Working, Disability and SSI N A V I G A T I N G T H E M A Z E O F W O R K I N G A N D S O C I A L S E C U R I T Y

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1 Working, Disability and SSI N A V I G A T I N G T H E M A Z E O F W O R K I N G A N D S O C I A L S E C U R I T Y

2 Some Definitions and Basics W H A T A R E T H E D I F F E R E N T T Y P E S O F S O C I A L S E C U R I T Y F O R I N D I V I D U A L S W I T H D I S A B I L I T I E S?

3 Social Security Disability Insurance Eligibility Recipient must have paid in Social Security Taxes Payment Benefits are based on the earnings record of the recipient Medical Coverage Medicare after two years of receiving benefits

4 Supplemental Security Income Eligibility Disabled or blind adult or child who meets all of the following: Limited income (generally earned income above $85/month and maximum $6840/yr student under age 22 and PASS income see handout) Income does not include Food Stamps Limited resources (general under $2000 which does not include home they live in) US Citizen or national

5 Supplemental Security Income (SSI) Payment based on need and varies up to maximum federal benefit rate $698 for individual $1048 for a couple Some states supplement federal benefit NC and GA have some supplement ( I am thinking this is a Special Assistance program administered by the county DSS agency.)

6 Supplemental Security Income (SSI) Medical Coverage Automatically eligible for Medicaid in most states, including NC not sure about GA SSA will automatically sign them up for Medicaid and county DSS agency will administer it.

7 Supplemental Security Income (SSI) What qualifies as a disability? Work history are you currently able to work and earn more than $1010 per month Severity does the condition interfere with basic work and living activities. Condition found on the list of disabling conditions. Some disabilities get expedited approval based on medical history. Down Syndrome Cerebral Palsy Seizure Disorder

8 Supplemental Security Income (SSI) Ability to continue to work? Ability to adjust to a new kind of work.

9 Supplemental Security Income (SSI) ALERT! If your child is already drawing SSI make sure to alert SSA that they have left your domicile and are at WCU in a residential living setting for vocational training and independent living skills training! This will increase their draw dramatically! David s went from $500/month to $698/month.

10 Supplemental Security Income (SSI) Each year recipient or representative payee is required to complete a financial report which asks how the SSI was spent. Food and Housing Clothing, Education, Medical and Dental Recreation and Personal Items How much saved need to keep under $2000 unless under an approved PASS plan (next item) Keep good records! Keep receipts, bank statements. Hint use of a debit card helps gives detail on bank statement.

11 Supplemental Security Income (SSI) Other Reporting Required Periodical medical re-assessment and work history report is required. Just because recipient is on the list of disabling medical conditions does not necessarily mean you will not be asked to provide interim information. I had to complete one for David this year because he went to WCU. Always report changes in address, work placement, etc. The more you communicate, the better!

12 Working and SSI Going to work does not automatically terminate SSI payments. Continue to receive SSI until earnings and income exceed SSI limits (different for each state). DO NOT automatically lose Medicaid even if lose SSI in most states. This is dependent on income level determined by state and other factors.

13 SSI and Working What is considered income? Earned income as wages, self employment income, royalties and honoraria, and sheltered workshop income. Unearned income not earned which includes SSI, pensions, state disability payments, interest income, and cash from friends and relatives. In-kind income food and shelter gotten for free or less than FMV Deemed income income from spouse or parents with whom you live if under age 18.

14 SSI and Working What is NOT considered income? First $85.00 earned Value of Food Stamps Income Tax Refunds Home Energy Assistance Special Assistance received based on need funded by State or Local Government (contact DSS to see if they qualify in your county. Grants or scholarships for tuition and educational expenses Expenses paid for recipient for items other than food and shelter (telephone and medical) this is where Special Needs Trusts are a MUST! Expenses approved under a PASS.

15 SSI and Resources What is considered resources? Cash Bank accounts and investments Land held for investment Life Insurance with a cash value exceeding $1500 Personal Property Vehicles (unless approved under a PASS) Anything that is convertible to cash and used for food and shelter

16 SSI and Resources What is NOT considered as resources? Home you live in and the land where it sits. Household goods and personal effects. Burial plot. Burial funds of $1500 or less. Life Insurance with a face value of $1500 or less. One vehicle if used to transport the recipient. Retroactive SSI benefits for up to 9 months ( this occurs if SSI is denied, appealed and then allowed. SSA pays retroactive benefits from the date of the application forward.) Educational grants held for 9 months for educational expenses.

