Ticket to Work / Benefits Basics:

DRC’s & One-Stop Staff Serving as a Resource on SSA Disability Benefits &

Work Incentives

2011 Training Series – March 24, 2011

Hosted/Facilitated by: Laura Gleneck

Presented by: Jamie Robinson & Elizabeth Jennings, NDI Technical Assistance Team Members

DEI Projects at the state level and/or local level participating LWIBs are required to become Employment Networks (EN) under Social Security Administration’s (SSA) Ticket to Work Program (TtW).

Training and Technical Assistance to DEI Projects in attaining Employment Network status and implementing effective EN operations is provided under U.S. DOLETA contract with NDI Consulting, Inc. and the National Disability Institute (NDI).

Evaluation of the impact of the DEI Projects implementation and outcomes as Employment Network will be provided under U.S. DOL ODEP contract with Social Dynamics.

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Upon completion of this webinar, DEI Project staff will: Understand the DRC’s role as a resource on SSA disability benefits & work

incentives, & other non-SSA incentive programs

Have an understanding of the basic components of SSA’s two disability benefit programs: SSDI & SSI

Recognize the importance of coordinating work incentives & how they are designed to increase an individual's work effort

Have basic information about complimentary non-SSA incentives that beneficiaries can and should utilize

Have downloadable TOOLKITs with information & resources on SSA disability benefits & work incentives, & other non-SSA incentive programs that help to build One-Stop staff & customer awareness

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Ticket to Work/Benefits Basics Ticket to Work/Benefits Basics Learning Learning

ObjectivesObjectives

Background from Part I TtW/Benefits Basics:◦ Ticket to Work as Major Component of DEI

SSA Disability Benefits Basics◦ Critical Components of SSI/SSDI◦ Other Incentives & Programs

Downloadable TOOLKITs on SSA Disability Benefits:◦ For One-Stop Customers Who Need Information on Applying for

SSA Benefits ◦ For One-Stop Career Centers◦ For Customers Who Are Ready to Work

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DEI pilot sites are required to become EN’s to expand services to individuals with disabilities who receive either SSI or SSDI benefits within the One-Stop system

One-Stop Career Centers serve ALL customers, including individuals with disabilities, many of whom are beneficiaries

One-Stop Career Centers are able to provide the services expected of ENs, which can lead Ticket holders to greater levels of self-sufficiency

DRCs can greatly enhance the likelihood of increased employment and training opportunities for Ticket holders within the workforce system

Partnership Plus

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SSA Disability BenefitsSSA Disability Benefits

Overview/Knowing rules before attempting work

Substantial Gainful Activity

Work Incentives

Continued Medicare

Good record keeping

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Overview/Basic Calculations

Resource limits

Work Incentives

Continued Medicaid (1619b)

Good record keeping

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Medicaid Buy-In Program HUD Programs

Earned Income Tax Credit

Other Financial Stability programs

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SSA has two programs to support individuals with disabilities with an inability to work at a substantial level.◦ Social Security Disability Insurance (SSDI)◦ Supplemental Security Income (SSI)

Many people with disabilities who receive SSDI and/or SSI want to work or return to work but are unsure what will happen to their benefits when they do.

SSA has special work incentives available that make it possible for individuals to test their ability to work and continue to receive some or all of their cash and health benefits.

Overview: SSA Disability BenefitsOverview: SSA Disability Benefits

Individuals must prove 2 things to be eligible for SSDI or SSI:

1. Prove that they have a documented medical disability that will last 12 months or longer or result in death.

1. Meet SSA’s definition of disability: The inability to engage in Substantial Gainful Activity (SGA, which is paid work) by reason of any documented medical impairment (physical or mental) that will lasts 12 months or longer and/or result in death.

*Individuals who are blind do not have to prove that they are unable to work. They only have to prove that they meet SSA’s level of blindness.

SGA is a basic test used by SSA to establish disability status

SGA is the performance of significant mental and/or physical duties for profit.

It is usually determined to be gross earnings (before taxes) of an amount of money that is set January 1 of each calendar year based on the National Average Wage Index.

To meet this test a person must not be working, or if working, earning less than the SGA level amount.

*2011 SGA for non-blind individuals = $1000/month

*2011 SGA for blind individuals = $1640/month

SSDI is a Title II Benefit.

SSDI benefits are based on a person’s work history looking at length of time and amount of money earned in F.I.C.A.. SSDI check amount will vary from person to person.

