Understanding How Understanding How Work Affects SSI/SSDI Work Affects SSI/SSDI

BenefitsBenefits

Developed by the Work

Incentives Planning

and Assistance (WIPA)

Project. WIPA is a

cooperative agreement

between the Social

Security Administration and

the RI Office of

Rehabilitation Services.

What do all the SSS’s Mean???

SSA=

SSDI=

SSI=

SOCIAL SECURITY ADMINISTRATION

SUPPLEMENTAL SECURITY INCOME

SOCIAL SECURITY DISABILITY INSURANCE

What Kind of BenefitsWhat Kind of Benefitsdo you Receive?do you Receive?

Title II

SSDI BenefitsYou are disabled and

have insured status as a former worker.

Must have worked in SSA covered employment.

CDB BenefitsYou were disabled before age 22 and are receivingbenefits on the record ofa parent who is retired, disabled, or deceased.

DWB

You are a qualifying widow/

widower and were found

disabled before the end of a

certain period prescribed by

law. (Not payable

before age 50)

SSDI BENEFICIARIES RECEIVE MEDICARE 24 MONTHS AFTER DATE OF ENTITLEMENT.

What Kind of Benefits do What Kind of Benefits do you Receive?...you Receive?...

SSIYOU MAY RECEIVE THESE BENEFITS

IF:

You are aged ordisabled.

You have little or no other income.

Your resources

do not exceed

$2,000.

In RI, SSI RECIPIENTS AUTOMATICALLY RECEIVE MEDICAID WHEN THEY BECOME ELIGIBLE FOR SSI BENEFITS. THERE IS NO WAITING

PERIOD.

Just a Reminder…Just a Reminder… Work is not the only thing that may cause benefits Work is not the only thing that may cause benefits

to end.to end.

Social Security may do a medical review and Social Security may do a medical review and decide that you have medically improved. If so, decide that you have medically improved. If so, both your cash payments and your health both your cash payments and your health insurance may stop.insurance may stop.

You may no longer be eligible for the workYou may no longer be eligible for the work incentives discussed below.incentives discussed below.

Major SSDI Work Major SSDI Work Incentives:Incentives:

Provided that your impairment continues,Provided that your impairment continues, you will be entitled to the following:you will be entitled to the following:

Trial Work Period (TWP) -Trial Work Period (TWP) - you will receive full SSDI payments you will receive full SSDI payments for for at leastat least 9 months, regardless of how high your earnings might be. 9 months, regardless of how high your earnings might be. In 2010, months when you earn gross wages of $720 or more will be In 2010, months when you earn gross wages of $720 or more will be counted as Trial Work months. (This amount is adjusted each year.)counted as Trial Work months. (This amount is adjusted each year.)

Grace Period (GP)Grace Period (GP) - When Social Security decides that - When Social Security decides that your work is at a level they call Substantial Gainful Activity (SGA), your work is at a level they call Substantial Gainful Activity (SGA), they will pay you a full SSDI payment for that month and for thethey will pay you a full SSDI payment for that month and for the following 2 months.following 2 months.

Extended Period of Eligibility (EPE) -Extended Period of Eligibility (EPE) - a period of 36 a period of 36 consecutive months following the TWP when, if you qualify, SSA consecutive months following the TWP when, if you qualify, SSA may restart your SSDI benefits without a new application, disability may restart your SSDI benefits without a new application, disability determination, or waiting period. determination, or waiting period.

What is Substantial Gainful What is Substantial Gainful Activity (SGA)?Activity (SGA)?

Substantial Gainful Activity (SGA)Substantial Gainful Activity (SGA) - a term SSA uses - a term SSA uses to describe a certain level of work and earnings.to describe a certain level of work and earnings.

Work is “substantial” if it involves doing certain Work is “substantial” if it involves doing certain physical or mental activities, or a combination of the physical or mental activities, or a combination of the two.two.

