consumers. Hopefully you will know that there are programs under SSI the consumers can use to retain all or some of their monthly cash benefits and

Transcription

1 Joining us to give us our presentation today is the start a series on three presentations is Social Security work incentives. Sarah will be focusing on the supplemental security income piece. You can see her PowerPoint on her computer top. I will go through a few reminders before I introduce Sarah. You should be able to see one of the highlighted blue headers that says question. And a question box is where you are going to indicate to Sarah and myself and share with us any of you your impressions or questions. If you want to repeat something. Just to make sure that you all understand that why do send me a little note that says I know Sarah she is a great person. Any of the messages that you may want to send us go ahead and do that. I have a couple coming in already. It sounds like you all can hear us. It sounds like you guys have got your keyboards out and that you are operational. Just a few more things about Sarah. Just a reminder this is a series of three different webinars. Each webinar is an hour and 15 minutes. We will finish at 11:15 AM. For those you do not know Sarah Kendall she is a program specialist for the Texas Department of assistance and rehabilitative services. She is with the division for rehabilitation services. In this capacity she re-creates and implements the benefit subject matter and resource staff program. She has been working with all of our counselors and up writing providing intensive training. We are touching about 140 people today and dart stuff. That is a lot of work. 100 and -- you also have a lot of background and the first time I met you is working with Medicaid infrastructure grant here in Texas. You're also familiar with [Indiscernible] and the personalize customized employment grant. We are so happy to have you with us and sharing this information. With that why don't we get started. Great, thank you so much and good morning everyone. I just want to let you know that I do not work for Social Security as Noreen said that I do work for the division of rehabilitation services. One of the things that is unfortunate about the Social Security Administration is that other people then Social Security staff has to train on this information. Social Security may business retirement, supplement security income another disability programs are very small programs. There just simply isn't enough money or staff in the Social Security Administration for them to have individuals within the local offices. With that just so you know why I am training on this, and not Social Security. We will start. I'm trying to advance my slide. It is not advancing Noreen. We start out with a technical problem. Let's go for the goals today. The goals are so that you have a very basic understanding of supplemental security income or SSI. It is not to become an expert in this or even to know enough to really have a robust conversation with the consumers that you are working with. It is very important that you have a basic understanding of the system. You should be able after we are done to do the SSI calculation sheet for your

2 consumers. Hopefully you will know that there are programs under SSI the consumers can use to retain all or some of their monthly cash benefits and more importantly than that cash benefit is there Medicaid health insurance. You will know what the documents that you need to get about SSI, that the consumer has, you will need to know what you need to ask your consumer [Indiscernible]. You will find out where the consumer can Additional system with SSI issues and you can get assistance as well. Very importantly from this date forward you always encourage consumers receiving supplemental security income to earn as much as possible. To work as many hours as possible of their new job. You will never again say to someone you can only work a certain number of hours or you can only make a certain amount of money or your SSI is going to be affected. That is what we are hoping to a couple is today. We are going to start off with some of the basics. Supplemental security income pays a standard monthly cash benefit of $733 and 2015 to individuals.. Couples get $1100. The purpose of this program is to provide food and shelter. To help people who have no other way to get shelter or food. If you have another way to get food and shelter this is not the program for you. Obviously, if you really need to get food and shelter and you have another way to get it other than to SSI you have little to no money. And countable resources, you can only have $2000 in any given month. And countable resources or anything you can convert to cash within a 20 day.. That excludes the personal items in your house like jewelry and antiques. If you for instance have a retirement account, maybe you are 25 years old, and you have a retirement account. You only have a few thousand dollars in the account. SSI is going to tell you that you have to liquidate that account. You can use that to buy food and shelter. There are exceptions other than -- besides household goods that you are encountered by Social Security toward resources. The most popular ones are the once you've heard are a house you own and live in, one how someone car, and specific burial expenses. There is a long list of exclusions to that $2000 a countable resource limited in any month that is on the Social Security website. SSI counts parents income and resources if the individual is under 18 or married. This is why you might have heard people on SSI say I cannot get married. Their spouses income could make them and eligible for SSI and therefore in eligible for Medicaid. SSI is knowing as title 16 and the Social Security world. When you send consumers to Social Security they should refer themselves as a title 16 recipient. Consumers receiving SSI are recipients and not beneficiaries. This may seem a little ridiculous. They just go in and say I get SSI. Again, remember that SSI and the other disability benefits program are not Social Security's main source of business. Their main source of business is retirement. The more you and the consumer are able to speak the Social Security Administration staff language the more welcoming they will be to you. They understand what you are asking or saying to them. It is important to know their language. That is true for any of us. As CRP's you know locational rehabilitation language. When you are talking to a vocational rehabilitation counselor you probably uses acronyms without even you

