Making Employment Work: Creating Financial Independence Through Work Incentives. Lauren Horner Program Director Maryland Benefits Counseling Network

Transcription

1 Making Employment Work: Creating Financial Independence Through Work Incentives Lauren Horner Program Director Maryland Benefits Counseling Network 1

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3 Why is Work Important? Employment allows beneficiaries to move towards financial independence. Employment helps in the recovery process, increasing selfrespect, dignity and self-worth Employment creates contributing members of society. Improving the economy and community as a whole. Employment offers the opportunity to develop new skills and to grow a successful employment record. 3

4 What Benefits Questions Do You Hear? How many hours can I work and not lose my SSA benefits? How will this job affect my SSA benefits? Will I lose my medical assistance if I work? Can I get my benefits back if I can t continue to work? 4

5 Alphabet Soup BPQY SGA SSA BS&A SSI EID SSDI TWP 5

6 Difference Between Medicaid & Medicare Medicaid A state-run program that provides hospital and medical coverage for people with low income and little or no resources. aka Medical Assistance (MA) Receive with SSI Managed Care and Fee-for- Service Will cover Medicare premiums Apply for Medicaid at DSS or online at mydhrbenefits.gov or marylandhealthconnection.gov Medicare Health insurance program for people age 65 or older, certain individual s with disabilities and those who have permanent kidney failure or Lou Gehrig s disease. Receive with Title II benefits There are 4 parts Part A Hospital Coverage Part B Medical Insurance Part C Supplemental Medicare Advantage Part D Prescription Apply for Medicare through SSA 6

7 Employed Individuals with Disabilities (EID) State of Maryland s Medicaid Buy-In Program Work incentive that provides Medicaid for a fee to people with disabilities who work and would ordinarily have incomes and/or resources above limits for other Medicaid programs Eligibility Requirements Must meet SSA s disability definition (does not necessarily need to receive SSA disability benefits) Be between years old Be working for pay (employed or self-employed) Meet income limits ($36,18 individual or $48,72 married) Have resources below $1, individual or $15, married Be a U.S. citizen or qualified alien 7

8 Title II: SSDI, CDB, DWB A federal disability insurance program that provides benefits to individuals with disabilities who are insured by workers' contributions to the Social Security trust fund. Title II pays benefits to eligible individuals and certain members of his/her family if he/she worked long enough and paid Social Security taxes. 8

9 Title II Eligibility Criteria Social Security Disability Insurance (SSDI) - An individual is a former worker, has achieved insured status and has become disabled Childhood Disability Beneficiary (CDB) - An individual is a disabled adult child of a worker who has retired, became disabled, or who is deceased. The disabled adult child must: Be at least 18 years old Have become disabled before age 22 Be the child (or in some cases the grandchild) of a former worker who is eligible for Social Security retirement benefits or SSDI, or who is deceased Disabled Widows/Widowers (DWB) - An individual is a widow(er) age 5 or older that is disabled and has not remarried before age 6 All must meet Social Security s definition of Disabled There is no resource limit for Title II benefits 9

10 Title II Phases & Work Incentives Phase 1-Trial Work Period (TWP) Phase 2-Extended Period of Eligibility (EPE) Phase 3-Post EPE/Expedited Reinstatement (EXR) Subsidies/Special Conditions Impairment Related Work Expenses (IRWEs) 1

11 Phase 1 Trial Work Period (TWP) The first nine months (not necessarily consecutively) during which an individual earns more than $85/month or works more than 8 hours in selfemployment in a month. In 218, the TWP amount is $85/month but this amount was less for previous years. An individual who worked in the past may have used TWP months already without knowing it. During the Trial Work Period, Title II benefits will not be affected, no matter how high the earnings. However, if Social Security determines an individual has medically improved he/she may lose benefits. Medical reviews will happen regardless of work. Trial work months do not necessarily have to be consecutive. The TWP is calculated over a rolling period of 6 months. 11

12 TWP Scenario Sandy has been entitled to SSDI for six years. She started to work for the first time in April of 216. She had a couple of breaks in her earnings. Sandy s earnings and TWP usage looks like this: 216 Jan. Feb. Mar. Apr. May Jun. July Aug. Sept. Oct. Nov. Dec. Earnings TWP No No No Yes No No No Yes No Yes Yes Yes Count

