WIPA Training for AWICs
Session 4
May 13, 2015
1
Providing Effective WIPA Services
The Work of the CWIC:
– Preparing for Individualized WIPA Services –
Information Gathering, Benefits Verification, and
BPQYs
– Resolving issues brought by the beneficiary or
identified in the verification process; communication
with the local field office and AWIC as needed to
address issues
– Developing Benefits Summary and Analysis Reports
and Work Incentives Plans
– Providing Individualized WIPA Services and Ongoing
Follow-up
2
Pulling it All Together
• The CWIC’s role includes:
– Information gathering and verifying benefits
– Planning the level and intensity of services needed by the
beneficiary
– Making referrals for supports and services
– Providing individualized analysis pertaining to the employment
goal
– Planning action steps with the beneficiary
– Guiding the beneficiary in benefits literacy and benefits
management
– Facilitating the use of work incentives
– Providing ongoing education and follow-up over time
3
Preparing for Individualized WIPA
Services
4
Preparing for Individualized WIPA Services
CWICs provide individualized WIPA services to those who:
– Meet the specific eligibility criteria:
• Age 14 to Full Retirement Age
• Disabled per Social Security's definition
• Receiving or approved to receive SSI or Title II
based on disability
• Receiving Medicaid under 1619(b), or
• Receiving only SSI State Supplementary payment
• Receiving Medicare under EPMC as a former Title II
disability beneficiary
5
Two Service Categories
Individualized Work Incentives
Planning & Assistance
• Requires an in-depth intake
• Long-term services
• Services rendered in variety of
ways
• Requires verification of
benefits
• Includes benefits summary &
analysis and work incentive
plan development
• Continued follow up services
Basic Information & Referral (I&R)
• First contact with Help Line call
center or WIPA project
• Can often be handled via
phone, mail, and email
• Basic information about
benefits, work incentives,
programs & services
• Beneficiary may not be ready
to pursue employment
• Majority will move on to
receive intensive WIPA services
6
Determining Eligibility and Priority
To determine where the person is on the Employment
Continuum and assess importance and urgency of presenting
needs, CWICs screen to answer the following questions:
– Is the caller eligible for WIPA services?
– How close are they to work?
– What services are needed?
7
Determining Eligibility and Priority
Questions for Beneficiaries
Determining the Priority:
• Are you currently working or actively seeking employment?
• Do you have a job offer pending or are you on the brink of starting
a small business or otherwise becoming self employed?
• Are you actively seeking a job or working to start a small business?
• Are you preparing for work in any way?
• Have you taken any steps to start pursuing employment?
• Are you seriously considering pursuing paid employment or self
employment in the near future?
• Do you have any interest in finding out how paid employment or
self employment might affect your benefits?
8
Determining Eligibility and Priority
• The beneficiary does not have to be employed, have a job
offer, or be actively engaged in a return to work effort to be
eligible for WIPA services, but may be lower priority.
• The beneficiary may need assistance with non-employment
related needs if she/he is also employed, pursuing
employment, or interested in employment.
• The beneficiary may be receiving other federal benefits in
addition to receiving or approved for Social Security benefits.
• Individuals in 1619(b) status or in Title II suspension during
EPE are great candidates for WIPA services.
• Individuals with a recent decision of SGA are high priority.
9
Determining Type, Intensity and Duration of
WIPA Services
• All beneficiaries are NOT equal in terms of presenting
needs; CWICs must conduct a “triage.”
• Determination must be made as to how close the needs
are to the mission of WIPA, which includes:
– Increase # of Social Security beneficiaries who work,
– Support beneficiaries in maintaining employment,
– Provide Work Incentives assistance that enables
increased self sufficiency.
10
Importance versus Urgency
Importance of a presenting need is directly related to where
the individual is on the employment continuum.
• Low importance: not considering employment or in the
contemplation stage
• High importance: preparatory stage, job search stage,
employment stage
Urgency relates to issues that are pressing, require
immediate attention or time-sensitive.
11
Planning Delivery of WIPA Services
• Importance and urgency determinations guide the CWIC in
determining appropriate service delivery:
– Type & Intensity: individualized work incentives
counseling or generic information and referral services?
– Service Method: face to face, or phone/internet/email?