3 thinking about it. If you work with a long term support services use other acronyms. This is not any different than that. We want to speak the language of the person that we are trying to get to help us. Never ever sent someone who gets title 16 or supplemental security income without giving very specific directions or information. Even writing down exactly what they should ask and what they should say. If you are working with consumers who would be unable to do that independently, if you can accompany them to the local office you should do that, if you cannot you should work with their family member, friend, other support person or maybe ABR counselor. We really need to work together to find someone who can go in and assist them when they are talking to Social Security. It is entirely different world and language. Eligibility for adults adult SSI is determined by SSA and SSA disability determination services. They use financial and disability criteria. Those things are mixed together. Everybody who gets SSI or another disability benefit goes through an evaluation that consists of five steps. I would like to give you some background before we really start to get into the work incentives so you can understand why some people get and some people don't. The first question in the evaluation is are you working and earning above a certain amount of money? That amount is called substantial gainful activity. If the answer to that is yes you are not eligible for SSI. It does not matter how severe the disability is. How that disability impacts your functioning in your daily life. If you are working and earning a certain amount of money or SGA which is $1090, if you're making above that you are done. You do not go any further. There is a difference on staff one for people who are blind. They skips -- skip as one. Do have a medical condition or a combination of medical issues that have lasted more than 12 months, are expected to last more than 12 months, or are going to result in death. This is why you will be working with consumers who have had a stroke or a heart attack, and their eligibility seems to be taking a really long time. It is because Social Security is holding that, and they will ask for updated medical information within that first year. They want to see if the disability has improved. The third question is do you mean and SSA disability listing and the severity. They don't even get the disability until the third question. SSA has a listing, a different listing, of categories of disabilities. You can find those by going online and googling SSA bluebook. If you have for instance autism, that is a listing, that does not get you in. You also have to meet the severity, you have to meet below and category one and be B. It is not an easy eligibility test to get onto SSI income. If you get to all of those things great. If you get to number three and you may both the disability listing and the severity, you are in. Most people actually get in using these three steps. There are group of people and I'm sure you have run across them who meet a disability listing that they do not meet the severity. They go on to step four and five of this evaluation which is really what we call the [Indiscernible]. And step four if you are able to do any work that you did in the past 15 years and earn SGA. If I worked at Lowe's 15 years ago and then I became a nuclear physicist, and then I went to Social Security disability they would say go back

4 and water plants at Lowe's. If the answer is yes or no to step for you still have to go on to step five, which is are you able to do work anywhere in the country with your current abilities. With your current disability maybe you cannot water plants at Lowe's, that we have a plant in Jackson Mississippi that does something that you can do. We are going to tell you to move there. They actually have specific places and parts of the country and they will tell you to move there. Steps four and five are where people hire lawyers. People who get on to social season security. There are good lawyers who help people get on to supplemental security income. One of the ways that you can tell someone will be a good lawyer for you is that the first thing they will tell you is if you can go to work though to work. Do not get on the system. That is really the test to see if it is a good lawyer. Those are the basics of SSI. Now we will go into the different types. There are three types of supplemental security income. There is SSI for children, SSI for adults, and SSI [Indiscernible]. SSI child if you're under 18 and disabled by Social Security's definition, that evaluation is not the one for children. We looked at the adult one. The child evaluation is really focused on that specific individuals function in comparison to others without a disability of their same age. In the home environment and at school. Parents of the individual lives with or whoever takes care of that individual has to have limited income. Remember any income that you get or that people give you affect short SSI. Even children have to have very limited income. Parents income is deemed, and we will talk about that more than a little bit. This is why often times people who make a good amount of money may not be able to get their children on SSI because all that income is deemed to that child. That determines and in eligible for SSI. When someone turns 18 Social Security we evaluate the disability side if they meet that adult definition. This is an automatic process. We always advise people when their child is turning 18 to go into SSA and say their birthday is coming up in a month, I would like to get this process started. We have seen child disability that a fisheries, I am sorry not child disability beneficiaries not get benefits until they are 25 years old. Especially if the disability is based on a learning disability. That is not going to get you and under that adult evaluation but it would as a child. The family and the individual thinks well I can just get SSI for ever. Seven years later they get around to doing the redetermination and tells the child you are not eligible. If they do that you do not need to pay that money back that you got from 18 until you were deemed ineligible. You must be 18 or older and disabled by SSA's definition and have very limited income and resources. SSI usually have little or work -- no work experience. There is SSI [Indiscernible] these are folks that are 65 years or older. They have very limited income and resources, and the reason that they get SSI is because their work experience, if they have any, do not pay enough to enable them to drop retirement benefits in the amount that the federal government requires. Those folks who turn 65 and are supposed to get retirement, and Medicare, may not a may get SSI and Medicaid. SSI also provides folks with health insurance. It comes with Medicaid in Texas. The Medicaid you get as a result for being eligible for