13 TWP Exercise Sara became entitled to SSDI benefits in May of 24. She began working at the library January of 216, earning $9. a month. Sara worked at the library for 6 months and then stopped working. Sara then began working again October of 216 at a local restaurant and continues to work through the end of 217. She is currently earning $1 per month. Use a SSDI Tracking Form to illustrate Sara s TWP. 13

14 Year 216 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings Benefit Status TWP 2 TWP 3 TWP 4 TWP 5 TWP 6 TWP 7 TWP 8 TWP 9 TWP Year 217 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings Benefit Status Year 218 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings Benefit Status Year 219 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings Benefit Status 14

15 Phase II Extended Period of Eligibility (EPE) Immediately following the 9 th TWP month, Social Security will begin to look at an individual s countable gross earnings every month to see if they are above or below a certain earnings limit known as Substantial Gainful Activity (SGA). In 218, SGA is $1,18 gross earnings per month (non blind) or $1,97 gross per month (blind). The first month an individual performs SGA (after the TWP) and the two months immediately following are called the Grace Period. During these 3 months, Title II benefits will continue. Following the Grace Period, benefits will continue each month the individual does not perform SGA, but will cease each month he/she works at the SGA level. The Extended Period of Eligibility (EPE) is a work incentive protection during this time that allows benefits to be reinstated without a new application, if earnings drop back below SGA again within 36 consecutive months of the end of the TWP. 15

16 Phase II Extended Period of Eligibility (EPE) The EPE begins immediately following the 9 th TWP month. (for example, if the TWP ends January the EPE begins February) The EPE lasts for 36 consecutive months (3 years) whether or not the individual is working during that time. Remember, during the EPE benefits continue for each month the individual has countable earnings of less than the SGA limit but the individual is not eligible to receive a benefit payment for months earnings are above SGA (following the 3 month Grace Period). If earnings fluctuate above and below SGA during the EPE, benefit payments may be stopped and re-started again frequently. Reporting to SSA changes in earnings is critical for benefit payments to stop and start appropriately. 16

17 EPE Exercise In January 218, Sara works increases her hours and earns $12 per month. In May she cuts her hours and is now earning $1 per month once again. Use a SSDI Tracking Form to illustrate Sara s EPE, 3 Grace Period months and to indicate what months she should receive her benefit check. 17

18 Year 216 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings Benefit Status TWP 2 TWP 3 TWP 4 TWP 5 TWP 6 TWP 7 TWP 8 TWP 9 TWP Year 217 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings Benefit Status EPE Starts Year 218 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings Benefit Status Grace Grace Grace No check Check Year 219 Jan Feb March April May June July Aug Sept Oct Nov Dec Countable Earnings Benefit Status EPE Ends 18

19 Phase III Post Extended Period of Eligibility Once the EPE ends (in month 37 following the end of the TWP and beyond): An individual will continue to receive benefit payments for each month they are not performing SGA as long as they continue to meet the medical criteria as disabled. An individual will lose eligibility for Title II, meaning benefits are terminated the first month they are performing SGA. One last work incentive protection is available - Expedited Reinstatement (EXR). If benefits were terminated because the individual worked and had earnings above SGA, they can request that their benefits start again without having to complete a new application (if all below criteria are met). While Social Security determines whether he/she can get benefits again, Social Security can give the individual provisional (temporary) benefits for up to 6 months. Stopped receiving benefits because of earnings from work, Are unable to work or perform substantial gainful activity, Are disabled because of an impairment(s) that is the same as or related to the impairment(s) that allowed you to get benefits earlier, and Make the request within 5 years from the month benefits terminated 19

20 Review Title II Work Incentives Phases Phase I Trial Work Period 9 months (not necessarily consecutive) Individual can earn any amount from work and will receive cash benefit payments during this time Earnings still need to be reported to SSA Phase II Extended Period of Eligibility 36 consecutive months starting immediately after TWP ends Cash payments made for months of earnings below SGA Cash payments suspended for months of earnings above SGA Phase III Post EPE-EXR 5 year period following end of EPE Individual s benefit will be terminated if earnings are above SGA Individual can apply for reinstatement of benefits through EXR, if needed 2