DAC –Disabled Adult Children• Disability prior to age 22 & never legally married• Insufficient FICA or higher parent amount• Parent is deceased, disabled or retired• Possible continuation of Medicaid

Medical Insurance – MEDICARE

5 Month Waiting Period for cash benefits

24 months waiting period for Medicare

No Asset limit

Individual must have 12 months consecutive-initial eligibility

SSDI is obsessed with SGA

Important to Note about SSDIImportant to Note about SSDI

These are the list of programs under SSDI called Work Incentives:

◦ Trial Work Period (TWP) = $720/Month 2011◦ Extended Period of Eligibility (EPE)◦ Extended Medicare Coverage◦ Impairment Related Work Expenses (IRWE)◦ Section 301◦ Special Condition/Subsidies ◦ Expedited Reinstatement (EXR)

A 9-month period, within 60 months, in which a person on SSDI can work and earn any amount of money without the earnings affecting their SSDI eligibility.

Each month an SSDI recipient earns more than $720 counts as one month of the TWP (indicated 2011 amount).

These months do NOT need to be consecutive.

A period of extended eligibility that starts with the month after the TWP ends and continues for the next 36 months.

Months that countable earned income is less than the SGA level they receive their full SSDI check.

Months that countable earned income is more than the SGA level they do not receive a SSDI cash benefit.

When countable wages first exceed the SGA level (cessation month), Social Security will plan to stop the benefits - but will allow the person to receive a check for that month and for 2 more months as a “grace period” before stopping checks altogether.

An IRWE exists when:

◦ The individual with a disability pays for the item or service

◦ The item or service is related to the person’s condition

◦ The person would not be able to work if s/he did not spend the money and receive the item or service

◦ Can apply to SSI or SSDI

A Subsidy exists when the employer:

◦ Willingly pays more in wages than the value of services performed (Employer Subsidy); or

◦ Receives full value only because some agency provides extra services to the employee (sometimes called Special Considerations)

◦ Applies it to SSDI beneficiaries.

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An SSDI beneficiary is entitled to continued Medicare coverage after the Trial Work Period (TWP) and for up to an additional 93 months following the ninth trial work month.

During this entire period, hospital coverage is automatic and cost-free. Outpatient coverage continues to be optional and subject to premium payment ($115.40/month in 2011. For individuals already enrolled in Medicare in 2010, they should not see an increase from the 2010 rate of $110.50/month).

Re-Application with SSA

Expedited Reinstatement (EXR)

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SSDI benefits shall be reinstated without a new application if the person:

◦ Was eligible for SSDI; and Lost SSDI due to performance of SGA Requests EXR within the consecutive 60-month period

beginning with the month of entitlement termination Is disabled by the same as (or related to) the physical or

mental disability that was the basis for their original claim Is under a disability based on the application of the medical

improvement review standards (MIRS) Is unable to perform SGA due to his or her medical condition

SSDI dependent’s benefits may be reinstated if the dependent satisfies all of the requirements for entitlement to the benefits.

Provisional benefits may be received up to 6 months pending the reinstatement application.

Once the individual receives EXR benefits for 24 months (called the Initial Reinstatement Period, or IRP), he or she will be eligible for a new Trial Work Period, Extended Period of Eligibility and Expedited Reinstatement period. (This is a new period of disability).

Supplemental Security Income (SSI) is a Title XVI program.

SSI is the payer of last resort.

An individual must prove that they are financially eligible for SSI.◦ Monthly income less than $674/month◦ Assets less than $2000◦ Eligible couple = $1011/month and $3000 assets

Federal Benefit Rate Maximum: 2011 equals $674 per month.

Medical Insurance - MEDICAID

Not everyone receives the full benefit amount

The rate of pay an individual is eligible for is based on:◦ Family composition (i.e. Living alone, with others, etc.)◦ Marital status◦ Deeming of income ◦ Type of housing (i.e. congregate care)◦ In-Kind support and maintenance

Income: Anything received in cash or in kind that can be used to meet needs for food or shelter.

Two Types of Income: Earned Income and Unearned Income

◦ Earned Income: Typically, gross wages - salaries, commissions, bonuses, self-employment; sheltered workshop earnings.

◦ Unearned Income: All income that is not earned income. Unearned income is counted when it is actually or constructively received.

Resources: Cash or other liquid assets or real or personal property that an individual owns and could convert to cash which can be used to provide for food or shelter.

◦ The general rule is that an item received in a month is income and, unless spent, becomes a resource in the following month.

