Florida Benefits Information Referral Network Presents

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Florida Benefits Information Referral
NetworkPresentsChanging Face of Benefits
Knowledge for Successful EmploymentSponsored
ThroughAgency For Persons With
DisabilitiesMedicaid Infrastructure
GrantDeveloped BySharon Brent,
DirectorTraining and Technical
AssistanceNational Disability Institute
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Principles of Project Training

1. Information provided in the training is one tool
   for decision making about employment
2. Good decisions are the result of good planning
3. The training is based on the philosophy of
   self-determination and person centered planning.

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Building Blocks for Self-Determination

1. A person has the FREEDOM to dream, make his or
   her own decisions and plan their own life.
2. A person has the AUTHORITY to control how money
   is spent for supports
3. A person has the SUPPORT needed from people they
   choose, i.e. family, friends, employees.
4. A person is required to take RESPONSIBILITY to do
   what he or she says they will do

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Overview of EligibilitySSI and SSDI

• Call Social Security at 1-800-772-1213 0r Apply
  On-Line
• www.socialsecurtiy.gov or visit local SSA Field
  Office
• Collect information about the disability and
  about work history
• Complete Forms from SSAMake copy
• Keep appointment with SSA
• SSA moves file to DDS (Disability Determination
  Service) for medical review, returning decision
  to SSA
• SSA sends letter of eligibility determination
• Approved Denied (reconsideration) 2nd denial
  (Appeal)

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CHECKLIST FOR SUCCESS

• Make copies of all documents you give to SSA
  both forms you fill out and evidence you want
  them to have that are in your possession. Do not
  LOSE your copies!!
• When you call SSA (1-800-772-1213) keep a record
  
• Date
• Name of person you spoke to
• What you asked
• What they told you

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Checklist-continued

• Promptly open and read ALL mail sent by SSA.
  When SSA gives a deadline response date,
  compliance within that date is required. Seek
  help immediately for help. Keep ALL paperwork,
  letters, and mailing envelopes in your file. Do
  Note Lose!!!!
• You must report pay stubs each month to SSA. Be
  sure to report to correct field office (Zip Code
  of the payee is the key). Report by mail, and/or
  walk into the office. Keep wage records in your
  file. If on SSI SSDI report to each program
  separately.

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Checklist-continued

• If a person receives SSI and/or Medicaid,
  remember to keep all resources/assets below
  2,000/individual 3,000/couple in any month to
  maintain eligibility. Medicaid eligibility may
  vary from State to State.
• When a major life change occurs (address,
  marriage, employment, lose of job, divorce,
  children) report to SSA immediately, both to
  1-800-772-1213 and to local SSA field office.

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DEFINITION OF DISABILITY

• The SSA defines disability for both SSI and SSDI
  programs as the inability to engage in
  Substantial Gainful Activity (SGA) by reason of
  any medical (physical and/or mental or blind)
  impairment.
• Disability must have lasted or be expected to
  last for a continuous period of not less than 12
  months or result in death.

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DefinitionSubstantial Gainful Activity

• SGAA 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 annual SGA
  level amount.

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Eligibility of Benefits

• Supplemental Security Income-SSI
• Unearned Income (Not Wages)
• SSDI, VA, Annuities
• Income (Earned Wages)
• 12 months no SGA income
• SGA factor during initial eligibility
• Once eligible SGA non-issue
• Resources (NOT Wages or Unearned Income
• 2,000/month/Individual
• 3,000/month/Couple
• Medical Eligibility
• Medical Eligibility Defined
• Medical Insurance-MEDICAID
• SSI connected, State Administered

• Social Security Disability Insurance-SSDI
• Required Work Credits in F.I.C.A
• 5 Month Waiting Period
• SGA
• 12 months consecutive-initial eligibility
• Factor During EPE and Beyond
• Medical Eligibility
• Medical Eligibility Defined
• DAC Disabled Adult Children
• Disability Prior to Age 22
• Never Legally Married-NOT On Title II Benefits
• Insufficient FICA-or Higher Parent Amout
• Parent FICA Opens(DiesRetiresDisabled)
• Possible continuation of Medicaid-Pickle
• Amendment

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SSI and MedicaidResource Example

• The SSI/Medicaid programs have specific resource
  limitations in order to be eligible to receive
  and/or maintain benefits. The monthly maximum
  amount for SSI (Federal) is 2,000/individual
  3,000/couple. Medicaid (State) may vary the
  allowed amount for eligible status based on State
  rules. (Neither must not exceed the specific
  amount at the beginning of each month).
• The Resource limitation is set by statute and is
  countable real or personal property including
  cash.