5 SSI is provided by management [Indiscernible]. However this is Social Security Administration has nothing to do with Medicaid at all. It is administered by the health administration services. People who have Medicaid have two cards, one will be for your Texas benefits, and one will be for -- from a management care agency. If the consumer is receiving SSI at a salary, and gets a job at a salary that would eliminate their cash benefits there are ways to keep Medicaid which we will talk about. If you earn income -- you can actually buy Medicaid when you are working and an individual with a disability. I am going to talk about MDI in detail you can find out about it by going to this link. This link has not been updated in a number of years. The figures on it are not correct. It will give you some basic information about the program. It is a really good resource cause I am sure you'll all know much better than I that is what you hear from folks and their families. There going to lose that Medicaid and that is really important. Whether for the health insurance or to keep them on a home community-based waiver like HCS. There are some potential disincentives to working under SSI income. One is deeming which I talked about with the parents and the children on SSI. One is called income support maintenance and one is cop resume maximum value. And there is that resource limit of $2000 that we talked about. Deeming, and we mentioned that a parent, is a parent to a child, a spouse to a spouse, and a spouse to an immigrant. These are the three legal categories where that individual is legally bound to provide food and shelter for that other party. The parent is legally bound to provide food and shelter to that minor child the spouse is to their spouse, and the sponsor is to the immigrant. Any income that parents spouse earned as well as our resources. If they have resources over $2000 all of that will be counted against this child, spouse or immigrant. It could cause oh -- in eligibility for Medicaid and SSI. [Indiscernible] maintenance also known as the value of one third reduction. If a person is living in a household with a person who provides them with food and shelter. The whole point of SSI is so you can buy food and shelter. If someone else is helping you out you don't get SSI or you may get a reduced amount. That reduced amount is two thirds of the total federal benefit for the rate of the calendar year. This cannot beat -- be contested. There is a way that you can get rid of having any kind of support maintenance. This year consumer being charged [Indiscernible] would receive 4867 and SSI. The federal benefit rate is 733 it is a third of that. You can probably think of consumers who received 4867 right now and think that is why they get that. Delivered home with mom or dad and mom and dad pays for room and board. There is an easy fix to this., Or die can do standard lease agreement, get a blank lease agreement and a blank and the -- invoice book, and every voice -- must say that John pays me this amount. They are charging a reasonable amount for rent and food. That is -- consumers benefit will return to the full rate. You do have to tell Social Security that you have done this. They do not automatically know that. Mom or dad has to go and -- in with that individual and say that they are paying me. Mom or dad or whoever the person is living with does become a landlord. They do have to put that on their