21 Subsidies/Special Conditions Special circumstances that indicate a worker is not actually earning the full wages he or she is being paid. A dollar value for this circumstance is determined and then subtracted from the individual s monthly gross wages to calculate Countable Income. Examples of Subsidies are: Reduced productivity. Performing fewer work duties than co-workers. Receiving extra supervision from employer or a job coach. 21

22 Subsidy Exercise Samantha receives SSDI. She is changing jobs and will be employed as a receptionist at an insurance office. She will be earning $13 per month. Her new job is more challenging but her employer has made some exceptions to Samantha s job description. Samantha will only be required to complete 7% of the standard job description for the receptionist. Samantha will qualify for a Subsidy, a Work Incentive that will allow her to earn more then someone without a Subsidy. Samantha completed her TWP already and is in her EPE. Calculate Samantha s countable earnings using her Work Incentive. Will she continue to receive her benefit? 22

23 Subsidy Exercise Samantha is earning $13 per month but is only required to complete 7% of her job duties. Therefore Samantha has a 3% subsidy. Even though Samantha is earning $13 per month SSA is only going to count $91 (or 7%) of her earnings when determining her countable earnings. Therefore, Samantha will continue to receive her SSDI benefit. 23

24 Impairment Related Work Expense (IRWE) IRWE s must be work related, necessitated by the worker s disability, and paid for by the worker. Examples of IRWE s are: Vehicle modification. Assistive devices (including repair, maintenance, and training to use them). Job coaching. Attendant services. Therapies. Transportation necessitated by disability (e.g. wheelchair van service). Medications, medical services and supplies. 24

25 IRWE Exercise You are an Employment Specialist working with Joe. Joe comes to meet with you to discuss his new job as a cashier. Joe will be working full time and earning $125 per month. Joe is unable to take public transportation because of his disability, therefore, Joe pays his neighbor $15 per month to drive him to and from work. Joe has completed his TWP and is in his EPE. Calculate Joe s countable earnings with his Work Incentive. Will Joe continue to receive his benefit? 25

26 IRWE Exercise Joe is earning $125 per month as a cashier and has an Impairment Related Work Expense of $15 per month. Even though Joe is earning $125 per month SSA will only count $11 per month of his earnings when calculating his countable earnings. Therefore, Joe will continue to receive his SSDI check. 26

27 MD-BCN Online Tools Social Security Disability and Work Calculator

28 What about Medicare? 28

29 Extended Period of Medicare Coverage (EXR) If an individual loses Title II due to work (by performing SGA after the EPE has ended), he/she will retain Medicare for at least 93 months (7 years and 9 months) after the end of the Trial Work Period. *Important to Note: Medicare premiums are typically deducted from an individual s monthly benefit. It is important that individuals know they will be billed directly for their Medicare premiums (usually quarterly) once they are no longer receiving a benefit. But if they qualify for EID, Medicaid will cover the premiums! 29

30 Supplemental Security Income (SSI) Provides supplemental income to adults with low income who are age 65 or older or are blind or have a disability. Needs based program for which the individual must have limited resources and income to qualify. Eligible individuals also receive Medicaid 3

31 SSI Eligibility Criteria General Criteria Individuals who meet SSA's disability criteria or are over 65 and meet income and resource limit guidelines Be a US citizen or qualified alien Income Limits To initially qualify, an individual cannot perform Substantial Gainful Activity (SGA). An individual may be performing SGA if she/he earns more than $118/month gross wages (or $197/month gross wages if the individual is blind). The SGA limit does not apply once approved for SSI. An individual's countable income cannot be greater than $75/month (for 218) Resource Limits Individual resource limit: no more than $2 Married couple (two SSI eligible persons residing together) resource limit: no more than $3 SSA does not count the following resources: An individual s home he/she lives in and the land it is on; Life insurance policies with a face value of $1,5 or less; One car (usually); Burial plots for the individual and members of his/her immediate family; and Up to $1,5 in burial funds for the individual and his/her spouse. Special Needs Trust Fund ABLE Accounts 31