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SSI ResourcesCounted-Maybe

• Countable by SSA (maybe)
• Cash, Savings Accounts, Stocks, Bonds, CDs,
  IRAs etc.
• Land (Owned but not lived on)
• Anything owned which could be converted to cash
  and used for Food and Shelter (including
  utilities)
• Resources of a spouse. Resources of parent if
  beneficiary is under 18 (minor).

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SSI Resources(Maybe) Excluded

• An owned home you live in and the land it sits
  on.
• Household goods and personal property in total
  (as of March, 2005)
• Clothing someone might give or gift to a
  beneficiary (as of March 2005)
• Burial Space for beneficiary and immediate family
• Burial funds up to 1500 for individual and
  spouse
• Life Insurance with a combined face value of not
  more that 1500
• Retroactive SSI or SSDI amount for up to 9 months
  (Keep receipts on how money is spent)
• Property in Specific Trust
• A bank account for Plan for Achieving
  Self-Support (PASS)
• An Individual Development Account (IDA)
• Property Essential for Self-Support (PESS)
• One automobile, regardless of value (as of March
  2005)
• 1. Employment or medical treatment
• 2. Modified for use by an individual with a
  disability
• 3. Geographic climate, terrain, distance, or
  similar factors impeding the performance of
  essential daily activities.

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SSI Wage Calculation Formula

• SSI and Earned Income (No Unearned Income/No Work
  Incentives)
• Step 1
• ________ Earned Income (Gross Wages)
• - 20.00 General Exclusion
• - 65.00 Earned Income Exclusion
• _________ Countable Earned Income
• Step 2
• _________Countable Earned Income from Step 1
• ? by 2 Division Answer ________
• - _________Subtract division answer from
  Countable Earned Income
• _________Final Revised Countable Earned Income
• Step 3
• _________Maximum SSI Benefit (Federal
  Benefit Rate State
• Supplement)
  
• - ________ Final Revised Countable Earned
  Income (Step 2)
• _________New Monthly SSI Benefit

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SSI Wage CALCULATION Formula

• Step 4
• _______ Gross Earned Income (Step 1)
• _______ New Monthly SSI Benefit (Step 3)
• ________Total Monthly Gross Income
• Step 5
• _____Gross Earned Income (Step 1)
• x 15 FICA, Medicare,
  State
• Federal Income Tax, SDI, etc.
• - _____Estimated Tax from Gross Income
• _____Net Income After Taxes
• _____New SSI Amount (Step 3)
• _____Total Monthly Cash In Hand

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TRIAL WORK PERIOD-TWPSSDI WORK INCENTIVE

• Unless medical recovery is determined, (SSDI)
  beneficiaries are entitled to a 9 month Trial
  Work Period (TWP) for testing work skills while
  maintaining the monthly cash benefits. During
  this TWP full benefit checks will continue
  regardless of the amount of money earned. The 9
  months of TWP do not need to be earned in a row.
• TWP months are counted when an individual earns a
  specific amount of income. (Determined January 1
  each year by SSA)
• The TWP ends only when an individual has 9 months
  of TWP within a 60 month consecutive period of
  time (5 years).
• Once all 9 months of TWP have been earned within
  the 60 month window a person then enters Extended
  Period of Eligibility (EPE).

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EXTENDED PERIOD OF ELIGIBIITY (EPE)SSDI WORK
INCENTIVE

• At the conclusion of the 9 month TWP
  beneficiaries will immediately enter into the 36
  month EPE as long as the medical eligibility
  continues.
• The 36 month period begins in the month following
  the 9 month TWP whether a person is determined to
  be earning SGA or not.
• During EPE cash benefits continue only for months
  SGA is not earned. Any month SGA is earned the
  individual is not eligible for the cash benefit.
  The first month of SGA (grace months) benefits
  continue. Next two months are considered grace
  months and if SGA is earned benefits continue.
• When EPE is complete, a person earning gross
  wages below SGA will continue to receive a
  benefit check as long as medical eligibility
  continues. If a person is earning SGA or above
  and the EPE is completed, a person is no longer
  eligible for a cash benefit.
• For self-employment, an individual determination
  of SGA will be established during EPE. An SSDI
  claims representative will look at hours and
  income when making SGA determination.
• If a person needs support in order to earn income
  document and record the time and activity of
  support in order to determine if earnings are
  actually SGA. (See Work Incentive Subsidies and
  Impairment Related Work Expenses).