““Gainful” work activity is work performed for pay or Gainful” work activity is work performed for pay or profit, of a nature generally performed for pay or profit, of a nature generally performed for pay or profit, or work intended for profit, whether or not a profit, or work intended for profit, whether or not a profit is realized.profit is realized.

SGA Guideline Level:SGA Guideline Level:

In 2010, gross earnings averaging over $1000/month In 2010, gross earnings averaging over $1000/month generally demonstrate SGA if your impairment is generally demonstrate SGA if your impairment is anything other than blindness. (Amount changes anything other than blindness. (Amount changes each year.)each year.)

If you are blind, earnings averaging over $1640 per If you are blind, earnings averaging over $1640 per month (in 2010) generally demonstrate SGA.month (in 2010) generally demonstrate SGA.

Other factors may be taken into consideration when Other factors may be taken into consideration when SSA is making an SGA decision, however.SSA is making an SGA decision, however.

Work Incentives That Work Incentives That Affect SGAAffect SGA

Impairment Related Work Expenses Impairment Related Work Expenses (IRWE)(IRWE)

SSA will deduct the cost of certain disability-related SSA will deduct the cost of certain disability-related items and services that you need to work from your items and services that you need to work from your

“ “gross earnings” when they are deciding if your gross earnings” when they are deciding if your work demonstrates the performance of Substantial work demonstrates the performance of Substantial Gainful Activity.Gainful Activity.

Possible IRWE’S that Social Security may Approve:

Plus many more………….

Work Incentives That Work Incentives That Affect SGAAffect SGA

SSA considers the existence of SSA considers the existence of subsidies and subsidies and special conditionsspecial conditions when they make an SGA decision. when they make an SGA decision. They try to determine the real value of your work. They try to determine the real value of your work.

A A “Subsidy”“Subsidy” is support provided by your employer is support provided by your employer that may result in your receiving more pay than the that may result in your receiving more pay than the actual value of the services you perform. actual value of the services you perform.

““Special Conditions”Special Conditions” refers to support provided by refers to support provided by someone other than your employer.someone other than your employer.

During Extended Period During Extended Period of Eligibility:of Eligibility:

If earnings are If earnings are below below Substantial Gainful Substantial Gainful Activity (SGA) level Activity (SGA) level

If earnings are If earnings are at or above at or above Substantial Gainful Substantial Gainful Activity (SGA) level Activity (SGA) level

EntitledEntitled to SSDI cash to SSDI cash paymentpayment

Not entitledNot entitled to SSDI to SSDI Cash PaymentCash Payment

EXCEPTION – EXCEPTION – Entitled to SSDI payments during 3 month Grace Entitled to SSDI payments during 3 month Grace Period (G.P.) (G.P. occurs 1st time after TWP that you perform Period (G.P.) (G.P. occurs 1st time after TWP that you perform SGA.)SGA.)

Year 2009 Jan Feb Mar April May June July Aug Sept Oct Nov Dec Gr Wages 500 500 600 910 865 925 0 0 0 850 850 850

Ben Status PT PT PT TWP 1 PT TWP 2 PT TWP 3 PT PT PT PT TWP 4 PT TWP 5 PT TWP 6 PT

Yr 2010 Jan Feb Mar April May June July Aug Sept Oct Nov Dec

Wages 1000 1000 1000 0 0 0 0 1800 1500 1500 0 500

Ben Status TWP 7 PT TWP 8 PT TWP 9 PT EPE 1 PT EPE 2 PT EPE 3 PT EPE 4 PTEPE 5 GP -

PTEPE 6 GP -

PTEPE 7 GP -

PT EPE 8 PT EPE 9 PT

Yr 2011 Jan Feb Mar April May June July Aug Sept Oct Nov Dec

Wages 0 0 0 0 0 0 0 0 0 0 0 0

Ben Status EPE 10 PT EPE 11 PT EPE 12 PT EPE 13 PT EPE 14 PT EPE 15 PT EPE 16 PT EPE 17 PT EPE 18 PT EPE 19 PT EPE 20 PT EPE 21 PT

