Social Security & Working -Very Basic Overview- But lets bust some myths!

Transcription

1 Social Security & Working -Very Basic Overview- But lets bust some myths! Upcoming full 2-day disability training sessions, visit: look under Conferences & Training Key resource: Social Security Administration s (SSA) on-line Redbook at a 50+ page document providing basic understanding of all SSA s work incentives and more. Joe Longcor, Specialist, Behavioral Health & Developmental Disabilities Administration Michigan Department of Health & Human Services longcorj@michigan.gov

2 SSA s definition of Disability 1. A physical or mental impairment, which 2. Prevents someone from performing substantial gainful activity (SGA), and 3. Has lasted or is expected to last more than 12 months or result in death Physical or mental impairment 2

3 Social Security Benefit Programs SSDI/SSD/RSDI SSI Title II Social, Security Disability Insurance Concurrent Title XVI Supplemental Security Income 3

4 SSDI and SSI: What s the Difference SSDI Cash benefit based on work history of: individual parent deceased spouse Paid Social Security (FICA) taxes No resource limits Comes with Medicare Check paid on the 3 rd OR 1 st Wed (Born 1 st -10 th ) 2 nd Wed (Born 11 th -20 th ) 3 rd Wed (Born 21 st 30 th ) Concurrent Needs Based SSI Federal Benefit Rate(2015) $733/individual, $1,100/couple Resource limits $2,000 for single, $3,000 for a couple Comes with Medicaid Check paid on the 1 st If SSDI benefit is less than the Federal Benefit Rate ($733+ $20 in 2015) an individual may be eligible to a portion of SSI in addition to the SSDI benefit (concurrent beneficiary). 4

5 Work Incentive Programs SSDI Only Trial Work Period (TWP) Extended Period of Eligibility (EPE) Subsidy and Special Conditions Medicare Continuation Both Expedited Reinstatement (EXR) Impairment Related Work Expenses (IRWE) Plan to Achieve Self Support (PASS) Freedom to Work (FTW) Section 301 SSI Only Earned Income Exclusion Blind Work Expenses (BWE) Extended Medicaid Property Essential to Self-Support (PESS) Student Earned Income Exclusion 5

6 Medicaid Doors & Challenges Healthy Michigan Plan Challenge for those with Medicare or other insurance Spend-down General fund challenges Possible alternative is Freedom to Work (FTW) Disabled Adult Child (DAC)-a.k.a. Childhood Disability Beneficiary (CDB) Potential for some individuals to remain Medicaid Eligible MI-Choice

7 Supplemental Security Income (SSI) and Work 7

8 General Income Exclusion General Income Exclusion = $20 Social Security disregards $20 of your income whether you earn it or not. The $20 general income exclusion is applied to any unearned income that you may receive. 8

9 SSI: Earned Income Exclusion Earned Income Exclusion = $65/month Social Security does not count $65 of the gross earnings a person receives in a month, plus one-half of the remaining earnings. This means that Social Security does not count more than half of a person s gross earnings when figuring their SSI payment amount. The Earned Income Exclusion is applied in addition to the $20 general income exclusion. 9

10 SSI Example: Basic Countable Income Formula $ amount of gross wages paid in a month - $20 = $ General Income Exclusion - $65 = $ Earned Income Exclusion 2 $ = $ result above divided in half equals amount of wages to be deducted from SSI payment $ Amount of SSI payable per month - $ Minus amount of countable wages =$ Equals new SSI payment 10

11 SSI: HOW SSA Counts your Wages Jan Paid $0 Benefits $733 Total $733 Feb Paid $500 Benefits $733 Total $1233 March Paid $500 Benefits $733 Total $1233 April Paid $500 Benefits $ Total $ May Paid $0 Benefits $ Total $ Gross wages received in one month will effect the SSI check two months down the road 11

12 Examples of Income for Determining SSI Payment Income Counted Unearned Income (SSDI check, Worker s Comp, Veterans Benefits, Retirement Check, etc.) Earned Income (earnings, selfemployment) In-Kind Income (Rent, utilities, etc paid by another person) Income NOT Counted Federal Work Study Program under Title IV Michigan Work Study Gifts for education or grants, scholarships, fellowships, for 9 months after received 12

13 SSI: Student Earned Income Exclusion Allows beneficiary under age 22 and regularly attending school to reduce countable earnings. Regularly attending school means taking at least one or more courses. -8 hrs/wk in college -12 hrs/wk in grades hrs/wk in job training - Less time if beyond student s control -Can include home study 2015 threshold on excludable earnings is $1780/month and $7,180/year. 13

14 ) What Happens to Medicaid When Earnings Reduce SSI to $0 Free SSI Medicaid continues even after SSI payment is reduced to $0 due to work and earnings, until earnings exceed $34,512 per year (2015). Note: SSI check will reduce to $0 (zero) sooner if the person has Unearned Income such as SSDI, Veterans, etc. Note: beneficiary may be eligible for Freedom to Work (FTW) Medicaid Buy-in if the person s earnings exceed this threshold. 14

15 Break Even Point (for individual receiving SSI only) STEP ONE $ Federal Benefit Rate x 2 Multiply by Two = $ 1, Subtotal STEP TWO $ 1, Subtotal + $ General and Earned Income Exclusion = $ 1, Break Even Point without Unearned Income (SSDI, etc.) otherwise occurs sooner. 15

16 1619(b) Section 1619(b) provides for continued Medicaid eligibility. To qualify for 1619(b) Medicaid status: Must have a disabling condition or continue to be blind; Must need Medicaid in order to work; Must be unable to afford benefits equivalent to those received if not working; and/or Must meet all other requirements for SSI payments other than earnings. At the time that SSI cash payments cease due to increased earnings over the Break Even Point, the SSA computer is to automatically determine eligibility for 1619(b). 16

17 SSI: Plan to Achieve Self Support (PASS) Allows you to set aside money (income and/or resources) for a specified time for a specified work goal. Download form SSA does not count the money set aside when determining your SSI eligibility or payment. A PASS is a SSI only work incentive, BUT, it can be used to create SSI entitlement for SSDI beneficiaries or increase the amount of SSI payable also see 17

18 Plan to Achieve Self Support (PASS) How to Contact SSA for Help Michigan PASS Cadre: Kevin Troup: Lower Peninsula Joanie Werner: Upper Peninsula (866) Ext

19 Property Essential to Self Support related to Self-employment This SSI provision allows individuals to exclude certain resources which are essential to their means of selfsupport. Properties that are used in trades or businesses by individuals for work as employees are totally excluded as of May 1, SI Essential Property Excluded Regardless of Value or Rate of Return 19

20 Expedited Reinstatement Must not be performing SGA in the month applying for EXR Be unable to work at SGA due to medical condition Have stopped performing SGA within 60 months due to termination Have current medical impairment that is the same or related to original impairment Continue to be disabled based on the Medical improvement review standards 20

21 Contact and Other Joe longcorj@michigan.gov Follow for additional 1 & 2 day training events on working while on SSI and/or SSDI Virginia Commonwealth University benefits training such as the 5-day, intensive Community Work Incentives