Continued on next slide
• 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
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
• 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
• 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
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.
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
• 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
• 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”
• 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/maepd (scroll
down to “MA-EPD monthly premium
esitmator”)
Still more…
• 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
• DHS mailing to MA/DX enrollees
Still need more?
Disability Linkage Line
1-866-333-2466
Beth Grube
DHS Health Care Eligibility/Pathways to Employment
651-431-2412
Beth.grube@state.mn.us
MAXIS email “QS”
Work Incentives Connection
Work Incentives Planning and
Assistance (WIPA)
Yikes--The Connection Again?
The Connection
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?”
Partnership: DEED, DHS & SSA, funded
mostly by SSA. Now equal $$$$.
News: Became a nonprofit agency in
October 2006.
Connection Services
• Focused on providing information.
• Provided through phone hotline.
Primary services include:
• Specialized information and referral
• Problem-solving and advocacy
• Benefits Analysis
• Outreach on changes in benefit
programs.
What are Work Incentives??
Work Incentives are special rules that
Social Security uses to encourage an
individual to work.
• On Supplemental Security Income (SSI), work
incentives increase the amount of the SSI
payment.
• On Social Security Disability Insurance (SSDI),
work incentives let individual keep their SSDI
cash payment when earning more than $900
in 2007.
Work Incentives To Look
For:
• Impairment Related Work Expenses (IRWE)
• 1619(b) to continue Medical Assistance
• Plans for Achieving Self-Support (PASS)
“THE FORMULA”
Gross Earnings:
Minus General Exclusion:
Minus Earned Income Exclusion:
Divided by 2:
Countable Earnings
$615
- 20
$595
- 65
$530
÷ 2
$265
2007 Federal Benefit Rate (FBR): $623
Minus countable earnings: - 265
SSI PAYMENT: $358
Impairment Related Work
Expenses (IRWE)
• An 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
Examples of IRWEs
• Medication copays
• Adaptive Equipment
• Transportation different from what nondisabled worker use for work
• Special assistance – note takers,
readers, interpreters.
Impairment Related Work
Expense (IRWE)
Gross Earnings:
Minus GE and the EIE:
Impairment Related Work Expense:
Divided by 2:
Countable Earnings
$615
- 85
$530
- 80
$450
÷ 2
$225
2007 Federal Benefit Rate (FBR): $623
Minus countable earnings: - 225
SSI PAYMENT: $398
SSI with & without IRWEs
Mike is on SSI, earning $615/month. He
has $80 in IRWEs each month that have
been approved by the SSA.
• Without IRWEs, SSI payment is $358.
• With $80 in IRWEs, SSI check is $398.
The IRWE results in a
$40.00 increase in SSI payment!
SSI and High Wages
Step 1.
Step 2.
Step 3.
Step 4.
$1,350.00 Earned Income
- 20.00 General Income Exclusion
$1, 330.00
- 65.00 Earned Income Exclusion
$1,265.00
÷ by 2 = $632.50 Countable Income
$623.00 2007 Federal Benefit Rate
- 632.50 Countable Income
$
0 SSI Payment
What happens to Medical Assistance
eligibility?
Work Incentives 1619(b)!
Allows Medical Assistance (MA) coverage
to continue after the individual’s earned
income becomes too high to allow an
SSI cash payment.
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 $44,009 per
year.
Plan for Achieving Self-Support
(PASS)
PASS allows an individual to set aside
income or resources for a set amount of
time to achieve a specific vocational goal.
• Examples of possible PASS goals include:
Education
Equipment
Transportation
• The funds that are set aside are not used to
calculate the individual’s SSI payment.
PASS EXAMPLE:
Gross Earnings:
Minus GE and the EIE:
Countable Earnings
Divided by 2:
$615
- 85
$530
÷ 2
$265
PASS deposit: -$265
0
2007 Federal Benefit Rate (FBR): $623
Minus countable earnings:
-0
SSI PAYMENT: $623
Myths
about working and benefits
• Working will cause you to lose your benefits
and this is a bad thing!
• You will be worse off financially by working!
• You will lose your health care if you work!
MYTH BUSTING
Using Benefits Analysis and Work
Incentives
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
Anne, Not Working
SSDI
SSI
MSA
MA
Medicare
Food Support
Subsidized Housing
Available Income
$575.00
$ 68.00
$ 81.00
Yes
Yes
$ 10.00
-$207.00
$527.00
Earning $650 per
Anne
month vs. not working
Wages:
Minus 15% taxes
SSDI:
SSI:
MSA:
MA:
Medicare:
Food Support:
Subsidized Housing:
Available Income:
Not Working Earning $650/mo.
$650.00
$0.00
-$ 97.50
$0.00
$575.00
$575.00
$ 0.00
$68.00
$ 0.00
$81.00
Yes
Yes
Yes
Yes
$10.00
$10.00
-$373.00
-$207.00
$764.50
$527.00
$237.50 - A 45% increase in available income
Anne earning even more!
Wages:
Minus 15% taxes:
SSDI:
SSI:
MSA:
MA:
Medicare:
Food Support:
Subsidized Hsng.:
Available Inc.:
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
$356.00 - A 67.5% increase in available income!
Significant Earnings for Anne
Wages:
Minus 15% taxes:
SSDI:
SSI:
MSA:
MA:
Medicare:
Food Support:
Subsidized Housing:
Available Income:
Not
Working
$0
$0
$575.00
$68.00
$81.00
Yes
Yes
$10.00
$207.00
$527.00
Earning
$1,400/mo
$1,400.00
$ 210.00
$0
$0
$0
Yes, 1619(b)
Yes
$0
$409.00
$781.00
$254 - A 48% increase in available income!
Healthcare with SSDI and
working
Social Security Disability Insurance (SSDI)
• Medicare – after 24 months on SSDI.
• Extended Medicare---off SSDI, but may continue to
receive Medicare for at least 93 months after the
end of the Trial Work Period. Still disabled.
• Medical Assistance for Employed Persons
with Disabilities (MA-EPD)
• State Medical Review Team process if no longer
eligible for SSDI benefits. Still disabled.
Healthcare with SSI
Medical Assistance – Automatic eligibility
with SSI, but must apply at the county.
• 1619(b) – When work off SSI
• Medical Assistance for Employed
Persons with Disabilities (MA-EPD) –
If working and 1619(b) eligibility ends.
ONE MORE THING…….
Disabled Adult Child
What are DAC benefits?
• DAC stands for Disabled Adult Child.
• The child:
• receives SSA benefits based on a parent’s
work record not their own
• disabled prior to age 22---meets SSA’s
definition of disability
• is at least age 18
• has a parent who is eligible for disability or
retirement benefits, or is deceased
DAC Disregard for MA
• DAC payment may make individual ineligible
for SSI (thus losing MA without a spenddown).
• The Disabled Adult Child (DAC) Disregard
allows the DAC payment to be excluded when
calculating the spenddown for MA. Only
applies to people who lose SSI eligibility due to
receipt of the DAC payment.
DAC Disregard for MA cont . . .
Qualifiers:
•
•
•
•
Must be 18 years old or older, and
Were blind or disabled before age 22, and
Were eligible for SSI due to disability, and
lost SSI after 7-1-87 due to receipt of DAC
benefits under a parent’s record.
DAC Disregard for MA cont . . .
Spenddown Calculation:
• The DAC Disregard allows the
spenddown to be calculated without
using the DAC payment in the
calculations. It has the effect of reducing
or eliminating the MA spenddown, due
to the receipt of DAC benefits.