YR 2012 Jan Feb Mar April May June July Aug Sept Oct Nov DecWages 1400 1300 1780 1400 1300 0 450 670 350 800 1500 1950

Ben StatusEPE 22 NO

PTEPE 23 NO

PTEPE 24

NPEPE 25 NO

PTEPE 26 NO

PT EPE 27 PT EPE 28 PT EPE 29 PT EPE 30 PT EPE 31 PTEPE 32 NO

PTEPE 33 NO

PT

Yr 2013 Jan Feb Mar April May June July Aug Sept Oct Nov DecWages 1280 1400 1700 1700 1700 700 700 700 700

Ben StatusEPE 34 NO

PTEPE 35 NO

PTEPE 36 NO

PT NO PT NO PT

TWP Mo. Used (Allowed 9 within 60 Months)

Extended Period of Eligibility EPE Mo. Paid (36 Mo. After TWP)

Grace Period GP Mo. PaidNP Month when there is no payment

SSA Uses Gross Wages

May request EXR

Trial Work Period

Payment when wages below SGA level (generally 41,000 per month in 2010)

Payment due - the 1st month of SGA following Trial Work Period and following 2 months.

Gross monthly wage of $700 = Trial Work Month in 2009Gross monthly wage of $720 = Trial Work month in 2010

Sample SSDI Worksheet

SSDI Work IncentivesSSDI Work IncentivesContinued…Continued…

Expedited Reinstatement of BenefitsExpedited Reinstatement of Benefits –If your cash –If your cash payments ended because of your work and earnings, payments ended because of your work and earnings, and you must stop working at SGA level within 5 and you must stop working at SGA level within 5 years of the month your benefits were terminated, years of the month your benefits were terminated, SSA may be able to start your payments again. SSA may be able to start your payments again.

Continuation of Medicare CoverageContinuation of Medicare Coverage – Most – Most individuals with disabilities who work will continue individuals with disabilities who work will continue to receive at least 93 consecutive months of to receive at least 93 consecutive months of premium- free Medicare Part A after the Trial Work premium- free Medicare Part A after the Trial Work Period. They may also continue to have Medicare Period. They may also continue to have Medicare Parts B and D during this time period if enrolled.Parts B and D during this time period if enrolled.

MovingMoving on to SSIon to SSI . . . . . .

SSI: Before SSI: Before and and

After Age 18After Age 18 Some children may receive SSI benefits.Some children may receive SSI benefits.

At age 18, they must undergo a medical review to At age 18, they must undergo a medical review to determine if they meet the adult disability standard.determine if they meet the adult disability standard.

There is no guarantee that an individual will continue There is no guarantee that an individual will continue to be eligible for SSI benefits simply because he or to be eligible for SSI benefits simply because he or she received SSI as a child.she received SSI as a child.

EarnedEarned

Income:Income: Wages earned from Wages earned from

employment or self employment or self employmentemployment

UnearnedUnearned Income:Income: Any other income such Any other income such

as SSDI, Pensions, TDI, as SSDI, Pensions, TDI, Unemployment Benefits, Unemployment Benefits, Interest or Dividends, Interest or Dividends, Gifts from Grandma etc…Gifts from Grandma etc…

Major SSI Work Major SSI Work IncentivesIncentives

General Income Exclusion (GIE) - $20 exclusion is applied General Income Exclusion (GIE) - $20 exclusion is applied first to unearned income, if any. (If little or no unearned first to unearned income, if any. (If little or no unearned income, the $20, or remainder of $20, is deducted from income, the $20, or remainder of $20, is deducted from earned income along with EIE).earned income along with EIE).

Earned Income Exclusion (EIE) - $65 and half of remaining Earned Income Exclusion (EIE) - $65 and half of remaining earned income received in a month is deducted from gross earned income received in a month is deducted from gross earned income.earned income.

