CONSIDERING WORK:

1
CONSIDERING WORK BENEFITS PLANNING AND WORK
INCENTIVE PROGRAMS FOR PEOPLE RECEIVING CASH
BENEFITS AND PUBLIC HEALTHCARE COVERAGE Michael
J. Van EssenNational Working Positive
CoalitionPasadena, CA
2

• FEAR!

• OF LOSING HEALTH CARE COVERAGE
• OF LOSING MONTHLY CASH BENEFIT
• OF LOSING SDI, SSI, SSDI, ETC.

3
!

• FEAR

of the SYSTEM
4
WHAT IF?

• I earn too much money?
• I dont earn enough money?
• I get sick again?
• I cant get my benefits back?

5

• T H E C H E C K S T U B

• SDI (California) State Disability Insurance
• SSA Social Security Administration
  (Federal)
• SSI Supplemental Security Income (SSA)
• SSDI Social Security Disability Insurance
• Medicaid Californias Medic-Aid
  (Federal/State)
• Medicare Medicare (Federal)
• All Others Private Long Term Disability
• Private Health Care
• Housing, etc.

6
SOCIAL SECURITY ADMINISTRATIONS DISABILITY
BENEFITS PROGRAMS
7
SUPPLEMENTAL SECURITY INCOMESOCIAL SECURITY
DISABILITY INSURANCE
8
BENEFITS PLANNING ASSISTANCE OUTREACH WORK
INCENTIVES PLANNING ASSISTANCE
9
S U P P L E M E N T A L S E C U R I T Y I N
C O M E
10
SUPPLEMENTAL SECURITY INCOME

• Needs based program provided by the state of
  California and the Social Security Administration
• Cash Benefit paid from date of application
• Supplements a monthly benefit when the
  individuals disability income is below 836
  (Federal Benefit Rate and State Supplement)from
  all income sources.
• Amount of payment for single individual is 836 a
  month (856 a month if also receiving SSDI)

11
PRESUMPTIVE SSI

• Category of SSI that provides pay-ments while
  claim is being processed
• Payments can be made for a maximum of six months
• There is a list of conditions that could qualify
  applicant for Presumptive SSI (see notes)

12

• How much can I earn
• and still keep my
• benefits?!

13
SSI EARNED INCOME CALCULATION

• Only reported earned Income is counted
• First 85 earned per month is exempt
• Above 85, SSI deducts 1 for every 2 of
  counted income
• SSI deductions are based on gross monthly
  wages, before taxes

14
SSI EARNED INCOME CALCULATION

• 1000 Wages (reported earned income)
• -85 Exempt (not counted)
• 915 Subtract 1 dollar for every 2
  counted
• 2 / 915 487 Countable wages
• 836 Californias SSI Monthly Benefit
• - 487 Subtract countable wages
• 303 SSI Adjusted Benefit
• 1000 Wages
• 1303 Total Income (excluding taxes)

15
REPLACING YOUR SSI DOLLARS

• To calculate SSI benefit break even point,
  double your SSI monthly benefit and add 85
• 836
• x2
• 1672 85 1757
• (Remember, these are California Numbers The
  Federal Benefit Rate and State Supplement varies
  from State to State)

16

• How much can I earn
• and still keep my
• benefits?!

17
SSI WORK INCENTIVE RULESSOCIAL SECURITY
PROVISION 1619b

• 1 dollar of SSI guarantees continuing Medicaid
• When earnings reach SSIs break even point
  Social Securitys provision1619b will protect
  Medicaid health care coverage
• 1619b retains Medicaid until annual wages reach
  approximately 35,000 (CA Threshold)
• The 35,000 (approx.) threshold can be negotiated
  upward
• The Medicaid Buy In Program, available in some
  states, is also an option
• For all State Threshold amounts visit
• http//www.socialsecurity.gov/disabilityresearch/
  wi/1619b.htm