6 IRS tax returns. The presumed maximum value role applies when a consumer is living in another person's household but not receiving food and shelter from that person. Or living in their own household but someone else outside the household is paying for the finances. Typically someone who is living in their own apartment, mom or dad or friends is giving them money to pay the rent or to buy groceries. And I case -- in that case they are not actually getting food and shelter from the household. They are getting some kind of help from outside. Instead of taking that one third, SSA is going to say that the maximum value can be up to that one third plus $20. This amount can be contested. You have to show them that mom only gives me $20 a month for groceries. You have to show them that you are not getting as much as they would generally assigned to you. If you do not give them this information are going to assign you the general amount of groceries for household in your area. The resource limit, and I want you to know that this information will change with the implementation for many people. That will not be implemented until the end of this year or the beginning of next year. Right now this is the current information about resources for people on SSI. They cannot have more than that $2000, we talked about what accountable resources are. We talked about all of those different exclusions that people might have. Some of the others that you can see is if they get energy assistance that is included. Maintenance payments from DRS are excluded, we often get this question from our counselors and consumers. I'm getting a check for gas to get to and from college or work or whatever it is. DRS is paying me for -- to go to college. Is that counted? It is not, it is not counted toward your resources. Remember you have an income limit and you have a resource limit. Resources are different than income. Resources are what you got, income is what you get. You already have those resources, and then you are earning that income. SSI figures out how much a person's monthly cash benefits will be using a standard mathematical formula. The most important thing that you can tell all your consumers and their family members [audio cut out] always have more money when they work. There is no possible way, it is a mathematical formula, that they will ever have less. They will always have more and they get to keep that Medicaid to. You will only be able to provided estimate consumers to what their cash benefit might be when they are earning income. There are a lot of variables. There's no way to know how much taxes will be taken out or lots of other things. The estimate is going to be very close, and it will prove to the consumer that they really can't go to work when they are on SSI and make a living wage and be much that are off. How you estimate a month earning, this is really important, is that you take the hourly wage the person is making and multiply by the amount of hours they are working per week and then you take that and multiply the total by Not by four but by If the consumer is on a fixed salary you can divided by 12 only if it is a fixed salary. There are no bonuses or over time or anything else. When we get into this, which we are getting into now, try not to get tangled up in the why or worry about it. Take your time and just plug these numbers

7 into the formula. Here is what the calculation sheet looks like. This was sent to with the handout you should have 10 of these. You should have a calculator with you and a pencil or pen. We are going to do some exercises with this calculation sheet. You can never change this calculation sheet, ever. This is a math formula. You just printed out the way it is and that is how you use it here somebody makes a gross income of $942 a month. They have certain exclusions as you can see below that. We will talk about all these. They still have 942 everyone gets a general income exclusion. That is $20 and the remainder is 922. Everyone gets an earned income exclusion of $65. That leaves you with $857. At this person had an impairment related work expense that would take more off. They don't, so we still have 857. You divide that remainder by two and you get 428 $ If they were blind more would come off here but they don't. We have $ of the countable income. You go down to the third section and add anything from the on and income to the accountable earned income, and if they had a plan of [Indiscernible] that amount would come off here. This person does not. The total countable an earned and earned income is $ You take the best -- these SSI rate of 733 and take away the total accountable income of $ and they get an adjusted SSI payment of $ They earn $942 plus they get a cash bonus of $ And they will get Medicaid. This is the formula. What we will do now is if you problems or exercises basically. The first when you're going to do is take out your calculation sheet and your pencil. James receives SSI, he starts a job earning an hour he works 30 hours a week. You're going to tell us what his SSI is. Lucy is getting SSI and she gets a job earning $40,000 a year, you're going to tell us what her new SSI amount is. Meredith also receives SSI and she gets a job earning $9.50 an hour working 40 hours a week. What is her new SSI amount? We are going to take the next five minutes, and I want you all to do these calculations and if you have questions you certainly can ask them all be happy to help out. Hopefully everybody has gone started. We have a couple people who said they do not have the handout. I am wondering what you want to go back to the calculation sheet. If everyone can look at that first one. James starts at $7.50 an hour and it is 30 hours a week and you want to know what his new SSI is. The first when you do is $7.50 an hour at 30 hours a week. Write that down. Number two is, someone earning $40,000 a year, and number three is someone earning $9.50 an hour working 40 hours a week. We have one question that is asking for the 4.33, how does that number come in to the calculations? Isn't that figuring out the monthly? Is that correct?