– Duration of Service: multiple contacts or extensive followup over time?
– Service Timing: is an immediate response needed, or can
services begin at a later date?
12
Information Gathering
Information Gathering Involves:
• Identifying the presenting problem, needs, or questions,
• Determining the information necessary to resolve the
problem or meet the beneficiary’s need,
• Verifying ALL benefits information when providing casespecific advisement & individualized WIPA services.
13
Information Gathering:
Family Systems Approach
• Often, return to work may affect benefits of family
members receiving auxiliary benefits, or for SSI, additional
work income may affect individuals in the same
household, such as SSI eligible couples.
• CWICs must address the effect of return to work on Social
Security benefits and other federal and state programs.
14
Information Gathering:
Focus on Financial Stability
• Beneficiaries generally want to know “How much can I earn?”
(focus on limits) because of the belief that there are income
and resource limits when working and receiving benefits.
• CWICs must focus on the person’s potential, not benefit limits
by focusing on financial stability:
– Exploring the beneficiary’s monthly financial
requirements,
– Exploring desired earnings goals,
– Referring him/her to an appropriate resources for
assistance in achieving goals and addressing financial
stability needs.
15
Collecting Required Information
• Social Security requires that WIPA projects collect,
analyze, and summarize specific data elements:
– Beneficiary Information
– Employment Information and Outcomes (including
employment and earnings goals)
– Benefits (current and future)
– Work Incentives to be Used
– Services to be Used
16
Verification of Benefits
• Required PRIOR to offering any specific advisement,
before writing a BS&A, etc.
• ALL other federal, state and local benefits that the
beneficiary may be receiving must be verified, including
Ticket assignment, spouse or children’s benefits if
necessary.
• CWICs clarify inconsistencies or abnormalities in
information gathered.
• CWICs use signed consents to verify Social Security
benefits (SSA-3288).
• Other agency releases are used to verify other state or
federal benefits.
17
Obtaining the Benefits Planning Query
(BPQY)
• CWICs are required to obtain comprehensive information
about Social Security disability benefits, earnings history,
status of work incentives use for all WIPA service
recipients.
• May request this from the AWIC, WIL, or have beneficiary
request this themselves.
• Local office may not charge for the BPQY – consult POMS
reference GN 03305.001 Disclosure With Consent –
General for more information.
18
Resolving Issues Identified During
Verification of Benefits
19
Common Areas Where CWICs May Request
Information or Assistance
• Clarification of information on the BPQY, for example:
– Cash benefit discrepancies
– Clarification of work incentives previously used
– Work activity not listed on the BPQY
• Dual entitlement on more than one SSN—Is there another
BPQY to be retrieved?
• Other information on the MBR that clarifies discrepancies
in benefit amounts
– Clarification of garnishments or taxes withheld
• Blind status not listed on T2 or T16 or stat blind update
needed on Social Security record.
20
Common Areas Where CWICs May Request
Information or Assistance
• Questions about specific beneficiary issues, for example:
– Deeming
– Section 301
– Return to work within 12 months of onset
– Implications of work on T16 Married couples
– Self-employment
– Subsidy or IRWE development
– Notices of Overpayment
– Work CDRs and SGA Determinations
– Changes in in-kind support and maintenance
21
Common Areas Where CWICs May Request
Information or Assistance
• Developing past work for beneficiaries, for example:
– Work activity that has not been reported or evaluated
– Reported work activity that is not recorded on the
BPQY
– Work CDRs in process
• Clarification of policies, for example:
– Assistance in understanding the POMS that apply to
specific work issues or uncommon benefit situations
22
Helpful Information for CWICs
• Current list of AWICs
– Contact information (telephone and fax)
• Current list of WILs (T2 ,T16 or both)
– List of coverage for area offices
– Telephone and fax numbers
• Who to contact for specific issues
• Best times to reach AWIC or WILs
• Best method for contacting
23
Developing Benefits Summary and
Analysis Reports and Work Incentives
Plans
24
What is a Benefit Summary & Analysis
(BS&A)?
• A Benefits Summary & Analysis is a formal written report
developed for beneficiaries enrolled in intensive WIPA services
who:
– have an earnings goal, and
– need individualized, case-specific work incentives information
or advice that is customized to the earnings goal
• Summarizes current benefits and offers case-specific information
about the use of work incentives.
