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Enhancing the Employment Outcomes of SSISSDI Beneficiaries

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Title: Enhancing the Employment Outcomes of SSISSDI Beneficiaries


1
(No Transcript)
2
Enhancing the Employment Outcomes of SSI/SSDI
Beneficiaries
ARCA 50th Anniversary Educational
Conference November 10, 2007 This presentation
is provided through the Department of
Correctional Services System Change Initiative
at Cornell Universitys Employment and Disability
Institute funded by the New York State
Developmental Disabilities Planning Council in
collaboration with the New York State Department
of Correctional Services and Division of Parole.
3
So what is the current employment outlook for
people with disabilities in the U.S. ?
4
The American Community Survey
  • Much of the following statistics are derived from
    the American Community Survey (ACS) which is a
    new continuous data collection effort conducted
    by the U.S. Census Bureau.
  • The ACS is used to produce annual estimates at
    the national, state and local level on the
    characteristics of the United States population.
  • The ACS collects information on an annual basis
    from approximately 3 million addresses in the US
    and 36,000 addresses in Puerto Rico.

Calculations by the Rehabilitation Research and
Training Center on Disability Demographics and
Statistics (StatsRRTC) using the 2006 ACS Public
Use Microdata Samples (PUMS).
5
ACS - Employment Rates
  • In 2006, the employment rate of working-age
    people with disabilities was 37.7 in the US
  • In 2006, the employment rate of working-age
    people without disabilities was 79.7 in the US
  • In 2006, the gap between the employment rates of
    working-age people with and without disabilities
    was 42.0 percentage points in the US

Rehabilitation Research and Training Center on
Disability Demographics and Statistics. (2007).
2006 Disability Status Report. Ithaca, NY
Cornell University.
6
CPS - Labor Market Activity
The labor market activity rate is the percentage
of men and women, aged 18-64 in the United States
who worked more than 52 hours in the prior
calendar year from 1981 - 2004
with work limitation
w/out work limitation
Houtenville, A. J., Erickson, W. A., Lee, C. G.
(2005, April 4). Disability Statistics from the
Current Population Survey (CPS). Ithaca, NY
Cornell University Rehabilitation Research and
Training Center on Disability Demographics and
Statistics (StatsRRTC). Retrieved September 17,
2007 from www.disabilitystatistics.org
7
ACS- Household Income
  • In 2006, the median household income of
    working-age people with disabilities was 36,300
    in the U.S. as compared to 65,400 for those
    without disabilities.

Rehabilitation Research and Training Center on
Disability Demographics and Statistics. (2007).
2006 Disability Status Report. Ithaca, NY
Cornell University.
8
ACS Poverty SSI
  • In 2006, the poverty rate of working-age people
    with disabilities in the US was 25.3 as compared
    to 9.2 without a disability
  • In 2006, the percentage of working-age people
    with disabilities receiving SSI payments was
    16.5 (n3,699,000) in the U.S.

Rehabilitation Research and Training Center on
Disability Demographics and Statistics. (2007).
2006 Disability Status Report. Ithaca, NY
Cornell University.
9
The Longitudinal Study of Vocational
Rehabilitation Services Programs
  • Stapleton and Erickson (2005) documented that
    SSDI and SSI beneficiaries attain lower
    employment and earnings outcomes than other VR
    clients.
  • SSDI and SSI beneficiaries were more likely to
    work part-time as compared to other VR clients.
  • Mean weekly hours worked were 26.5 for
    beneficiaries as compared to 35.8 for other VR
    clients.
  • Mean hourly income showed a 2.56 difference
    between beneficiaries and other VR clients.
  • Beneficiaries were less likely to have jobs with
    employer-sponsored healthcare.

10
So, what would it take to improve the employment
outlook for SSI and SSDI beneficiaries?
11
Variables Impacting Employment Outcomes
  • Disability benefits and other entitlements
  • Current policy barriers to work
  • Proving inability to work
  • Making work pay
  • Unintended consequences across programs
  • Expectations
  • Livable wages and quality jobs
  • Belief in full employment
  • Greater economic independence through an earning
    offset

12
SSA Organizational Structure
  • The Social Security Administration (SSA) is a
    federal agency.
  • SSA administers two benefit programs for people
    with disabilities
  • Social Security Disability Insurance (SSDI)
  • Supplemental Security Income (SSI).