Student Earned Income Exclusion (SEIE) - if under age 22 Student Earned Income Exclusion (SEIE) - if under age 22 and regularly attending school, may exclude $1,640 per and regularly attending school, may exclude $1,640 per month up to a maximum of $6,600 per year (2010 figures; month up to a maximum of $6,600 per year (2010 figures; adjusted each year)adjusted each year)

Major SSI Work Incentives Major SSI Work Incentives cont…cont…

1619(a) – Once you begin receiving SSI, you may 1619(a) – Once you begin receiving SSI, you may continue to receive SSI payments while you work, continue to receive SSI payments while you work, even if your earnings are at the SGA level.even if your earnings are at the SGA level.

1619(b) or (continued Medicaid while working) – 1619(b) or (continued Medicaid while working) – After you return to work, your Medicaid may After you return to work, your Medicaid may continue if your wages (or your wages in continue if your wages (or your wages in combination with other income) become too high for combination with other income) become too high for you to receive an SSI cash payment. Certain you to receive an SSI cash payment. Certain conditions apply.conditions apply.

In most cases, your wages must be below a certain In most cases, your wages must be below a certain “threshold amount” - $37,828 in RI in 2010. ( Figure “threshold amount” - $37,828 in RI in 2010. ( Figure is adjusted annually.) In certain situations, is adjusted annually.) In certain situations, individualized thresholds may be calculated.individualized thresholds may be calculated.

Major SSI Work Incentives Major SSI Work Incentives cont…cont…

Impairment Related Work Expense (IRWE) –your out-of Impairment Related Work Expense (IRWE) –your out-of pocket and non-reimbursable expenses for items or pocket and non-reimbursable expenses for items or services which are related to your disability and which you services which are related to your disability and which you need to work. IRWE figure in the SSI payment calculation need to work. IRWE figure in the SSI payment calculation and may result in a higher SSI payment. and may result in a higher SSI payment.

BlindBlind WorkWork Expense (BWE) Expense (BWE) -- expenses incurred by blind expenses incurred by blind individuals while obtaining earned income. These individuals while obtaining earned income. These expenses need not be related to blindness. They play a expenses need not be related to blindness. They play a part in the SSI calculation and may result in a higher SSI part in the SSI calculation and may result in a higher SSI payment. payment.

Expedited Reinstatement of Benefits – If your SSI Expedited Reinstatement of Benefits – If your SSI payments ended because of your earnings, Social Security payments ended because of your earnings, Social Security may be able to restart them if you must stop working may be able to restart them if you must stop working because of the same or a related disability within five because of the same or a related disability within five years.years.

Earning wages…

means your SSI check

decreases or stops

BUT… your total income for the month

increases

Sample SSI Formula for Sample SSI Formula for Individuals With SSI and Wages Individuals With SSI and Wages

Only (No IRWE)Only (No IRWE)Gross Monthly WagesGross Monthly Wages

Income Exclusions Income Exclusions Remainder (divided by 2) Remainder (divided by 2)

Countable earnings:Countable earnings:

Maximum SSI Rate for 2010 Maximum SSI Rate for 2010 Minus Countable Earned Income Minus Countable Earned Income Adjusted SSI PaymentAdjusted SSI Payment

$500.00$500.00-85.0085.00

$415.00$415.00

$207.50$207.50

$713.92$713.92-207.50207.50

$506.42$506.42

TOTAL MONTHLY INCOME = $1,006.42TOTAL MONTHLY INCOME = $1,006.42

Not Working

If you do not work, your SSI payment will be $713.92 or less, unless you are in assisted living.

$713.92 (SSI Maximum in RI in 2010)

Sample SSI Formula For Individual Sample SSI Formula For Individual

With Wages And IRWE’sWith Wages And IRWE’s Gross monthly wagesGross monthly wages Income ExclusionsIncome Exclusions RemainderRemainder minus IRWEminus IRWE RemainderRemainder Countable EarningsCountable Earnings

Maximum SSI Rate for 2009Maximum SSI Rate for 2009 Minus Countable Earned Inc Minus Countable Earned Inc

Adjusted SSI PaymentAdjusted SSI Payment Notice that SSI payment is Notice that SSI payment is

$50 higher than in previous $50 higher than in previous example due to IRWE. example due to IRWE.