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WORK INCENTIVESCOMPARISON CHART

• Social Security Disability Insurance
  Supplemental Security Income
• SSDI SSI
• Trial Work Period Continuation of SSI
• Extended Period of Eligibility Student Earned
  Income Exclusion
• Continuation of Medicare 1619 A and 1619 B
• Impairment Related Work Expense Impairment
  Related Work Expense
• Section 301 Section 301
• Special Rules for the Blind Blind Work Expense
• Subsidies Subsidies
• Ticket To Work Property Essential for
  Self-Support
• Expedited Reinstatement Plan for Achieving
  Self-Support
• Ticket To Work
• Expedited Reinstatement

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WORK INCENTIVES PLANNING AND ASSISTANCE

• Work Incentives Planning and Assistance (WIPA)
  Program
• http//www.socialsecurity.gov/work/ServiceProvider
  s/wipafactsheet.html
• The goal of the WIPA program is to better enable
  SSA beneficiaries with disabilities to make
  informed decisions about work. Each WIPA project
  has Benefits Specialists called Community Work
  Incentives Coordinators (CWIC) who will
• Provide work incentives planning and assistance
  to beneficiaries of SSI an/or SSDI with
  disabilities and
• 2. Conduct outreach efforts to those
  beneficiaries who are potentially eligible to
  participate in federal or state work incentives
  programs.
• WIPA Agencies by State For more specific
  information, visit the state-by-state contact
  list AT ABOVE ADDRESS.

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DISABILITY PROGRAM NAVIGATOR INITIATIVE

• Disability Program Navigator (DPN)
• http//www.doleta.gov/disability/onepagers/dpn_fac
  tsheet_august2006.pdf
• The Department of Labor (DOL) and the Social
  Security Administration (SSA) have jointly
  established a new position, the Disability
  Program Navigator, within DOLs One-Stop Career
  Centers.
• The Disability Program Navigator helps people
  with disabilities navigate through enormous
  challenges of seeking work, complex rules
  surrounding entitlement programs, and provides
  work support programs now available at DOL funded
  One-Stop Career Centers.
• Disability Program Navigators by State
• For more specific information, visit the
  state-by-state contact list.

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Area Work Incentives Coordinator SSA-AWIC

• Area Work Incentives Coordinator (AWIC)
• http//www.ssa.gov/work/Beneficiaries/awic.html
• AWICs provide assistance to personnel in field
  offices on employment supports outreach by
• Coordinating and/or conducting local public
  outreach on work incentives
• Providing, coordinating, and/or overseeing
  training for all personnel on SSAs employment
  support programs
• Handling some sensitive or high profile
  disability work-issue cases, and
• Monitoring the disability work-related issues in
  their respective areas.

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SSI and Earned Income Tax Credit

• NOTE On July 18, 2005, SSA issued Final Rules
  amending the SSI regulations by making technical
  revisions to rules on income and resources based
  on the Social Security Protection Act (SSPA) of
  2004 and several other statutory changes. These
  revisions, among other things, clarify that
  certain types of income are excluded when
  determining SSI income and resources. Any unspent
  portion of Federal income taxes related to an
  Earned Income Tax Credit (EITC) is excluded from
  resources for a time period of 9 months following
  the month of receipt.For more information
  seehttp//www.ssa.gov/regulations/articles/rin09
  60_ae79f.htm
• States may have different rules for how they look
  at a persons resources and eligibility to both
  SSI and/or Medicaid in a State. States decide
  what counts as income and resources when there is
  a State Supplement to SSI and when administering
  the Medicaid Program. Important to understand
  State rules as well as the Federal rules above.

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Individual Development Accounts

• An IDA is a special savings account for people
  with low incomes. The money set aside by a
  person who is earning wages in an IDA Account
  will be matched with another dollar or more for
  every dollar saved by the individual. An EITC is
  looked at as earned income and can be matched in
  and IDA program.
• Savings and matched money can be used for
  education, starting a small business, or first
  time home purchase.
• A person will learn budgeting, saving, banking
  and credit information
• Individuals in an IDA can also receive one-on-one
  counseling and other training
• Match dollars come from a combination of Federal
  money and other business, or organizations
  supporting Asset Development.
• A person who is eligible for SSI and/or Medicaid
  who has an approved IDA account will not have
  money that is set aside for the IDA count as a
  resource.

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Websites of Importance

• http//www.socialsecurity.gov Social Security
  Administration Home Page
• http//www.socialsecurity.gov/work Social
  Security Administration Work
• http//www.fdhc.state.fl.us/ Florida Agency for
  Health Care Admin
• http//www.floridajobs.org/ Agency for Workforce
  Innovation
• http//www.dcf.state.fl.us/ess/ssifactsheet.pdf
  Medicaid
• http//www.dcf.state.fl.us/ess/fsfactsheet/pdf
  Food Stamps
• http//www.myflorida.state.fl.us Public Housing
  Agencies
• http//www.advocacycenter.org Protection and
  Advocacy
• http//rehabworks.org Vocation Rehabilitation
• http//www.fddc.org Florida Developmental
  Disabilities Council
• http//www.apd.state.fl.us Agency for Persons
  with Disabilities
• http//disability.law.uiowa.edu/dpn Law, Health
  Policy and Disability Center
• http//www.cfed.or IDA Directory
• www.reitour.org Real Economic Impact Tour