13
Definition of Disability for Adults
  • The inability to engage in any substantial
    gainful activity (SGA) by reason of medically
    determinable physical and/or mental impairment(s)
    which can be expected to last for a continuous
    period of not less than 12 months or result in
    death.

14
Five-Step Sequential Analysis
  • STEP 1. Is the applicant engaging in Substantial
    Gainful Activity (SGA)?
  • STEP 2. Does the applicant have a severe
    impairment?
  • STEP 3. Does the applicant suffer from an
    impairment which meets or equals the severity of
    a listed impairment?

15
  • STEP 4. Does claimant have the residual
    functional capacity (RFC) to perform his/her past
    relevant work (work performed in the last 15
    years)?
  • STEP 5. Does the claimant have the RFC to perform
    any other work that exists in significant numbers
    in the national economy? Burden of proof shifts
    to SSA at step 5.

16
Substantial Gainful Activity (SGA)
  • SGA threshold changes every year. In 2007 it is
    900/month and will be 940 in 2008.
  • SGA threshold for blind SSDI applicants in 2007
    was 1500/month and will be 1570 in 2008. No
    SGA test for blind SSI applicants.
  • If self-employed, look at net income after
    business deductions value of work to business.

17
Continuing Disability Reviews
  • CDRs are a critical part of the SSI disability
    program. CDRs insure that those entitled
    recipients continue to receive benefits and those
    who medically improve do not.
  • CDRs maintain the credibility of the program
  • CDRs occur in ALL disability cases.

18
Continuing Disability Reviews
  • The CDR process occurs at 3, 5 or 7 year
    intervals depending upon the disability involved
    and medical improvement standard.
  • SSA must prove that there has been medical
    improvement and that this medical improvement
    relates to the ability to work.

19
Social Security Disability Insurance
20
SSDI
  • SSDI benefits are paid to individuals and their
    dependents after the individual has worked and
    paid Social Security taxes.
  • Benefits are paid upon retirement and disability.
    Survivors benefits may be available upon the
    death of the insured worker.

21

SSDI Eligibility Overview
  • Called SSDI, Disability Insurance Benefits (DIB),
    or Title II.
  • Must have insured status which is gained by
    working and paying FICA taxes and earning credits
    or quarters of coverage. 1000/QC in 2007 and
    will be 1050 in 08.
  • Insured wage earners may be eligible for
    retirement benefits and disability benefit.
  • No income or asset limits.

22
SSDI Overview Continued
  • Medicare will provide health care coverage to
    retired workers upon retirement. Disabled
    beneficiaries will begin Medicare coverage in
    month 25 of SSDI eligibility.
  • Benefits are payable, after application is filed,
    beginning 5 months after the onset date, but
    not more than 1 year prior to the date of
    application

23
SSDI Work Incentives
  • Trial Work Period
  • Extended Period of Eligibility
  • Vocational Rehabilitation Program
  • Impairment-Related Work Expenses
  • Subsidies and Special Conditions

24
Trial Work Period
  • Unless medical recovery is an issue,
    beneficiaries are entitled to a TWP
  • Opportunity to test work skills while maintaining
    full cash benefit
  • SSA will evaluate work activity and earnings
    after the 9th month is completed.
  • Annually indexed (640 in 2007 / 670 in 2008)

p. 49
All earnings
9 months
60 mos. window
640/ 80hr.
25
p. 67
26
Extended Period of Eligibility
  • The EPE begins in the month immediately after the
    completion of the 9th trial work month.
  • The EPE continues for 36 consecutive months.
  • The recipient will be eligible to receive a full
    benefit payment in each month that income drops
    below the current SGA level.