18
SSI WORK INCENTIVE RULESWORKING DISABLED
MEDICAID BUY-IN

• Employment is required
• Must meet SSAs definition of disability
• Share of Cost Medicaid is replaced by No Share
  of Cost Medicaid
• A sliding scale premium payment is applied
• Annual gross income must be approx. 50,000 or
  less (all amounts subject to annual adjustment)

19
SSI WORK INCENTIVE RULESSSIs EARNED INCOME
REVIEW

• Allows for part-time or full-time work
• Earned income reduces benefit using the 85 ½
  rule.
• You keep Medicaid with 1 SSI benefit
• When SSI payment is suspended, 1619b Medicaid
  takes over until annual earnings exceed 35,000
  (Californias 2006 qualifying gross annual
  income)
• All state thresholds can be viewed at
• www.socialsecurity.gov/disabilityresearch/wi/161
  9b.htm
• It is possible to apply for a Working Disabled
  Medicaid program if one exists

20
S O C I A L S E C U R I T Y D I S A B I L I T
Y I N S U R A N C E
21
SSDI WORK INCENTIVE RULES Social Security
Disability Insurance (SSDI) (Title II)

• Entitlement program administered by the Social
  Security Administration
• Pays monthly benefit for duration of individuals
  disability

22
SSDI WORK INCENTIVE RULES SSDI ELIGILIBITY

• Must have made FICA contributions five of the
  previous 10 years
• Five month waiting period unpaid
• Benefits can be retroactive 12 months
• Benefits average from 1 to approx-imately 1800
  a month

23
SSDI WORK INCENTIVE RULESMEDICARE ELIGIBLITY

• Individuals can receive both SSDI and State
  Disability if total monthly income is within 80
  rule
• After 24 months of SSDI payments, automatically
  enrolled in Medicare part A
• Part B is elective --88.50 (2006) premium will
  be deducted from the SSDI each month

24
SSDI WORK INCENTIVE RULESUNDOCUMENTED WORKERS

• Due to 1997welfare reform law- undocumented
  residents are no longer eligible to receive SSDI
  benefits. Proof of residency must be provided to
  SSA at time of filing claim. Undocumented
  resident who apply for SSDI after august 22,
  1996, must return to their country of origin
  before social security will process the
  application or pay benefits.

25
SSDI WORK INCENTIVE RULESTHE TRIAL WORK PERIOD

• Allows 9 Trial Work Months (TWM) in a 60 month
  (5 year) period
• Any month when earnings are at or above 620 is
  considered a Trial Work Month
• The Trial Work Period starts with the first
  Trial Work Month
• TWMs do not have to be consecutive
• No matter the amount earned, the SSDI benefit
  wont be affected until all nine Trial Work
  Months have been used

26
SSDIs WORK INCENTIVESTHE EXTENDED PERIOD OF
ELIGIBLITY

• The Extended Period of Eligibility (EPE) begins
  the month after the Trial Work Period Ends.
• The EPE spans 36 consecutive months.
• During the 36 months of the EPE the disability
  claim remains active
• If works stops at any time during the EPE, or if
  wages fall below 860 (SGA), the full benefit is
  paid for that month(s).
• When the EPE has been used the claim is
  suspended.

27
SSDIs WORK INCENTIVESSUBSTANTIAL GAINFUL
ACTIVITY

• Gross monthly wages above 836constitutes, in
  most cases, SGA. (Self-Employment is subject to
  additional Earnings Tests.)
• Reported earnings at SGA or above disqualify the
  cash benefit for that month.
• When a pattern of earnings over SGA three Grace
  Period months of full benefit are paid.

28
SSDIs WORK INCENTIVESSSDI EARNED INCOME MAP
(Take a deep breath and dont panic)
29
SSDIs WORK INCENTIVESMEDICARE CONTINUATION

• 24 months of SSDI payments qualifies the
  recipient for Medicare Part B.
• Medicare stays in place for 8 years throughout
  the 9 month trial work period, 36 month EPE and
  an additional 4-1/2 years.
• Medicare A is free, the part B premium is 88.50
  a month, Medicare C and D are premium based, too
• To retain Medicare Part B when SSDI benefits
  stop the consumer must arrange direct payment
  with the Social Security Administration.