Your total monthly income would be $1056.42 in this example.

$500.00$500.00-$ 85.00-$ 85.00$415.00$415.00- - 100.00100.00

$315.00 $315.00

$157.50$157.50

$713.92$713.92

$157.50$157.50

$556.42 $556.42

(divided by 2)(divided by 2)

Sample SSI Formula For Individual Sample SSI Formula For Individual With Unearned Income And With Unearned Income And

Wages.Wages.Unearned Unearned Income (SSDI) $200.00Income (SSDI) $200.00Minus general incomeMinus general incomeExclusion -Exclusion -$20.00$20.00Countable Unearned Countable Unearned Income $180.00Income $180.00

Gross monthly earnedGross monthly earnedIncome $500.00Income $500.00Minus earned incomeMinus earned incomeexclusion -$ exclusion -$ 65.0065.00Remainder $435.00 / 2Remainder $435.00 / 2Countable Earned Inc. $217.50 Countable Earned Inc. $217.50

Countable Unearned Inc. $180.00Countable Unearned Inc. $180.00Countable Earned Inc. +Countable Earned Inc. +$217.50$217.50Total Countable Inc. $397.50Total Countable Inc. $397.50

Maximum SSI (2009) $713.92Maximum SSI (2009) $713.92Minus Countable Inc. Minus Countable Inc. -$397.50-$397.50Adjusted SSI paymentAdjusted SSI payment $316.42$316.42

Your total income for month Your total income for month would be would be $1016.42$1016.42!!

The Ticket to Work ProgramThe Ticket to Work Program

What is a Ticket to Work?What is a Ticket to Work?

It is an employment program.It is an employment program.

It is a free and voluntary service.It is a free and voluntary service.

Most beneficiaries between the ages ofMost beneficiaries between the ages of 18 18

through 64 are eligible for a ticket.through 64 are eligible for a ticket.

It allows individuals expanded opportunities toIt allows individuals expanded opportunities to

obtain the services and supports that they needobtain the services and supports that they need

to work and to achieve their employment goals.to work and to achieve their employment goals.

What Is The Goal Of The What Is The Goal Of The Ticket Program?Ticket Program?

The Ticket to Work program expands the choicesThe Ticket to Work program expands the choices available to SSA beneficiaries with disabilities available to SSA beneficiaries with disabilities who want to enter or re-enter the workforce.who want to enter or re-enter the workforce.

The ultimate goal of the program is to reduceThe ultimate goal of the program is to reduce reliance on Social Security disability benefits andreliance on Social Security disability benefits and to promote increased self-sufficiency forto promote increased self-sufficiency for beneficiaries with disabilities through work.beneficiaries with disabilities through work.

Where Can The Ticket Be Where Can The Ticket Be Used?Used?

The Ticket program allows participants to choose The Ticket program allows participants to choose from several providers of vocational services called from several providers of vocational services called Employment Networks (EN’s).Employment Networks (EN’s).

EN’s are organizations or agencies that have agreed EN’s are organizations or agencies that have agreed to work with SSA to provide employment services to to work with SSA to provide employment services to beneficiaries with disabilities.beneficiaries with disabilities.

and/orand/or The state Vocational Rehabilitation Agency – the The state Vocational Rehabilitation Agency – the

Office of Rehabilitation Services (ORS). Office of Rehabilitation Services (ORS).

Where Can I Find Contact Where Can I Find Contact InformationInformation

For ORS Or EN’s Serving RI?For ORS Or EN’s Serving RI?

Visit Visit www.yourtickettowork.comwww.yourtickettowork.com for a list of EN’s for a list of EN’s serving RI.serving RI.

oror

Contact Maximus at 1-866-968-7842 and request Contact Maximus at 1-866-968-7842 and request Ticket to Work information and a current list of EN’s. Ticket to Work information and a current list of EN’s. TDD users call 1-866-833-2976.TDD users call 1-866-833-2976.