27
WAGES BENEFITS
p. 68
MONTHS
28
TWP/EPE Exercise
  • Identify the beginning and ending of TWP, EPE,
    and the Grace Period

 
 
29
TWP / SGA Amounts
  • TWP
  • 2000 / 200
  • 2001 / 530
  • 2002 / 560
  • 2003 / 570
  • 2004 / 580
  • 2005 / 590
  • 2006 / 620
  • 2007 / 640
  • 2008 / 670
  • SGA
  • 2000 / 700
  • 2001 / 740
  • 2002 / 780
  • 2003 / 800
  • 2004 / 810
  • 2005 / 830
  • 2006 / 860
  • 2007 / 900
  • 2008 / 940

30
Vocational Rehabilitation Programs
  • Upon a determination that a recipient has
    medically improved, participation in a vocational
    rehabilitation program will allow benefit
    payments to continue until the program is
    completed if

the plan will be completed in a reasonable
time and completion is likely to result in the
elimination of the need for benefits. This
provision is commonly referred to as the section
301 exception.
31
Section 301 Improvements
  • New regulations, effective July 25, 2005, improve
    301 and apply the provisions to children in
    transition.
  • An individual will be considered participating
    in a program despite a disability related break
    provided the break last no more than 3 months.
  • A child will be eligible for cash benefits
    continuation if participating in an IEP.

32
SGA Determinations SGA Levels
  • The SGA level now changes every calendar year.
  • In 2007, SGA is set at 900/1,500 per month.
  • In 2008, SGA is set at 940/1,570 per month.

33
SGA Tools
  • Unsuccessful Work Attempt (UWA)
  • Income Averaging
  • Impairment-Related Work Expenses (IRWE)
  • Subsidy
  • Un-incurred business expenses and unpaid help for
    self employed individuals

34
Unsuccessful Work Attempt
  • A Unsuccessful Work Attempt (UWA) is an effort to
    do substantial work in employment or
    self-employment which is discontinued or reduced
    to the non-SGA level after a short time (no more
    than 6 months) because of the individuals
    impairment that are essential to the further
    performance of work.

35
Income Averaging
  • Applied when earnings after TWP fluctuate above
    and below the SGA guideline and UWA criteria do
    not apply.
  • Averaging is unnecessary and should NOT be
    applied when work is consistently above or below
    SGA or when work is determined to meet UWA
    criteria.
  • NOT used when counting TWP months or during EPE
    after cessation month.

36
Income Averaging
  • If gross wages may be reduced by the value of
    Impairment-Related Work Expenses, or Subsidy, the
    earnings are averaged after these deductions are
    applied. Averaging is performed on countable
    earnings, not gross earnings.

37
Impairment-Related Work Expenses
  • SSA allows deductions from gross wages for
    disability related expenses, services and/or
    items necessary to the recipients work effort.
  • These expenses are used to reduce gross wages
    before SSA makes an SGA determination.

38
Impairment Related Work Expenses
  • An IRWE is an expense that meets all of the
    following conditions

it enables the recipient to work, it is paid
for by the recipient, it is not reimbursable by
any source, the cost is reasonable, it is
needed because of an impairment, and it is
necessary to perform the job.
39
IRWE Calculation
  • Jeff begins working on December 1, 2006, and will
    have monthly income of 1,250 per month. He has
    made home modifications to his bathroom and front
    door area needed to allow him to work. He has
    paid 6,000 for this work. His current SSDI
    benefit is 950 monthly.
  • Is Jeff performing SGA?

40
IRWE Calculation
  • STEP ONE 1,250.00 Gross Monthly Earnings
  • 500.00 Minus IRWE
  • 750.00 Equals Adjusted Gross Earnings
    (Non-SGA)
  • STEP TWO 1,250.00 Gross Monthly Earnings
  • 950.00 Plus SSDI
  • 2,200.00 Equals Monthly Income
  • 500.00 Minus IRWE
  • 1,700.00 Equals Total Usable Income

41
Subsidies
  • A recipient receives a SUBSIDY when the
    recipients work requires either

more supervision than other equally paid
employees doing the same job, or fewer or
simpler tasks than other equally paid employees
doing the same job.
42
Subsidies
  • Production Subsidy Production expectation is
    lowered yet wages remain a higher rate.
  • Employer Subsidy An expense to the employer for
    having the recipient on the jobe.g., additional
    on-the-job training/supervision.

43
Special Conditions
  • A special condition exists when a recipient
    receives a service necessary to work and that
    service is paid for by a third party.
  • The service cannot be considered an IRWE as the
    recipient has not paid for it.
  • The service cannot be considered a subsidy as the
    employer has not paid for it.