• Outlines the beneficiary’s employment options and use of work
incentives.
• Assesses the potential impact of employment and other changes on
federal, state and local benefits.
25
Who Receives a BS&A?
• Beneficiaries are considered to have an earnings goal and need a
BS&A if there is:
– A defined employment goal but no earnings amount in mind,
– No employment goal defined, but an indication of monthly
earnings needed to meet financial goals,
– No specific job goal, but the beneficiary knows how many hours
per week they’d like to work and how much they would like to
earn per hour,
– A range of hours and/or hourly wage the beneficiary would like
to work,
– No employment goal but is interested in knowing how work
may impact benefits,
– A desire to eliminate the need for disability benefits and the
beneficiary wants to know what level of earnings would
accomplish this.
26
Who Does NOT Require a BS&A?
• Beneficiary has no immediate plans to pursue
employment and is currently seeking only general
information on the potential effect of earnings on
disability payments.
• CWIC provides only basic information and referral
services.
• An earnings goal has not been identified and cannot be
defined through probing questions.
• Beneficiary states that individualized services are NOT
wanted, or refuses to allow verification of benefits.
• Alternatives to the BS&A can be considered.
27
BS&A Considerations
• CWICs must determine where the person is on their journey
to employment and consider the following:
– What is the next step on the road to employment and
what does the person need in order to take the next step?
– How much information is needed to facilitate taking the
next step?
– Are there any barriers to employment?
– What specific services and supports does this person
need?
– What other members of the Employment Support team
should the CWIC coordinate with to support the
beneficiary?
28
The BS&A Development Process
To develop an individualized BS&A, CWICs must:
•
•
•
•
•
Gather information and identify present problems
Verify all benefits information
Analyze the information – provide specific information about how
earnings goal will impact Social Security benefits and other federal
and state benefits; explain past/future use of work incentives;
Summarize the analysis in a formal, written report with supporting
documents:
– SSI calculation sheets
– Illustrations of use of TWP, etc
Advise beneficiary – based on the analysis of the beneficiary’s
specific situation.
29
Information in the BS&A
The BS&A is a narrative that describes:
• Verification of current Social Security benefits and other
federal or state benefits,
• Current employment situation and/or future employment
plans and earnings goal,
• How the current employment situation and/or future
earnings goal will affect Social Security benefits,
• How the current employment situation and/or future
earnings goal will affect public health insurance (Medicare
and Medicaid),
30
Information in the BS&A (continued)
• How the current employment situation and/or future
earnings goal will affect other benefits received (HUD
rental subsidies, SNAP), and/or other benefit issues not
related to employment,
• Employment services and supports the beneficiary may
need to attain the employment and earnings goal,
• Important things to remember or next steps (important
dates or deadlines, reporting, recordkeeping).
31
Presenting the BS&A to the Beneficiary
• CWICs thoroughly review the BS&A with the beneficiary
and any other concerned parties that the beneficiary
desires to be included to ensure understanding.
• Services do not end with the BS&A, rather, it is a starting
point to define services going forward.
• The CWIC and beneficiary review all options, and outline
next steps.
• This is the framework that determines the route going
forward in development of the Work Incentives Plan.
32
What is a Work Incentive Plan?
• A Work Incentive Plan (WIP) is a written document
developed by a CWIC in collaboration with the
beneficiary, and other key stakeholders, which delineates
an individualized action plan for using work incentives to
further the beneficiary’s employment and self-sufficiency
goals.
• It is developed after the BS&A has been completed and
reviewed with the beneficiary.
33
Purpose of the WIP
The WIP provides the framework for ongoing direct service
to guide the effective use of federal, state, and local benefits
and work incentives, and includes:
– Desired return to work and self-sufficiency outcomes
– Related steps or activities necessary to achieve the
outcomes
– Associated target dates or timeframes
The WIP guides the beneficiary towards the goal and refers
back to the items identified in the BS&A.