32 SSI Eligibility - Financial Requirements The SSI Federal Benefit Rate (FBR) in 218 is $75 per month. The FBR is the maximum amount of SSI any one person can be potentially eligible for. The amount of SSI an individual qualifies for depends on the amount of other income he or she receives. SSA looks at 2 different categories of income when calculating SSI payment amounts: Countable Unearned Income Countable Earned Income Note: Some individuals may not be eligible for the maximum SSI payment even if they themselves have no other income. An individual s benefit rate could be reduced if he or she is (1) married (deeming), or (2) under age 18 and living with his/her parents (deeming), or (3) not paying the full cost of his/her food and shelter costs (ISM) 32

33 Countable Unearned Income Unearned income is most income except that from wages, salary, or self-employment. For example: Veterans Benefits, Unemployment, Worker s Compensation benefits, other Social Security benefits (Title II), etc. To calculate countable unearned income: Subtract the General Income Exclusion (GEI) of $2 from the amount of unearned income. 33

34 Step Calculations Unearned Income General Income Exclusion (GIE) -- $2 Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate: $75 $75 Total Countable Income - Adjusted SSI Payment =

35 Unearned Income - Exercise Victoria is currently receiving the maximum SSI benefit of $75 each month. Next month she will start receiving an SSDI benefit of $345. Help Victoria by advising her of the effect her SSDI income will have on her SSI benefit amount and calculate her new SSI monthly payment. Use a SSI Calculation Sheet to calculate Victoria s new SSI Payment 35

36 Unearned Income Step General Income Exclusion (GIE) - Countable Unearned Income = Calculations Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate Total Countable Income - Adjusted SSI Payment =

37 Unearned Income - Exercise Once she begins receiving her SSDI payment of $345 per month, Victoria s new SSI payment would be $425 per month. What will Victoria s new monthly income be? With $345 SSDI and $425 SSI, Victoria s total monthly income will be $77 per month. 37

38 Countable Earned Income Like unearned income, earned income from work will reduce the amount of SSI an individual is potentially eligible for - but not dollar for dollar! SSI is only reduced by the amount of countable earned income. How is Countable Earned Income is calculated? 1. Subtracting from gross earnings the General Income Exclusion (GIE) of $2 (as long as it was not already applied to unearned income); then 2. Subtracting the Earned Income Exclusion (EIE) of $65; then 3. Dividing the remaining amount in half. In addition to the GEI and EIE, other special work incentive exclusions may apply (we will discuss these more later on). 38

39 Scenario Countable Earned Income You are a job coach and your client, Theresa, is considering accepting a job at a local pet store. She has scheduled a meeting with you to discuss the effect her new income will have on her monthly SSI payment. Theresa arrives for the meeting excited about the possibility of working for the pet store, but concerned that she will lose too much of a benefit she needs. Theresa tells you her monthly earning from the pet store will be $12, and she is currently receiving the maximum SSI monthly payment of $75. 39

40 Unearned Income Step General Income Exclusion (GIE) - Countable Unearned Income = Calculations Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate Total Countable Income - Adjusted SSI Payment =

41 Theresa s New SSI Payment Now that Theresa is working and earning $12 per month (earned income) her new SSI payment is $192.5 per month. 41

42 Earned Income - Exercise Dwayne is currently receiving the maximum SSI benefit amount each month of $75 per month. Next week he will start a job and will be earning $15 a month. As his job coach, you advise him of the effect his new income will have on his SSI benefit and calculate his new SSI monthly payment. Use a SSI Calculation Sheet to calculate Dwayne s new SSI Payment 42

43 Unearned Income Step General Income Exclusion (GIE) - Countable Unearned Income = Calculations Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate Total Countable Income - Adjusted SSI Payment =

44 Earned Income - Exercise Once he begins earning $15 per month from work, Dwayne s new SSI payment would be $267.5 per month. 44

45 SSI Work Incentives There are three key work incentives for which SSI recipients may qualify to help them receive or retain higher cash benefits: Impairment Related Work Expenses (IRWEs) Blind Work Expenses (BWEs) Student Earned Income Exclusion (SEIE) There is also another work incentive called a Plan for Achieving Self-Support (PASS) which is a tool to help reduce an individual s long term reliance on cash benefits. 45