What Kinds of Employment What Kinds of Employment Services May be Offered? Services May be Offered?

May help with developing a resume.May help with developing a resume.

May teach interviewing skills.May teach interviewing skills.

May do interest or aptitude testing.May do interest or aptitude testing.

May assist with education or training.May assist with education or training.

May provide job coaches.May provide job coaches.

May offer job development services.May offer job development services.

How Do I Choose A Provider How Do I Choose A Provider OfOf

Vocational Rehabilitation Vocational Rehabilitation Services?Services?

Think about the services that you may need in order Think about the services that you may need in order to work.to work.

Call or visit several EN’s and ORS.Call or visit several EN’s and ORS. Ask them specific questions about how they will Ask them specific questions about how they will

help you.help you. Talk to others who have used their services.Talk to others who have used their services. Choose the provider that best fits your needs.Choose the provider that best fits your needs.

What Happens Next?What Happens Next? When a beneficiary and a provider agree to work When a beneficiary and a provider agree to work

together, you will develop a written plan outlining together, you will develop a written plan outlining the services and supports that will be provided to the services and supports that will be provided to help you achieve your vocational goal.help you achieve your vocational goal.

If you choose to work with an EN, you willIf you choose to work with an EN, you will “assign” “assign” your Ticket to that EN.your Ticket to that EN.

If you choose to work with ORS, you will place your If you choose to work with ORS, you will place your Ticket in “in use status”. Then you may “assign” it Ticket in “in use status”. Then you may “assign” it to an EN after you become employed for ongoing to an EN after you become employed for ongoing support services after ORS closes your case.support services after ORS closes your case.

What If The Vocational What If The Vocational Provider Does Not Help Me?Provider Does Not Help Me?

If the services do not meet your needs, you may If the services do not meet your needs, you may choose to reassign the Ticket to another provider.choose to reassign the Ticket to another provider.

You may “retrieve” a Ticket or take it out of You may “retrieve” a Ticket or take it out of assignment at any time for any reason.assignment at any time for any reason.

You must notify the Operations Support Manager, You must notify the Operations Support Manager, Maximus, in writing.Maximus, in writing.

Why Should I Use My Ticket?Why Should I Use My Ticket?

You will obtain valuable Vocational services at no You will obtain valuable Vocational services at no cost to you.cost to you.

While using your Ticket, SSA may postpone your While using your Ticket, SSA may postpone your

medical continuingmedical continuing disability review (CDR)disability review (CDR) as long as long as you are working toward your employment goal as you are working toward your employment goal andand meeting the SSA Timely Progress Provision.meeting the SSA Timely Progress Provision.

Why Is This Important?Why Is This Important?

If a medical review is done and Social Security If a medical review is done and Social Security decides that you are no longer disabled because you decides that you are no longer disabled because you have medically improved, have medically improved, your cash payments and your cash payments and

youryour health insurance may stop, health insurance may stop, and you may not be and you may not be entitled to important work incentives such as the entitled to important work incentives such as the Trial Work Period, Extended Medicare Coverage, or Trial Work Period, Extended Medicare Coverage, or 1619(b).1619(b).

When Will This Protection End?When Will This Protection End?

This protection will continue while you are This protection will continue while you are

making “timely progress” toward achievingmaking “timely progress” toward achieving

self-sufficiency.self-sufficiency.

This means that you must achieve certainThis means that you must achieve certain

work/educational goals during eachwork/educational goals during each

12-month period.12-month period.

(See handout describing Timely Progress(See handout describing Timely Progress

requirements.)requirements.)

Why Should I Work?Why Should I Work?

The reasons for wanting to work are different for The reasons for wanting to work are different for everyone, but often include:everyone, but often include:

an increase in self-esteem.an increase in self-esteem.

a decrease in feelings of depression.a decrease in feelings of depression.

more social interaction. more social interaction.

the chance to use knowledge/skills.the chance to use knowledge/skills.

and of course, more $$$$$$$.and of course, more $$$$$$$.

Thanks for your time…