34
WIP Template Sections
• Accessing Employment Services and Supports
• Resolving Existing Benefit Issues
• Managing Social Security Benefits and Work Incentives
• Managing Federal, State or Local Benefit Programs
• Planning for Future Healthcare Needs
• Follow-Up Contact Plan
35
Providing Individualized WIPA Services
and Ongoing Follow-Up
36
Follow-Up Services
• Services do not stop once the Benefits Summary & Analysis
and Work Incentive Plan are completed!
• Services delivered from this point forward involve the actual
implementation of the WIP.
• Benefits Management is driven by the Work Incentives Plan
– Time spent and supports provided depends completely on
what is agreed upon in the Work Incentives plan
– Intensity of assistance will vary depending on the needs
and preferences of the beneficiary.
37
Proactive Benefits Management
• Proactive follow-up has the following characteristics:
– Services are pre-planned;
– Contact occurs at scheduled intervals as agreed upon by
the CWIC and the beneficiary;
– Interaction between the CWIC and the beneficiary or other
key stakeholders is predicated on events previously
identified in the Work Incentive Plan;
– Interaction provides an opportunity to reassess the
individual’s employment and benefit situation and revise
the WIP if necessary; and
– Follow-up anticipates changes in advance and reduces the
likelihood for negative affects or benefit complications.
38
Ongoing Follow-Up
• Critical touch-points are points in a beneficiary’s experience at which
a transition or change may be expected to occur.
• Touch-points vary depending on the individual, their employment
goal, the type of benefits they receive and myriad of additional
factors.
• The Work Incentive Plan is a valuable tool in which these anticipated
touch-points would be documented and plans made for follow-up.
Touch-point examples:
– Completion of the TWP, EPE. Cessation month
– Identification of a Subsidy or IRWE
– 1619b status
– Age 18 redetermination
39
Supports CWICs Provide
Related to Work Incentives
• Trial Work Period
– Verifying any previous usage
– Helping beneficiaries track TWP usage
– Prepare beneficiary for next steps toward end of TWP
• Extended Period of Eligibility
– Tracking use of EPE months
– Assist beneficiary with completing the SSA 821 or 820
– Paying attention to patterns of work that may indicate
SGA
– Preparing beneficiary for the SGA notices
– Updating WIP action steps
40
Supports CWICs Provide
Related to Specific Work Incentives
• Work CDRs and SGA Determination
– Ensuring the beneficiary understands SGA and is prepared
– Helping beneficiaries understand when income averaging or
unsuccessful work attempt is used
– Helping with subsidy/special condition development
• Asking questions to identify the subsidy/special condition early
in employment
• Meeting with employer or employment specialist, if needed for
development
– Helping with IRWE development
• Helping with documentation of IRWEs
• Reviewing and verifying changes in IRWEs
41
Supports CWICs Provide
Related to Specific Work Incentives
• Helping beneficiaries document SSI Work Incentives
– SEIE, IRWE, BWE, PASS
• Supporting beneficiaries to understand changes in Medicaid or Medicare
– 1619 (b), Medicaid Buy-In, Extended Period of Medicare Coverage, Low
Income Subsidy and Medicare Savings Programs (MSP), Extra-help and
LIS Support
• Supporting beneficiaries to understand Expedited Reinstatement of
Benefits
– Providing information on the EXR
– Tracking the 24 months of cash benefit receipt
– Refreshing beneficiary’s understanding of TWP, EPE, etc.
• Supporting Beneficiaries with Ticket to Work
– Locating Employment Networks
– understanding timely progress
42
Supports CWICs Provide
in Reporting Earnings
Teaching beneficiaries how to report income is one of the
most important jobs of CWICs. They should help beneficiaries
develop methods to organize, prepare and submit earnings
reports. Special considerations include:
– Work Reports within the Title II Disability Program
– Resolving BPQY Issues when Work Reports are not
Timely
– Reporting for the SSI Program
– Using the Automated Reporting System
43
Pulling it All Together
The Employment Supports Team
• CWICs partner with a
variety of entities to
promote successful
outcomes
• Ongoing collaboration
among the Employment
Support Team results in
enhancing the
beneficiary’s selfsufficiency and
successful employment
AWIC
WIL
CR
CWIC
Beneficiary
Return to
Work
Other
Benefit
Programs
44
Employme
nt Services
Other
Community
Supports