46 Impairment Related Work Expenses (IRWEs) IRWEs are defined the same for SSI as for SSDI IRWE amounts are deducted from gross earnings within the SSI benefit calculation and enable a person to keep more of their SSI while working IRWEs must be approved by SSA in order to be counted. Individual must provide SSA with copies of IRWE receipts every month. 46

47 Step Calculations Unearned Income General Income Exclusion (GIE) Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate (check for VTR or PMV) Total Countable Income - Adjusted SSI Payment =

48 IRWE Exercises You are a job coach and your client, Tanya, is a person with a hearing disability. Tanya is currently receiving the maximum SSI payment of $75/month. She has been offered a part-time job as a programmer and will be able to work from home. In order for her to work from home she will need specialized equipment and hearing aids. Since Tanya will be incurring the cost of the needed equipment and hearing aids, she schedules a meeting with you to determine how her new income will affect her SSI benefit. When Tanya arrives for the meeting, she tells you she is very excited about this position and will be earning $9 per month. Though she is happy, she is nervous about her new work-related expenses totaling $125 per month. You take a few minutes to review with her how her new income and her work expenses may impact her SSI payment. Use a SSI Calculation Sheet to calculate Tanya s new SSI payment. 48

49 Unearned Income Step General Income Exclusion (GIE) - Countable Unearned Income = Calculations Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate Total Countable Income - Adjusted SSI Payment =

50 IRWE Exercise Once she starts earning $9 per month from work with $125 per month in IRWEs, Tanya s new SSI payment would be $45 per month. Is she financially better off by working? Yes! Tanya s total financial outcome is $118 ($775 from work (after expenses) and $45 SSI) versus $75 while not working What would Tanya s SSI payment be if she did not have an IRWE? $342.5 (difference of $62.5) 5

51 Blind Work Expense (BWEs) A BWE must be incurred due to work and paid for by the individual. BWE s are not time limited. Examples of BWE s are: Guide dog expenses. Transportation. Work-related training. Assistive technology. Medical services and medications. Federal, State, and Local income taxes withheld. Social Security and Medicare taxes withheld. Mandatory pension contributions. Work-related equipment. Childcare. Meals consumed at work. 51

52 Step Calculations Unearned Income General Income Exclusion (GIE) Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate Total Countable Income - Adjusted SSI Payment =

53 Student Earned Income Exclusion (SEIE) The SEIE allows SSI recipients who are under age 22 and regularly attending school to exclude earned income up to $182 per month with a maximum of $735 per calendar year (for 218). Regularly attending school means taking at least one course of study and attending classes: In grades 7-12 for twelve hours per week. In college/university for eight hours per week. In training courses to prepare for employment 12 hours per week (15 hours per week if course involves shop practice). For less time than indicated above for reasons beyond control, such as illness. 53

54 Step Calculations Unearned Income General Income Exclusion (GIE) Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate Total Countable Income - Adjusted SSI Payment =

55 SEIE Exercise You are an employment specialist and your client, Antonio, is 2 years old and a full time student. He receives the maximum SSI payment of $75/month. Antonio starts working part-time at the college library making $55 per month. Antonio is under 22 years of age and attends school on a regular basis; he qualifies for a Student Earned Income Exclusion (SEIE) work incentive. Antonio can apply his earned income (up to $182 per month with a maximum of $735 per year) against his monthly SSI payment. Use a SSI Calculation Sheet to calculate Antonio's new SSI payment. 55

56 Unearned Income Step General Income Exclusion (GIE) - Countable Unearned Income = Calculations Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate (check for VTR or PMV) Total Countable Income - Adjusted SSI Payment = 75 75

57 SEIE Exercise Once he starts earning $55 per month from work and is using the SEIE, Antonio s new SSI payment would be $75 per month What would Antonio s SSI payment be if he did not use the SEIE? $517.5 How long can Antonio use the SEIE for 218 if he starts using it in August? Through December of