8 You look at your screen you take the hourly wage, you take 750 an hour and multiply that by the number of hours worked a week. The multiply that total by That will be the gross earned income that is countable and SSI. No other questions yet Sarah. You have just under a minute. Some of you who have finished, why don't you type in what you got for James. The gentleman who made $7.50 an hour. We have one that is saying, the first one would be $ for the total income. Another answer was $ Another was 974 $ Let's go over James folks. If you can put your pencils down let's go over James. The adjusted SSI ML is to hundred $ You guys are great. It is $ If you do the calculations you take your minus20 and general income exclusions and your minus65 for income exclusion and you have eight 8925 you divide that by two and you get four You take four 4463 from 733 and he has an adjusted payment of $288 payment of $ How about Lucy? Let's hear some answers about Lucy. I'm not sure if they got that far. No they did. Good. Let's go over Lucy. You are absolutely right, her gross income is By the way round up and ran down. If you do the formula for Lucy and your minus20 on general income exclusion and Michael -- minus65 on your income exclusion. Lucy has countable and uncountable earned income of 500 uncountable earned income of $ That leaves her with $ How about the last one. Was here with your answers are on Meredith. We got a $1645. Someone is really working hard on this. Any other answers? She is good at math. I struggle with math. This does take a lot of time and we do not have tons of time today. That is why we give you such a short amount of time. The point is you can see that this is -- if you plug in the numbers you get the right answer. It is an approximate answer and goes a long way in helping consumers. Here's what Meredith gets. She earned $ If you take your minus20 and your minus65 income exclusion, she is left with $ If you divide that by 12 her total accountable income is $ You will go into a minus column, and Meredith would not actually get a cash benefit.

9 That is okay, and I will tell you why it just a little bit. Let's talk about this thing called the break even point. When someone like Meredith or any consumer earns a certain amount they do not receive a cash benefit. Remember they are always going to have more money in cash on the table. This point where earnings caused the cash benefit to go to zero dollars a month is known as the breaking point. The consumer remains an active SSI recipient as long as there is no medical improvement to their condition. They still get to keep Medicaid. There absolutely so much better off. The break even point, like a lot of these numbers may change, to figure out the break point you just do that formula we did backwards. You multiply the federal benefit rate, you add 20, and then you add 65, and if you do that you get 1551 in the calendar year If the person earns 1551 and they have absolutely no work incentives that they are using you can see by doing the formula minus20 and minus65 and divided by two you get 733. It is very important that you do not keep this and your mind and say okay consumer you can only make $1551. You can use -- make more if you use work incentives. The first one is the student earned income exclusion. We are going to go over each one of these in the exact order they are in in the calculation sheet. People who qualify for the student earned income exclusion are those who are under the age of 22 and regularly attending school. Here you can see on your screen what regular attending school is. They will have to provide proof that they are going to school, and they can use for high school the formula they use for driver's ed. You have a request for the student earned income exclusion in your handout. It is a very short letter that can just be filled in. They provide proof of enrollment and they got a student earned income exclusion. What is it and why is it so great? It so great because consumers who meet the requirement for student earned income are allowed to deduct up to a certain amount of earned income each month. When they go to the formula, remember the calculation formula, read below is your student earned income exclusion. Anything that they earn comes right off the top of that grossed earned income. That is all SSA will count. The other neat thing about this work incentive is it resets every January 1. You have the full amount available to you every January 1. That amount in 2015 you can deduct up to a month and up to 7000 and up to $7180 in a year. A student can make $7180, and not a penny of that is going to count. They will get their full SSI cash benefits. It is a great induction. Here's how it would look. Jenny earns $471 a month, she is a student under 22 and regularly attend school. She gets to deduct the full amount, and there's nothing else to do. She gets her full cash benefit every month. Here is how this would break down. In a previous example of $471. Because she is age under 22 and goes to school regularly she gets to the dart that full amount and receive her full cash benefits. Even if Jenny works all 12 months she will get her cash benefit of $733 every single month because the amount that she would earn $471 times 12 is under that yearly amount of 7000 that yearly amount of $7180. That means and 2015 she would get 8000 $8976 and SSI and That that out to approximately $4500 in change and Jenny walks home at the end of year with $13,498. That is a

