Transcript BPA&O - Racine County, Wisconsin

Understanding Social Security:
Can It Be Done?
February 18, 2004
Toni Bender-ERI
Holly Johnson-ERI
Potential loss of benefits is one
of the most persistent and
pervasive fears among people
with significant disabilities who
are considering employment
Social Security Disability
Insurance (Title II)
SSDI
DAC
Entitlement programs
 Disability
 Medicare Coverage

SSDI Work Incentives
TWP -Trial Work Period
 SGA - Substantial Gainful Activity
 EPE - Extended Period of Eligibility
 Expedited Reinstatement
 IRWE/Subsidy
 EPMC

Trial Work Period (TWP)

9 months of $580 or more (no limit)
– as of January 1, 2004
2003 - $570
 80 hours of self-employment activity per
month
 Don’t need to be consecutive
 Only one TWP per disability entitlement
 Review by SSA when completed

Trial Work Period
Jan
$600
Feb
$400
Mar
$1,000
April
$0
May
$1,200
June
$570
July
$590
Aug
$810
Sept
$560
Oct
$700
Nov
$700
Dec
$700
Substantial Gainful Activity
(SGA)
Measure of ability to work
 $810 per month-as of January 1, 2004
 In 2003, SGA was $800 per month
 $1,350 per month for the blind (2004)

If performing work that is “SGA” after
the TWP cash SSDI benefits stop
Reducing Countable Income
IRWE
Subsidy
Impairment Related Work
Expenses (IRWE)

Expenses that are necessary to work,
related to the person’s disability and
paid for by the worker

May be considered to reduce countable
income below SGA
IRWE Example

John is working and earning $840 per month.
He pays $40 each month for specialized
transportation to drive him too and from
work.

How does this expense help John?
$840.00
-$ 40.00
$800.00
Work Earnings
IRWE
Countable Earned Income
Subsidy
Value of additional support to perform a
job, or difference between actual wages
received and value of work performed
 May reduce income below SGA like
IRWE

EXAMPLES: more frequent breaks, more
supervision/support, lower production
requirements
Extended Period of Eligibility
(EPE)
Consecutive 36 month period after TWP
 Cash benefits reinstated for months
under SGA ($810) without a new
application
 If at SGA at end of EPE, no more SSDI
payments

Expedited Reinstatement
(EXR)



Effective 1/1/01
Reinstate without new application if:
-Unable to work, because of medical
impairments
-Medical condition same or related, and
-File request within 60 months of date last
entitled.
After 24 months of EXR payments, receive a
new TWP and EPE.
Reapplication
If unable to maintain working at SGA
level after the completion of the EPE.
 Reapplying within 60 months of last
benefit payment, no waiting period.
 Reapplying after 60 months of last
benefit payment, 5 month waiting
period.
 New TWP and EPE

Medicare
Federal health insurance program
 24-month waiting period after SSDI
benefits start
 $66.60/month Part-B premium (year
2004); Part A is free

Extended Period of Medicare
Coverage (EPMC)
Continued Medicare coverage even if no
longer eligible to receive SSDI payment
because of work
 At least 93 months of coverage after
TWP ends
 Billed quarterly for months an SSDI
payment isn’t received

Supplemental Security Income
SSI- (Title XVI)

Needs based program

Elderly or Individuals with disabilities

Medicaid

State Supplements
Federal SSI Eligibility





Earnings must be below SGA at application
only
Unearned income below $584 if single, living
alone
Assets below $2,000 for single person, $3,000
for couple
Automatic Medicaid (Medical Assistance)
Maximum payment for a single person, living
alone is $564/month (2004 amount, changes
annually)
SSA Doesn’t Count All of Your
Income...

General Income Exclusion of $20
Deducted first from unearned
income

Earned Income Exclusion
$65 per month plus
1/2 of the rest
Example:

Rich is working at the grocery store
earning $775 a month.

What will his SSI payment be?
Example:
$775 (earnings)
- 20 (general income exclusion)
- 65 (earned income exclusion)
$690
÷ 2
$345 (countable earned income)
$564 (Federal Benefit Rate-2004)
-345 (countable earned income)
$219 (Federal SSI Payment)
Reducing Countable Income
for SSI purposes
Impairment Related Work Expenses
(IRWE)
 PASS Plan
 Student Earned Income Exclusion
 Blind Work Expense

IRWE for SSI Recipients
Same expenses allowed as for SSDI
 Can increase SSI payment $1 for $2 of
expenses

IRWE Example

$775 (earnings)
- 20 (general income exclusion)
- 65 (earned income exclusion)
$690
-$ 50 (IRWE-Specialized transportation)
$640
÷ 2
$320 (countable earned income)
$564 (Federal Benefit Rate-2004)
-320 (countable earned income)
$244 (Federal SSI Payment)
W/O IRWE
$219
W/ IRWE
$244
Plan for Achieving Self
Support (PASS)
Sets aside income/resources (such as
earnings or SSDI) for items or services
needed for a vocational goal
 Income/Resources set aside not
considered countable income
 Increases or establishes SSI payments
for the length of the plan
 Needs SSA approval

Student Earned Income
Exclusion




A student under age 22
Regularly attending
school
Excludes up to $1,370
per month in 2004 (in
addition to regular SSI
disregards)
Excludes up to
$5,520/yr (2004)
Blind Work Expenses
Only for SSI recipients
 Used instead of IRWE
Examples:

Transportation
Payroll taxes
Union dues
Adaptive equipment
Lunches while working
Service animal and expenses
Continued Medical Assistance
Section 1619 (b)





Continued Medicaid when earnings are too
high for an SSI payment
Income up to threshold of $ 27,645 (2004)
For SSI-E Eligible $29,948.48 (2004)
Can request individualized threshold if
medical costs are higher than average and
meet the needs test.
If lost due to excess assets or income, can requalify within 12 months
State SSI Supplements
Eligible if entitled to $1 of Federal SSI
 WI State Supplement - $83.78
 Exceptional Expense Supplement $95.99
 Caretaker Supplement-$250 1st child,
$150 for each additional child

Medical Assistance
MA Deductible
Medical Assistance for individuals with
higher income - “medically needy”
 6-month re-certification period
 Deductible amount increases with work
 Do a financial comparison between
county MA and MAPP

Medical Assistance
Individual Criteria for
MAPP
Applicant must:

Be considered to have a disability by the Disability
Determination Bureau (DDB) without counting
earnings

Have countable assets less than $15,000

Adjusted gross income of 250% FPL

Be working, OR, enrolled in an approved Health
and Employment Counseling Program
Medical Assistance Purchase
Plan
Medicaid waiver services available to
MAPP participants
 Enrolling in MAPP could eliminate cost
share or spend down
 May have a MAPP premium
 Applicant should do a financial
comparison before enrolling

BPA & O
Benefits Planning, Assistance
and Outreach
What does BPA & O have to
offer?

Benefits Planning Assistance & Outreach
– Information and Referral
– Benefit Problem Solving and Advocacy
– Benefits Analysis and Advisement
– Benefit Support Planning
– Benefit Management
How to contact
BPA&O?
ERI –1-877-826-1752
or
1-877-242-1357
Riverfront –1-800-949-7380 Ext 401
Independence First – 1-414-291-7520