58 Plan for Achieving Self-Support (PASS) Enables qualified individuals to set aside income or resources to pay for expenses related to services and/or equipment needed to reach a work goal. Must be approved by the Social Security Administration. A PASS is time limited the length is based on the individual s goal. If the individual changes his or her work goal, then he or she may apply for another PASS. No lifetime limit on the number of PASS s an individual is able to receive; only that each one be used to achieve different work goal. Subsequent PASS s are more difficult to get approved, so it is best to plan for only one. 58

59 Step Calculations Unearned Income General Income Exclusion (GIE) Countable Unearned Income = Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate Total Countable Income - Adjusted SSI Payment =

60 MD-BCN Online Tools Supplemental Security Income Payments Calculator 6

61 But what about Medicaid? 61

62 Continued Medicaid Coverage 1619(b) If an individual loses his/her SSI cash benefit due to earned income, he/she can retain his/her Medicaid through 1619(b). To qualify for 1619(b), a person must: Have been eligible for an SSI cash payment for at least one month; Still meet the disability and non-disability requirements; Need Medicaid in order to work, and Have gross earned income which is either below a predetermined state threshold level or below an individualized threshold. Maryland Threshold for 217 is $4,5 per year. 218 threshold has not yet been released. 62

63 Concurrent Beneficiaries Concurrent describes individuals who are eligible for disability benefits under both the SSI and Title II programs. Concurrent beneficiaries can use all work incentives available to SSI and Title II beneficiaries. 63

64 Concurrent Beneficiaries Exercise You are a job developer working with Laura. Laura has $22 in SSDI and $535 per month in SSI. Laura is offered a job earning $1 per month and wants to know how this will impact her benefits. This is her first job since she started receiving benefits. Calculate Laura s new SSI payment using a SSI Calculation Sheet. Will Laura s new job impact her SSDI benefit? 64

65 Unearned Income Step General Income Exclusion (GIE) - Countable Unearned Income = Calculations Gross Earned Income Student Earned Income Exclusion - GIE (if not used above) - Earned Income Exclusion (EIE) - Impairment Related Work Expense (IRWE) - Divide by 2 Blind Work Expenses (BWE) - Total Countable Earned Income = Total Countable Unearned Income Total Countable Earned Income + PASS Deduction Total Countable Income = Base SSI Rate Total Countable Income - Adjusted SSI Payment =

66 Concurrent Beneficiaries Exercise What is Laura s new SSI payment? $82.5 Will Laura s SSDI benefit be impacted? Laura will begin using TWP months because her earnings are over the TWP Threshold and will continue to receive her SSDI. What is Laura s total income before taxes? $1,32.5 Will Laura keep her health insurance? Yes, she will keep both her Medicaid & Medicare. 66

67 What is the Ticket to Work Program The Social Security Administration (SSA) started the Ticket to Work program to help people who get Social Security disability benefits get the services they need to find a job and to stay employed. SSA has set up agreements with hundreds of community programs around the country so that people can find these services in their communities. Most often, the services are career guidance, job placement, job coaching and/or benefits counseling Social Security calls these agencies employment networks and ENs. The beneficiary assigns a ticket to an EN. In turn, the EN provides needed services at no charge. SSA has contracted with a company called Maximus to administer the Ticket to Work program. 67

68 What is a Ticket Anyone who is receiving Social Security Disability benefits has a Ticket to Work. You do not need an actual ticket. However, this is what a ticket to work looks like. Social Security mails it in the award letter. 68

69 Goal of the Ticket to Work Program Increase the number of beneficiaries entering the work force Reduce beneficiary dependency on cash benefits 69

70 How does that help a beneficiary? When a Ticket is assigned to an employment network, SSA will not conduct a continuing disability review (as long as Timely Progress is met). The beneficiary gets no-cost employment support services Some agencies provide ongoing personalized benefits counseling about Social Security s safety nets for cash benefits and medical coverage 7

71 What to Expect with an Assigned Ticket The EN will work with the beneficiary to set up an Individualized Work Plan (IWP). The plan will include employment goals and the amount of money the beneficiary expects to earn. The EN will typically ask the beneficiary to provide information on wages earned. 71