44
Special Conditions
  • An example of a special condition is a job
    coach provided by a non-profit or VR agency.
    Neither the employee nor employer bears any cost
    for the job coach.
  • In this type of circumstance SSA will consider
    the job coach to be a special condition.

45
Valuing a Special Condition
  • A special condition is also valued differently
    by SSA when determining deductions from gross
    monthly earnings.
  • The value of a special condition in a job coach
    situation is determined by multiplying the number
    of hours of job coach services by the hourly wage
    of the employee.
  • This deduction is taken where general subsidy
    deductions are used when determining SGA.

46
Calculating Effect of Employer Subsidy
  • Julie begins working on November 1, 2006, at a
    monthly wage of 1,000. Her hourly wage is 5.85.
    She will have one extra hour of supervision by
    her employer each morning. The supervisor earns
    19.00 per hour.
  • Is Julie performing SGA?

47
Calculating Effect of Employer Subsidy
  • STEP ONE 20 Hours of extra sup
    each month
  • x 19.00 Multiply by hourly wage of the
    supervisor
  • 380.00 Equals monthly subsidy
  • STEP TWO 1,000.00 Monthly gross earnings
  • 380.00 Minus monthly subsidy
  • 620.00 Equals total gross wages
  • counted/SGA

48
Medicare
  • Hospital Insurance / Part A
  • financed through FICA
  • pays for inpatient hospital care and certain
    follow-up
  • Medical Insurance / Part B
  • pays for doctors services and variety of other
    medical services not covered under Part A
  • voluntary and financed through monthly premiums
    paid by beneficiaries opting for coverage (93.50
    in 2007 and 96.40 in 2008)
  • Medicare Advantage Program / Part C
  • Medicare Prescription Drug Plan / Part D

49
Medicare
  • 24 month qualifying period for Medicare coverage.
  • Cash benefits must be received.
  • Months neednt be accumulated consecutively.
  • Months accumulated can be applied to subsequent
    case should entitlement cease due to SGA and
    entitlement be re-established.
  • If 24 months of cash payments are received prior
    to losing entitlement and entitlement is
    re-established within 5 years (7 for CDB) a new
    24 month waiting period is not required.

50
Extended Medicare and Buy-In
  • Extended coverage is for a minimum of 39 months
    following the conclusion of the TWP
  • Beneficiaries can buy into the Medicare program
    once the extended Medicare coverage is exhausted.
  • They must no longer be entitled to benefits
    because of having earnings in excess of the
    amount permitted and must have worked a full 48
    months (nine-month TWP and 36-month EPE) having
    exhausted their extended period of Medicare
    eligibility.

51
TTWWIA Extended Medicare
  • Extended coverage (Part A free) is for a minimum
    of 93 months following the conclusion of the TWP
  • Beneficiaries can buy into the Medicare program
    once the extended Medicare coverage is exhausted.
    (Medicaid may help pay Part A premium if under
    income threshold)
  • They must no longer be entitled to benefits
    because of having earnings in excess of the
    amount permitted and must have extended period of
    Medicare eligibility.

52
Extended Medicare
  • If SGA after TWP and prior to 14th month of EPE
    and SGA again in the 16th month then Medicare can
    continue for 78 months following the 15th month
    of the EPE.
  • If SGA after TWP and prior to 14th month of EPE
    and no SGA in the 16th month then Medicare can
    continue for 77 months following that
    individuals first month of SGA after the 16th
    month of the EPE.
  • If first month of SGA after the TWP is after the
    13th month of the EPE, Medicare ends the last day
    of the 80th month following the first month of
    SGA in the EPE.

53
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54
Supplemental Security Income
55
Supplemental Security Income Eligibility Overview
  • Called SSI or Title XVI.
  • Categorical Eligibility Aged, Blind, Disabled.
  • Low income Countable income less than the
    maximum SSI payable to that individual.
  • Low Resources Countable resources of less than
    2000 for an individual and 3000 for a married
    couple.

56
SSI Overview Continued
  • SSI pays a monthly cash benefit depending upon
    the recipients categorical status and living
    arrangement.
  • The maximum monthly payment is set each January
    by the Social Security Administration. FBR is
    623/934 in 2007 and will be 637/956 in 2008.

57
SSI Overview Continued
  • Earliest possible payment date is the first of
    the month after the month of application.
  • Medicaid coverage is awarded automatically upon
    the award of disability and payment status.