17 Working and SSI and Medicaid NC is fairly simple NC Income cannot be above $1397 per month, including Social Security and other sources such as veterans benefits, pensions and other retirement income and resources above $22, GA is more complicated SSI recipients eligible as long as they are eligible to receive cash SSI or if under a work incentive program. Based on thresholds of earnings and resources and your medical expenditures need to contact agency for your case evaluation. al_eligibility.htm

18 Working and SSI Expedited Reinstatement If SSI stopped due to working and become unable to work again due to medical condition, become reinstated without a new application if it occurs within 5 years of benefits stopping due to work. Work Expenses Transportation and counseling expenses can be used to shelter income to calculate earnings vs. benefits.

19 Working and SSI Plan to Achieve Self Support Allows to use expenses and resources against income to determine how much SSI benefit is lost due to working More on this later

20 Working and SSI How to calculate benefits retained while working? As income increases, benefits decrease $.50 cents of every dollar earned after $85. Example: David s case - Draw $698 in SSI Begin working and make $500 per month. $500 minus $85 = $415 $415 divided by 2 = $ $698 minus =

21 Working and SSI Another way to look at it is at what point will my earnings cause me to lose all of my SSI? Take SSI amount, multiply it by 2 and add $85 to the product. David s case $698 SSI times 2 = $1396 Add $85 to $1396 = $1481 is the top level where he would lose all of his SSI

22 Working and SSI Philosophy of the calculation SSI supplements up to $.50 on the dollar of every dollar you earn, therefore, they try to keep you at the level of at least what you are drawing in SSI before you lose it. Understanding this calculation is vital as we try to budget for living expenses.

23 Plans for Achieving Self Support (PASS) What is PASS? SSI provision to help individuals with disabilities return (or go) to work. Source s.htm See Publication in handouts

24 Plans for Achieving Self Support (PASS) How does it help them go to work? Allow the individual keep more of their SSI while working by: Allowing them to set asde money and/or things they own to pay for items or services needed to achieve a specific work goal Items include: Additional training Supplies for starting a business School expenses Equipment and tools Transportation and Uniforms

25 Plans for Achieving Self Support (PASS) PASS also allows recipient to save money for installment payments and a down payment for big ticket items which will help them maintain employment Vehicles Wheeled mobility devices Computers

26 Plans for Achieving Self Support (PASS) How to get a PASS Decide on a feasible work goal Get help from VR, organizations which provide employment assistance who contract with SSA, SSA Complete application (SSA-545-BK) 15 page application Hint: SSA more likely to approve if VR is involved. If want to be self employed it must include a business plan so you may want to consult with a professional to assist.

27 Plans for Achieving Self Support (PASS) Elements of Successful PASS application Must be in writing, preferably on their application form and signed by individual and rep payee, if applicable. Must state a specific work goal and can be the VR assessment Must have a reasonable time frame, including beginning and ending dates, with milestones and a final step indicating how the job will be obtained.

28 Plans for Achieving Self Support (PASS) Elements of Successful PASS application Must include estimates of the additional expenses which are job specific NOT include everyday living expenses (SSI is already covering these) Reasonably priced might want to include actual cost estimates as documentation (i.e. cost of transit, cost of computer needed,) Additional expenses must be paid by beneficiary.

29 Plans for Achieving Self Support (PASS) What happens after the PASS application is submitted SSA reviews to ensure completeness SSA PASS expert reviews and decides if it is feasible to help make sure the plan will help with goal attainment Decide if expenses are necessary and reasonable Decide if changes are needed and discuss the changes with recipient Approve or denied If denied recipient can appeal and submit a new plan, if necessary

30 Plans for Achieving Self Support (PASS) Can the PASS be changed after it is implemented? Yes, but the SSA must approve the changes Changes may include changes in expenses and changes in amount set aside for large expenses Cannot implement the changes without approval! THE SSA MUST BE IN THE LOOP ON ANY CHANGES AT ANY TIME!

31 Plans for Achieving Self Support (PASS) What if the recipient cannot complete the PASS? ALWAYS contact SSA! Help recipient decide whether to terminate the plan and employment (if necessary) or rewrite with a new work goal When the plan terminates all of the expenses and resources set aside will start counting against the benefit amount and the SSI will start to diminish. Failure to advise and adjust the SSI can mean a payback to SSA (this is NOT what you want to do!)

32 SSI and Working RECAP Income includes other items besides earned income so be careful. Lose $.50 cents on the dollar for all income earned above $85 per month in SSI benefits unless you can shelter part of the income through a PASS Resources generally must be held under $2000 with some exceptions. Medicaid eligibility is generally automatic under SSI. If apply of SSI and get denied, always appeal. Unless the disability is under the list of medical conditions you will more than likely get denied first go round. Get an attorney and fight if you feel that the disability qualifies.