◦ General resource limit in 2011 is $2,000 for an individual, $3,000 for an eligible couple (Note: This rate was established on 1/1/89).

SSI Work Incentives enhance economics and can protect Medicaid◦ Student Earned Income Exclusion◦ Impairment Related Work Expense (IRWE)◦ Blind Work Expense◦ Plan For Achieving Self-Support (PASS)◦ Property Essential for Self-Support (PESS)◦ 1619a◦ 1619b◦ Section 301◦ Special Condition/Subsidies◦ Expedited Reinstatement

Sample of a SSI wage Formula:

$1085 gross Wages

-20 General Exclusion

-65 Earned Income Exclusion Wages = $1085.00

$1000 New Countable Wage New SSI = 174.00

$1259.00

$1000 ÷ 2 = $500 New Countable Wage

$674 Federal Benefit Rate for SSI 2009

- 500 Countable Wage

$174 New SSI

Student Earned Income Exclusion (SEIE) - The SEIE allows an individual who is under age 22 and regularly attending school to have earnings excluded from income as shown below:

For Year 2011, Monthly Exclusion is $1640, Maximum exclusion for calendar year is $6,600

Effective 4/01/05 To qualify for this exclusion, an individual must be:

◦ under age 22; and

◦ a student regularly attending school per SI 00501.020D.

IRWE reduces gross income due to disability-related out of pocket expenses that allow a person to earn income, even if those items or services are needed for non-work activities.

◦ The expenses must be directly related to supporting the disability

◦ Cost must be paid out of person’s pocket and not covered by other funding sources

◦ Expense must be paid in a month wages are earned

◦ Expense must be reasonable

The purpose of PASS is to allow SSI recipients to set aside income and/or resources to be used to assist in achieving specific work goals.

A PASS can be used to assist in the costs of education, starting a business or purchasing support services that will result in the reduction / cessation of benefits.

By utilizing PASS, an SSI recipient’s can help to off-set the costs associated with the return to gainful employment by reducing countable income and potentially increasing the amount of SSI cash benefits due.

The PASS plan must: Have a specific work goal Have a specific time frame for reaching the goal Show what money and any other contributions will be used to

reach the work goal Show how any money set aside in savings will be kept separate

from other funds Show how the money and resources will be saved and, later, spent Be submitted in writing and approved by Social Security’s PASS

Cadre Include a Business Plan if the PASS is for self-employment Be reviewed periodically to assure compliance Increase an individual’s ability to be self-supporting by decreasing

the amount they receive in cash benefits from Social Security

www.passonline.org

Protects Medicaid when SSI Cash Benefits is Zero:

◦ The person must lose eligibility for SSI cash benefits due to excess earnings

◦ Person must be otherwise eligible for SSI

◦ Person must need Medicaid to Work

◦ Earnings must be below State’s Earned Income Threshold: www.ssa.gov/disabilityresearch/wi/1619b.htm#threshold

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Re-Application

Expedited Reinstatement (EXR)

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SSI benefits shall be reinstated without a new application if the person:

◦ Lost SSI due to excess income above 1619(b), and exceeded 12-month suspension period

◦ Requests EXR within the consecutive 60-month period beginning with the month of entitlement termination

◦ Is disabled by the same as (or related to) the physical or mental disability that was the basis for their original claim

◦ Is under a disability based on the application of the medical improvement review standards (MIRS)

◦ Is unable to perform SGA due to his or her medical condition

SSI benefits may be reinstated if the dependent satisfies all of the requirements for entitlement to the benefits

Provisional benefits may be received up to 6 months pending the reinstatement application

Once the individual receives EXR benefits for 24 months (called the Initial Reinstatement Period, or IRP), he or she will be eligible for a new Trial Work Period, Extended Period of Eligibility and Expedited Reinstatement period (This is a new period of disability)

Open SSA mail immediately

Keep EVERYTHING SSA sends

Make copies of EVERYTHING sent to SSA

Report new work activity to the local SSA Office

Provide wage data to SSA regularly by providing a copy of pay check stubs◦ Wage data may be FAXED, hand delivered, or mailed◦ Be sure to write your S.S. # on pay check stubs, and your name if

not already printed on check stubs

The Work Incentives Planning Assistance Program is a grant funded program sponsored by the Social Security Administration

Community Work Incentive Coordinators (CWIC) receive training approved by SSA, and are certified under this program to provide accurate advisement to Social Security beneficiaries

http://www.ssa.gov/work/wipafactsheet.html

Protects the rights of beneficiaries of SSDI and SSI

◦ Check out any complaint against an employment network or other service provider helping an individual return to work

◦ Give information and advice about vocational rehabilitation and employment

◦ Explain SSA’s work incentives ◦ Provide consultation and legal representation to protect the rights

of any one wanting to return to work◦ Assist with problems concerning work plans under the Ticket to

Work Program

http://www.ssa.gov/work/PandA.html

Medicaid Buy-In Program

Housing & Urban Development (HUD) Programs

Earned Income Tax Credit (EITC)

Other Financial Stability programs

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SSA has provided a sense of financial stability.