58
SSI Income Rules
  • Types of Income
  • Earned from employment
  • Unearned from other sources, e.g., SSDI,
    alimony, pension, inheritance
  • Deeming counting portion of someone elses
    (parent, spouse, sponsor) income as SSI
    recipients.
  • In-kind shelter or food received free or at
    reduced cost.

59
Resources
  • SSI limits the amount of countable resources an
    SSI recipient can own.
  • An individual recipient can hold only 2000 in
    countable resources.
  • A married couple can hold only 3000 in countable
    resources.

60
Resources
  • A resource is cash on hand, other personal
    property, or real property that an individual
  • owns or has an ownership interest in
  • has the legal right to dispose of and convert to
    cash and
  • is not legally restricted from using for support
  • Income remaining after the month received becomes
    a resource.

61
SSI Work Incentives
  • Earned Income Exclusion
  • 1619(a) Special Cash Benefits
  • Impairment-Related Work Expenses
  • Blind Work Expenses.
  • Plan for Achieving Self-Support
  • Student-Earned Income Exclusion.

62
Earned-Income Exclusion
  • The original work incentive.
  • Basic earned income counting formula used in the
    SSI program.
  • First 65 plus one-half of remainder is excluded.
  • Remainder is countable income for SSI budget
    purposes.

63
Earned-Income ExclusionCalculation Example
  • 1085 Earned income
  • 65 Earned income exclusion
  • 20 General exclusion
  • 1000 Divided by 2
  • 500 SSI countable earned income

64
Earned-Income ExclusionFinancial Benefit
  • 603 2006 FBR
  • 500 Countable earned income
  • 103 SSI payable
  • 1085 Total earned income
  • 103 SSI benefit
  • 1188 Total monthly income

65
The 1619 Program
  • Provides significant benefit to those disabled
    SSI recipients who return to work and perform at
    SGA levels.
  • To be eligible a recipient must
  • have been eligible for SSI in a month before SGA,
  • continue to be disabled, and
  • meet all income and resource requirements of the
    SSI program.

66
Section 1619(a) Special Cash Benefits
  • 1619(a) Special cash benefits replace 1611
    benefits when the recipient begins to perform
    SGA.
  • Using the basic earned income budget formula of
    the SSI program, 1619(a) will see cash benefits
    decrease as earned income increases.
  • Cash out 1st 1619 Threshold.

67
Impairment-Related Work Expenses
  • SSA allows deductions from gross wages for
    disability related expenses, services and/or
    items necessary to the recipients work effort.
  • These expenses are used to reduce gross wages
    before SSA makes a monthly SSI award
    determination.

68
The Basic SSI Formula
STEP ONE Unearned Income - General
Income Exclusion (GIE) 20.00 Countable
Unearned Income STEP TWO Gross Earned
Income - SEIE
0 Remainder - GIE if not used above
0 Remainder - Earned Income
Exclusion 65.00 Remainder - IRWE
0 Remainder Divide by 2
/ 2 Remainder - BWE
0 Total Countable Earned Income
STEP THREE Countable Unearned Income
Countable Earned Income
. Countable Income - PASS
0 Total Countable Income STEP FOUR Base
SSI Rate (FBR) - Total Countable Income
. Modified SSI Payment
p.88
69
Blind Work Expenses
  • A blind recipient is entitled to a deduction from
    countable earned income equal to the cost of
    actual expenses reasonable attributable to work.
    Blind Work Expenses are NOT necessarily related
    to work.
  • Examples of BWEs
  • Guide dog expenses,
  • Transportation to and from work,
  • Fed, state and local taxes,
  • Social security taxes,
  • lunch

70
The Basic SSI Formula
STEP ONE Unearned Income - General
Income Exclusion (GIE) 20.00 Countable
Unearned Income STEP TWO Gross Earned
Income - SEIE
0 Remainder - GIE if not used above
0 Remainder - Earned Income
Exclusion 65.00 Remainder - IRWE
0 Remainder Divide by 2
/ 2 Remainder - BWE
0 Total Countable Earned Income
STEP THREE Countable Unearned Income
Countable Earned Income
. Countable Income - PASS
0 Total Countable Income STEP FOUR Base
SSI Rate (FBR) - Total Countable Income
. Modified SSI Payment
p.88
71
Plan for Achieving Self Support
  • PASS is a grossly underutilized SSI program which
    permits the SSI recipient to shelter income
    and/or resources which would otherwise be
    countable for SSI purposes.
  • A recipient is permitted to enter into a written
    plan designed to work toward a feasible
    vocational goal with the ultimate goal being
    financial independence.