10 pretty great work incentive. What is the catch? She has to keep her resources down to $2000. What good is that? She can make up to $14,000. She could start a 529 savings account. She might decide to start a business or by home. Jenny Capri pay her rent for the year. She could buy an ipad and go out to eat with her friends. There are lots of ways that she can keep her resources down to $2000. Now we are going to do a student income exclusion exercise. It's January 2015 and Mickey is 19 and receives SSI and attends community college 10 hours a week. He has a part-time job making $10.13 an hour and work 16 hours a week. Mickey can use as CIE so you need to let him know how SSI cash benefit is going to look how many months what he received this for cash benefit, and how much will his SSI be for the remaining months in the calendar year of 2015? We will do this together. These get more and more complicated as you go along. How many months what he received cash benefits? He is making $10.13 an hour at work 16 hours a week. You have to figure out how much is he actually going to make in the month, right? What he is going to be making as $ You would take $ and divide that or multiply that by $7180. That is the full maximum SIE that you can to get. For 10 months he will get his full cash benefits. In 10 months, the $701 the $ in earnings will be 7000 will be $ He can deduct up to $7180. How much with his SSI be for the remaining months in calendar year 2015? In November it would be 505 $55. Here's how it is going to look. For January through October he can take his entire amount of earnings off In November, he is coming up to that $7180. Is getting close to this amount. He is not going to be able to deduct the entire amount that he makes. He is going to be able to 2:. How you get to that 6190 is by taking. He will still get an adjusted cash benefits for 550 five $ In December he does not have anything left. He is the maximum SEI exclusion so he does not have any more left. You just do the regular calculation sheet. You minus20 and minus65 divide by two and he will still get an SSI cash benefit of 420 $ Is making working he would've had because you found in this great part-time job and you knew about the student earned income exclusion he is going to get because you found in this great part-time job and you knew about the student earned income exclusion he is going to get because you found in this great part-time job and you knew about the student earned income exclusion he is going to get $8260 in cash benefits and $8421 in gross income. If you have not told him about this earned income exclusion, and Social Security had just said what he is working and we do not know anything about this, nobody told us anything. He would've had four Plus his work income which is great. You get have more in his cash benefits back plus you get all that gross earned income. Net earnings he would walks home with $14,998 in his pocket. That is $6200 more than if he had just gotten SSI benefits. Pretty good, hot? Now we go on to the impairment related work expenses which is the next work incentive, and this allows consumers to deduct expenses that are directly related to helping them work and are necessary due to the disability. These are always paid by the consumer. It cannot be something that

11 someone else pays for. It cannot be a service that your dad is paying for or a service that [Indiscernible] is paying for. A lot of people might be on the waiting list or interest list for home community-based waivers and do not have extended support. They get some extended support through Dars when the case is close where are they going to get that long-term support. There on SSI they can why it by using an impairment related work expense. Expenses related to hearing aids are very common. Transportation to and from work, again it has to be related to the disability. Medication copayments, attending care, and mileage can be paid to someone who drives a consumer to and from work. If you want to say complete list of [Indiscernible] you can go to this link. Here's an example of the early and action. Let's say there earning $1600, they minus there 20, they are left with 1580, they minus their 65, and are left with 1515, now they get to do that that $250. The remainder is 1265 and they divide that by two and take it away from the basis SSI rate of 733 and they get an adjusted payment of $ Had they not have the [Indiscernible] their SSI payment would be about $50. Basically what SSA is doing as they are saying we are going to help you out. In order for you to work you do have expenses that other people don't have that are related to your disability. We will help you out by not counting some of those expenses when we figure out how much you should get in your SSI cash benefits. Social Security is helping you pay for something that you would have to pay for anyway. Here is another problem that we will do together. We're going to talk about LaShawn drug. It is January 2015 until Chandra is 20 and she receives 733 and SSI. She lives with her parents but the reason she receives the full amount is because she pays her fair share of room and board. She pays her parents for groceries to. She attends committee college 10 hours a week and works at a grocery store 30 hours a week and earns $9.55 an hour. Her doctors told her she cannot drive at this time, her mom drives her, it should say zero 30 miles nonzero miles. And less Chandra has a $20 co-pay for seizure meds and a five dollar a month code -- co-pay for asthma medications. Everyone she has to have her blood measures - - levels measured in Pisa $20 co-pay for that. First you have to identify what work incentives she can utilize and what her approximate cash benefit would be for that month. Her mom drives her to and from work, right? Because she has a seizure disorder. That would be an impairment related work expense. There is no public transportation that she can take, and even as she could they would say that it is not safe for her to take it at this time. That is impairment related work expense. Her $20 a month co-pay for seizure meds that is related to a disability. That is related to her work and that is an impairment related work expense to. Her five dollar a month copay for asthma medication that is not related to her seizure disorder. It is not related to a disability. Despite the fact that she has to pay $60 a year for asthma medication, so anybody with asthma, they may not have a disability. That is not an impairment related work expense. Not all co-pays are impairment related work expenses. Only those related to the disability. Every three months what level draws what she has to