30
SSDIs WORK INCENTIVESSSDI RTW INCENTIVES
REVEIW

• Reported wages under 620.00 have no effect on
  the SSDI cash benefit
• A Trial Work Month is any month when Earned
  Income exceeds 620
• Once all trial months are used, the Extended
  Period of Eligibility (EPE) begins.
• During the EPE, earned income above 860 SGA)
  will eliminate the benefit for that month.
• Once a pattern of work activity above SGA is
  established the full benefit is paid for three
  additional Grace Period months.

31
REPORTING EARNED INCOMEOVERPAYMENT

• Overpayments can be applied to both SSI SSDI
  recipients
• Even if all reporting is accurate and on time an
  overpayment can result
• Keep dates and times of all conversation and
  correspondence
• Overpayments can be waived
• Overpayment totals can be reduced
• Overpayments can be resolved with minimal
  deductions from future payments
• SSA Overpayments have nothing to do with IRS or
  delinquent income tax payments

32
REPORTING AND OVERPAYMENTSSI REPORTING
REQUIRMENTS

• What to report
• Change of Address
• Persons moving in or out of household
• Death of a member of the Household
• Changes of income
• Changes of In-Kind Support
• Marriage, separation or divorce
• Leaving the US for more than 30 consecutive days
• Changes in school attendance (if under 22)
• Death of recipient in deeming cases

33
REPORTING AND OVERPAYMENTSSI REPORTING
REQUIREMENTS

• When to report
• Report any changes immediately
• Report within 10 calendar days after the month
  in which the change occurred
• Report by telephone, in writing or in person.

34
SSI WORK INCENTIVE RULESSSI REPORTING
REQUIREMENTS

• Not reporting in a timely manner could result
  in
• Incorrect benefit amounts
• Overpayment
• Penalties deducted from SSI payment
• Loss of benefit

35
REPORTING AND OVERPAYMENTSSDI REPORTING
RESPONSIBILITIES

• What to report
• Improved Medical Condition allowing work(even if
  work has not yet begun)
• A return to work (employed or self-employed)
• Receiving a Workers Compensation Benefit
• Confinement to jail, prison, a penal intuition
  or correctional facility.

36
ANOTHERFREQUENTLY ASKED QUESTION

• Will my current state of health allow me to
  maintain my good health a part or full
  time work schedule?

37
I F U N C E R T A I N

• TEST YOUR ABILITIES!

38
F O R I N S T A N C E

• Volunteer
• Take a class
• Pursue a passion
• Go back to school and get that degree!

39
E D U C A T I O N

• Vocational Rehabilitation (Voc Rehab) may
  underwrite participation in vocational and
  educational programs.
• Federal money is available through Los Angeles
  One-Stop or Work Source Job Centers
• Community Colleges offer financial aid to
  qualifying people on permanent disability,
• There are other possible sources as well.

40
Find an E M P L O Y M E N T N E T W O R K

• Employment Networks provide services to assist
  the disabled to return to productive employment.
• Go towww.yourtickettowork.com to find out
  what Employment Networks are available in your
  community.

41
C O N S I D E R A P A S S P L A N

• Plan to Achieve Self Support (PASS)
• Pays for long-term educational programs or even
  start up businesses.
• See the accompanying fact sheet

42
I N C O N C L U S I O N

• BENEFITS AND WORK SERVICES DEPARTMENT ASSISTS
  ITS CLIENTS BY PROVIDING ACCURATE INFORMATION SO
  THAT HE OR SHE MAY MAKE THE MOST INFORMED
  DECISION(S) POSSIBLE.
• THESE DECISIONS HELP THE CLIENT TO DEVELOP
  RETURN TO WORK STRATEGIES THAT WILL ENHANCE
  PRODUCTIVITY, GENERATE INCOME AND RESTORE A
  QUALITIY OF LIFE THAT LEADS TO THE HOPE AND
  RESURRECTION OF A FUTURE!