72
PASS
  • A PASS must meet these requirements
  • be designed for the individual,
  • be in writing,
  • be approved by SSA,
  • be designed for an initial period of no more than
    18 months,
  • show the specific, feasible vocational goal,
  • show what income and/or resources will be
    sheltered and how they will be held,
  • list milestones
  • contain a business plan if self-employment is
    goal.

73
The Basic SSI Formula
STEP ONE Unearned Income - General
Income Exclusion (GIE) 20.00 Countable
Unearned Income STEP TWO Gross Earned
Income - SEIE
0 Remainder - GIE if not used above
0 Remainder - Earned Income
Exclusion 65.00 Remainder - IRWE
0 Remainder Divide by 2
/ 2 Remainder - BWE
0 Total Countable Earned Income
STEP THREE Countable Unearned Income
Countable Earned Income
. Countable Income - PASS
0 Total Countable Income STEP FOUR Base
SSI Rate (FBR) - Total Countable Income
. Modified SSI Payment
p.88
74
Student-Earned Income Exclusion
  • SEIE allows a significant amount of
    monthly/annual income to be excluded for the
    purposes of determining a monthly SSI award.
  • A student is defined as an individual regularly
    attending school (as defined by the regulations)
    who is under the age of 22.

75
Student-Earned Income Exclusion
  • In 2007, the SEIE is 1510 monthly / 6100
    annually.
  • In 2008, the SEIE will increase to 1550 monthly
    / 6240 annually.

76
The Basic SSI Formula
STEP ONE Unearned Income - General
Income Exclusion (GIE) 20.00 Countable
Unearned Income STEP TWO Gross Earned
Income - SEIE
0 Remainder - GIE if not used above
0 Remainder - Earned Income
Exclusion 65.00 Remainder - IRWE
0 Remainder Divide by 2
/ 2 Remainder - BWE
0 Total Countable Earned Income
STEP THREE Countable Unearned Income
Countable Earned Income
. Countable Income - PASS
0 Total Countable Income STEP FOUR Base
SSI Rate (FBR) - Total Countable Income
. Modified SSI Payment
p.88
77
Continuation of Medicaid for SSI Recipients 1619
(a) and (b)
  • SSI recipients do not lose Medicaid until their
    annual gross earned income exceeds the states
    individualized threshold
  • Eligibility for 1619 (a) or (b)
  • Recipient has received at least 1 month of SSI
    payments,
  • Continues to have original disabling impairment,
  • Currently meets income and resource test,
  • Reason income is higher is due to earnings.

78
1619 (b)
  • 1619 (b) Continued Medicaid eligibility
  • Individuals income exceeds breakeven point,
  • Continues to have original disabling impairment,
  • Needs Medicaid in order to work,
  • Cannot replace cost of medical care with
    earnings, and
  • Meets all other requirements for SSI payments
    other than earnings.

79
Medicaid Use Test
  • The following will be considered when SSA
    determines if continued Medicaid coverage is
    necessary to a recipients work effort
  • has Medicaid been used w/in past 12 months,
  • will Medicaid be needed w/in next 12 months,
  • is there an affordable replacement for Medicaid.

80
1619 (b)
  • State Threshold is average annual SSI Breakeven
    point plus state per capita Medicaid payment.
  • Individuals with higher-than-average Medicaid
    costs can have a higher threshold.
  • 1619 is available to disabled individuals 65
    years or older.

81
Individualized Threshold
  • If an individual has high medical expenses, the
    individual can request an individualized
    threshold.
  • The individualized threshold will be determined
    by using the states 1619(a) and adding the past
    years Medicaid expenses of that recipient. This
    total is the individualized threshold for that
    recipient.