Ticket to Work is about Self-Sufficiency, so building the Financial Stability of the Ticket Holder should be part of the plan.◦ Letting go of SSA is easier with a plan for financial stability

In the upcoming Ticket 301 Series in April, we will discuss additional financial stability programs.

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Medicaid Buy-In programs allow states to expand Medicaid coverage to workers with disabilities who are not typically eligible for Medicaid due to their income/assets.

States design their Medicaid Buy-In program (within certain parameters) to meet their State’s unique needs, resources, and objectives.

To be eligible for the Buy-In program, an individual must have a disability (as defined by the Social Security Administration), have earned income, and meet any other financial eligibility requirements established by their state.

*Check with Your State Medicaid office to learn more about Buy-In

HUD offers many (over 25) programs to support individuals in transitioning to work.

Programs vary by Public Housing Authority (PHA).

Important to Note: Earned Income Disregard ◦ First 12 Months of Employment = 100% disregard of New Wages◦ Second 12 Months of Employment = 50% disregard of New

Wages

www.huduser.org/publications/pdf/w2w.pdfwww.nls.org/ssassi/hud-earned-income.pdf

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The Earned Income Tax Credit (EITC) is a credit for people who earn low-to-moderate incomes.

EITC can reduce your taxes, and can mean a refund.

In simple terms, working families and individuals may keep

more of their hard earned money.

Earned Income and adjusted gross income (AGI) must be less than:• $43,352 ($48,362 married filing jointly) with three or more qualifying children• $40,363 ($45,373 married filing jointly) with two qualifying children• $35,535 ($40,545 married filing jointly) with one qualifying child• $13,460 ($18,470 married filing jointly) with no qualifying children

Tax Year 2010 maximum credit:• $5,666 with three or more qualifying children• $5,036 with two qualifying children• $3,050 with one qualifying child• $457 with no qualifying children

Investment income must be $3,100 or less for the year.

*For more information on whether a child qualifies you for the EITC,

see IRS Publication 596, Chapter 2.

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2010 Tax Year EITC

File For Free!!!

The VITA Program offers free tax help to low- to moderate-income (generally, $49,000 and below) people who cannot prepare their own tax returns. Certified volunteers sponsored by various organizations receive training to help prepare basic tax returns in communities across the country. VITA sites are generally located at community and neighborhood centers, libraries, schools, shopping malls, and other convenient locations. Most locations also offer free electronic filing.

To locate the nearest VITA site, call  1-800-829-1040.

Financial Education

Affordable Financial Services

Favorable Tax Provisions

Family Self-Sufficiency Program

Individual Development Accounts (IDAs)

The basic components of SSA’s two disability benefit programs, SSDI & SSI.

Work incentives that allow an individual to return to work while maintaining some or all of their cash benefits and/or medical insurance.

How these work incentives support the Ticket to Work program.

The importance of using other programs to build the financial security of an individual as they build their work effort and let go of some or all of the SSA benefit.

How DRCs can serve as a resource on SSA benefits & work incentives, and other incentive programs to expand employment & financial opportunities to individual with disabilities.

Questions? Questions?

A: Submit it to the host in writing via the Chat or Q&A Box to the right, or…

B: Click on the “raise hand” icon to have your line un-muted and ask your question/make your comment.

Ticket to Work & Social Security Disability Benefits TOOLKIT For One-Stop Customers Who Need Information about Applying for SSA Benefits

Ticket to Work & Social Security Disability Benefits TOOLKIT For Customers Ready to Work

Ticket to Work & Social Security Disability Benefits TOOLKIT For One-Stop Career Centers

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Elizabeth JenningsProgram AssociateNDI Technical Assistance Teamejennings@ndi-inc.org

Jamie RobinsonProgram AssociateNDI Technical Assistance Teamjrobinson@ndi-inc.org

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Contact InformationContact Information