72 Timely Progress Reviews In order for the Ticket to stay assigned to an EN, Maximus will track a ticket holder s progress Usually conducted at the end of every 12 month period the ticket is assigned or in use MAXIMUS checks the earnings of ticket holder If earnings meet SSA guidelines, no further action takes places If earnings don t meet SSA guidelines, MAXIMUS contacts beneficiary 72

73 What If I Don t Want to Participate? The Ticket to Work program and Social Security s work incentives are voluntary. There is no penalty if you decide not to participate. 73

74 Communicating with SSA Recordkeeping Keep all correspondence from SSA Ask for receipt when providing documentation to SSA Always keep a copy of submitted documentation Know claims representative that is handling case 74

75 Reporting Earnings SSI Needs to be reported monthly, by the 6 th of each month! In person, by mail, by automated phone system ( ), or with new smart phone app for IPhone & Android (search mobile wage reporting). The new smart phone app or the automated phone system are the best ways to report. Reporting in person or by mail does not guarantee the check will be impacted in a timely manner. 75

76 Reporting Earnings Title II Best way to report is online via an individual s my Social Security Account. Must be reported monthly! Other reporting options are providing copies of pay stubs to the local office in-person, by mail, or by fax. Use a Work Activity Report (SSA-821) to report past work history and update SSA records. This is the most important reporting tool for Title II beneficiaries. Work Activity Reports should be submitted at critical touchpoints that are best determined with a benefits counselor. 76

77 Reporting Earnings continued Concurrent beneficiaries Need to report to both SSI and Title II workers Needs to be done on a monthly basis for SSI by using the automated phone system or the smart phone app. Report online on a monthly basis for Title II via my Social Security Account and using the Work Activity Report (form SSA-821) based on a timeline as determined with a benefits counselor. 77

78 Making Employment Work Using this Information You are not expected to provide intensive benefits counseling. You should use this information to encourage employment. You should use this information to break down barriers to employment regarding loss of benefits. 78

79 Making Employment Work To make employment work you should be able to identify the need for intensive benefits counseling services and refer appropriately. Once a Beneficiary becomes employed you should: Work with Beneficiary & Benefits Counselors to develop and support a plan for self-management of benefits. 79

80 Accessing a Benefits Counselor Division of Rehabilitation Services (DORS) consumers DORS can add Benefits Counseling Services to a consumer s employment plan. Benefits Advocates should advocate for Benefits Counseling to be a part of the consumer s employment plan from the beginning. 8

81 Accessing a Benefits Counselor Maryland Employment Network (MD-EN) MD-EN is an Employment Network (EN) which provides Employment Services as well as Benefits Counseling Services. Phone: Website: Other Employment Networks may offer Benefits Counseling services but not all do. 81

82 Accessing a Benefits Counselor Maryland-Work Incentives Network Work Incentives Planning and Assistance (WIPA) project for Maryland which offers free Benefits Counseling Services to beneficiaries in the state. In most areas, services are provided only remotely. Phone: Website: 82

83 Evaluations/Assessment Please complete your evaluations before leaving today! You will receive an with the link and password to complete your training assessment. CEUs/COAs will only be issued after successful completion of the assessment! Be sure to dedicate time for your assessment. If you leave the assessment page once started, you will not be able to log back in where you left off and will need to start all over again. Remember to visit our website at for resources and tools! 83

84 Resources DORS (Division of Rehabilitation Services) Has programs and services that help people with disabilities go to work or stay independent in their homes and communities Website: EID (Employed Individuals with Disabilities) Has information on EID and how to apply. Website: SSA (Social Security Administration) - website provides information and resources for individuals who are receiving Social Security benefits or want to find out more about receiving benefits. Website: 84

85 Resources The Red Book - A Guide to Work Incentives - serves as a general reference source about the employment-related provisions of Social Security Disability Insurance (SSDI) and the Supplemental Security Income (SSI) programs for educators, advocates, rehabilitation professionals and counselors who work with people with disabilities. Website: MAXIMUS - responsible for managing the Ticket to Work Program for SSA. Send out Timely Progress Review letters to beneficiaries. Website: PASS (Plan for Achieving Self-Support) Resources - the following websites provide general information, link to PASS form, tutorials and examples of a completed PASS. SSA s PASS Website - Cornell University, Employment and Disability Institute - University of Montana Rural Institute