82
Medicaid Buy In BBA Rules
  • The Balanced Budget Act of 1997 created the
    Medicaid Buy in option for adults with
    disabilities who are employed
  • Not required to have been SSI eligible, but must
    meet SSI eligibility criteria, except for
    earnings,
  • Eligibility up to 250 of FPL, after income
    exclusions,
  • SGA doesnt matter,
  • Medicaid resource limit can be as high as
    14,000,
  • States can charge premiums and other cost-sharing.

83
Medicaid Buy In TTWWIA
  • TWWIIA expanded the Buy In options for states
  • Higher Income cap than BBA- up to 450 of FPL,
  • Same SSI eligibility criteria as BBA,
  • Cannot define minimum earnings to qualify for Buy
    In,
  • State can charge premiums within certain program
    limits,
  • Can charge full premium for persons with incomes
    over 75,000 per year.
  • 41 states have now implemented or are planning to
    implement a Buy In program.

84
Ticket to Work Act
  • Purposes of the Act are
  • to provide health care and employment preparation
    and placement services to individuals with
    disabilities.
  • to encourage State to adopt an expansion of
    Medicaid availability.
  • to expand Medicare availability.
  • to establish the Ticket to Work program to
    support efforts to obtain and regain employment
    and reduce dependency on cash benefits.

85
Additional Protections and Safety Nets
86
Ticket to Work
  • A disabled recipient will be provided a ticket
    to work which will allow that individual to
    obtain employment services, vocational
    rehabilitation or other support services. SSA
    will pay for all services provided in order to
    assist the individual return to work. Each
    recipient will develop an individual work plan
    for this purpose.

87
TWWIIA CDR Protections
  • Effective January 1, 2001, SSA will not initiate
    a medical CDR while an SSDI beneficiary is
    using a Ticket.
  • WHAT DOES USING A TICKET MEAN?

88
CDR Protections
  • Using a ticket requires that
  • the ticket be assigned,
  • the recipient must be actively making progress
    following their approved plan,

Employment Networks (ENs) monitor progress and
the Program Manager (PM) determines if the
recipients ticket is in use.
89
CDR Protections
  • SSA cannot initiate a medical CDR if the
    recipients ticket is in use.
  • However, if the ticket is assigned after a
    medical CDR has begun, the medical CDR will be
    completed.

90
CDR Protections
  • If an SSDI recipient has received 24 monthly
    payments, SSA will not be allowed to initiate a
    CDR based on work activity alone.

91
Expedited Reinstatement (EXR)
  • TWWIIA-established safety net
  • Effective January 1, 2001
  • For individuals who have stopped receiving
    benefits as a result of work and then at a later
    date find themselves unable to work because of
    their medical condition
  • Provides for up to six months of provisional
    benefits
  • Provides 5 years of coverage from month of
    benefit termination

92
EXR
  • Provisional benefits are paid upon the filing of
    an EXR application and will be paid for a maximum
    of 6 months or until SSA determines eligibility
    for EXR, whichever is sooner.
  • Provisional benefits will NOT be considered an
    overpayment unless fraud is involved.

93
EXR
  • In order for an individual to be reinstated via
    EXR the impairment must
  • Be the same or substantially related to the
    previous impairment giving rise to eligibility,
    and
  • the recipient must prove the inability to perform
    SGA due to disability.

94
Work Incentives Planning
  • Any recipient wishing to return to work can take
    advantage of free work incentives planning
    services.
  • Work incentives planning will allow the
    recipient to learn what will happen to their
    benefits (SSI, SSDI, housing, health, food
    stamps, etc.) during the return to work process.
  • www.socialsecurity.gov/work/ServiceProviders/WIPAD
    irectory.html

95
Advocacy Services
  • Protection Advocacy agencies in each state and
    territory have been funded to provide legal
    representation to any recipient who faces a
    barrier to the return to work effort. This
    program is known as PABSS Protection Advocacy
    for Beneficiaries of Social Security.
  • http//ssa.gov/work/ServiceProviders/pafactsheet.h
    tml

96
Questions?
97
Dont Forget to Visit theWork Incentives Support
Center!
http//www.workincentives.org
98
Thomas GoldenEmployment and Disability
InstituteCornell UniversityILR School201 ILR
Extension BuildingIthaca, New York 14853t.
607.255.7727f. 607.255.2763ilr_edi_at_cornell.edu
www.edi.cornell.edu
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