12 have done because of the seizure meds, that is related to her disability that $10 co-pay four times a year can be deducted. You break it down, you can use the student earned income exclusion, she can use the amount of mileage to and from work that her mom drives her, she can use her co-pay on seizure meds, and she can use her quarterly copayments for her blood draw. SEI is only for work not for school so she cannot use the mileage to the college and back. Her five dollar monthly asthma meds do not count. For five months from January to May she can detect her full salary, which remember she is working at the grocery store and she is making pretty good money, she is working 30 hours a week and earning $9.35 an hour. That is a gross of approximately $1215 a month. She can deduct that for five months. The six-month she has will $1105 left in her SEI i.e. she can use that and then use her [Indiscernible]. The [Indiscernible] each month breakdown two 7469 for that mileage plus her $20 copay on the meds of $ every month. Her extra [Indiscernible] is every three months is that $10 co-pay on her blood draws. For specific months her early's would come to but for every month it will be January through May she uses her student earned income exclusion, she does not to worry about a thing. She can deduct the whole thing. In June she has a blood draw event so she can deduct that $10 plus the mileage to and from work plus the co-pay on her seizure medication. $ She still gets her from SSI cash benefit. Even though she did not have enough, if you look appear, she do not have enough to reduce everything to zero. Her [Indiscernible] has been reduced to zero so she still got her cash benefits. In July, August, October, November she does not have that student earned income exclusion anymore. She has used all the maximum deductions. She has 9469 in those months so that gets her two 1534 back and SSI. In September and December she has led draws those months could so she could again 2: [Indiscernible] using work incentives brings her an extra $3684 and SSI the share. Plus all of her monthly gross income of 11, hurt SSI cash benefit breaks down to $5074 and her net entirely with her earned income and her SSI cash benefit is $17,364. Had she not known about that, she probably would have come home with almost nothing. Right? It would've been $13,680. The 160 comes from here. She makes 1215 and she doesn't know about the student earned income exclusion and she doesn't know about a pair of or related work expenses, so SSA just as the regular formula. They say while LaShawn drug you get $168. Her net would've been working at $2016 from SSI. Because she did not know about the way or the student income exclusion. That is a lot more money for someone to be taking home because they used to work incentives wisely. There is the [Indiscernible] support. That is a complicated work incentive I will say. You do have in your handout the past application. I am sorry by the way you have in your handouts to the application for an early week. There is no formal SSA form for an impairment related work expense. This is a request for one that has been developed nationally by advocates and is accepted by all Social Security offices. It is very easy to figure out. Not a lot of people have passes. Basically the allow people to save money and a

13 separate bank account for in item or service related to obtaining or maintaining advanced employment. Whatever money gets put into the past does not Count against your $2000 resource role. That has to gets deducted from all your accountable income. The money that is put into a path must be used to pay for a vocational goal. A lot of people use passes to buy cars. It is related to them getting to work. You cannot put any of your SSI benefits into a pass. You have to have something else, your family can give you money and you can put it into a pass or maybe you are working and can put some of that money into the past. The consumer can be working but doesn't have to be. They can be planning to work [audio cut out] or they could be working and mom and dad is driving them to school. Her seizure disorders, LaShawn drug, now she can drive herself to and from work but she needs a car. She can use a pass to save for that car. This is a very difficult and complex work incentive. It really can be used by consumers who extremely organized and dedicated to their goal or have not paid support. The worst person to do a pass as a paid staff member. If that paid staff member leaves, then that consumer is going to be left out in the cold. The reporting on this is very exact. Social Security really reviews these very carefully and they expect to get invoices. They expect to have constant medication with you. It is difficult to do. Possible candidates for a pass are students who want to start a business. There is the blind work expense. This is obviously for people who are with the division for blind services. The blind work expenses is kind of like an early. You can deduct anything that is a [Indiscernible]. Mills that you consume at work, lots of other stuff. All [Indiscernible] are blind work expenses. But not all blind work expenses are impaired work expenses. These are only good for those folks that have been statutory blind by Social Security administration. Now let's talk about the other great work incentive that has to do with Medicaid. Remember we talked about that break-even point of 1561 where you if you do the formula it comes to 733 you do not get any cash benefit. What happens, nothing. You make you more money and you have more money in your pocket. You get to keep Medicaid because of the 1619 be. As a matter of fact you can make up to 34,000 be. As a matter of fact you can make up to $34,289 in earnings this calendar year and remain an active SSI recipient and get your Medicaid. I always say to people when we get to this slide tell me a reason that someone on SSI does not want to go to work. Sometimes we have consumers on SSI who actually make up that threshold but they cannot afford medical services. They can apply for actual and device -- individual threshold., And fresh holders or individualized holders or those. Expedites [Indiscernible] statement. The good news never ends with SSI went you know about it. If you exceed the 1519 the threshold and you do not qualify for in interval and develop -- individualize threshold. You can get through the back door, you have five years for the determination of your SSI benefits to go in of the on webpage one-page application. The individual doing that will receive six months of cash benefits and Medicaid. SSA will determine if your medical condition has improved face on your original medical condition that qualified you. If it has not

14 improved everything will just continue. If it has improved you have six months of free cash and six months of Medicaid and you do not have to pay it back. However in SSI very few people use the XR because by the time they reach the point of that threshold they are usually able to draw Social Security disability benefits. Do not could use his overpayments. And supplemental security income and the disability program overpayment are extremely common. In SSI it is because Social Security uses retrospective accounting. It runs two months behind. The cash benefit someone receives this month is actually based on their August earnings. A simple payment of $1000 or less has to be automatically waived by this the social security administration. The consumer needs to know this and they have to request it in the title 16. They will not tell you about this automatic waiver. You must go in and say I want this waiver. They are not going to give you any information about it they are not allowed to. The best offense against overpayment is to report it. In SSI their program operations manual say that people on SSI must report their income monthly. The worst thing that can ever happen who has an overpayment, even if it is at $300,000 overpayment, is that they can negotiated to a reasonable amount. This is the single and critical important thing. If you do not get anything else out of this webinar get those folks to report their income regardless of how little they earn or regardless of what Social Security tells them. They should report monthly. If they receive supplemental security income and they are not using any of the work incentives they can report by phone or they can take it into their local office, or militant. They can also report using the app. Most of our consumers mail it in. They should have copies of all the documents they sent in. The way the document that you need to get from the PRC is called a benefits planning query. If the consumer has a [Indiscernible] it will tell you that. You need to be in contact with that individual if they say they have that. If they receive an overpayment and SSI they should never be paid more than 733 back four months. You can advise them to go into their local SSA office. They can only take 10%. If they have a representative and overpayment is a clue that that authorized Representative needs education on reporting earned income. The benefits planning query will tell you noncertified yearly total earnings. Especially if the person is a historian. Here is what it the peak you what PPBQ looks like. This person is netting $ Why, because they have a overpayment. They have and overpayment balance of 8000 some dollars. I'm sure we told this consumer to go back in and negotiate a lower repayment plan. The second page of the BQ why they are eligible for Medicaid. It tells you if they have used or are using any of those work exclusions that we talked about. The student income working exclusion, the blind expense, there are way. Here is where you get assistance. DRS has 160 benefit subject utilization resource facilitators who were referred to as [Indiscernible]. They have gone through intensive five-day training. There is at least one [Indiscernible] and every unit. If you need help and they say I don't know how to figure any of this out, [Indiscernible] can say [Indiscernible]. Consumers can contact a [Indiscernible] and we actually pay for this service even

15 though it is a free service to anybody on SSI or SSDI. We pay for it because we get faster service, and we also get to see the deliverables and we have some control over the quality of work we are getting from the community work incentive coordinators. If you need your coordinator need some assistance with benefit planning ask the [Indiscernible]. I need you to pay for some benefit counseling. They can also call a national help one -- line. They can request information and assistance especially with overpayments related to work. If you have a consumer that has an overpayment and their freaking out and they do not want to go back to work. Have them call the [Indiscernible] number. If that overpayment is related to the earned income that they made the [Indiscernible] will help it get reduced or wiped out. The thing that we want you to remember today is instead of spending time trying to figure out why someone on SSI can't take that great job that you are able to find them do some innovative forward thinking. Use this information and remember that working with family members is as important as working with the consumer on these issues. Now you were done. We are at the close of our session it is 11:15 AM. That is an incredible amount of information. A reminder to all of our participants please join us again next week at 10 AM. This is the first session of three. If you have any questions or things they want Sarah to know from this presentation you can send it to us at our website. Sarah, thanks a lot this is an amazing amount of information and is very good. I hope to see everybody next week at 10 AM thank you all, have a good day.