Work Incentives & Benefits Planning MN APSE State Conference - - PowerPoint PPT Presentation

SocialSecurity.gov

Work Incentives & Benefits Planning

MN APSE State Conference

SocialSecurity.gov

• Employment support provisions to assist

beneficiaries in moving from benefit dependency to independence

• Designed to help beneficiaries enter, re-enter, or

stay in the workforce by protecting their eligibility for cash payments and/or health care

What are Work Incentives?

SocialSecurity.gov

• Disability Programs
• How We Define Disability
• Substantial Gainful Activity (SGA)
• Evaluation of Work for SGA

Understanding the Basics

SocialSecurity.gov

Disability Programs

Title II

SSDI Social Security Disability Insurance

Medicare

Title XVI

SSI Supplemental Security Income

Medicaid

Change to branded colors, replace red with teal

SocialSecurity.gov

• “Substantial gainful activity” (SGA) is a term used to

describe a level of work activity and earnings.

• If the impairment is anything other than blindness, earnings

in 2018 averaging over $1,180 a month generally demonstrate SGA.

• The SGA amount in 2018 for blind individuals is $1,970.
• SSI only uses SGA as a measure of work during initial claims
• SSDI uses SGA throughout the life of the claim

Substantial Gainful Activity

SocialSecurity.gov

• We generally use earnings guidelines to evaluate whether your

work activity is SGA.

• The amount of monthly earnings we consider to be SGA

depends on the nature of your disability.

• The Social Security Act specifies a higher SGA amount for persons who

meet the definition of blindness described by the law.

How Do We Evaluate Your Work Activity for SGA Purposes?

SocialSecurity.gov

Form SSA-821 Work Activity Report

SSA-821 is used to document work activity and work incentives when SSA is making SGA decisions.

SocialSecurity.gov

• Subsidies and Special Conditions
• Impairment-Related Work Expenses (IRWE)
• Plan to Achieve Self-Support (PASS)
• Ticket to Work
• Expedited Reinstatement (EXR)

SSDI and/or SSI Employment Supports

SocialSecurity.gov

What is a subsidy?

• A “subsidy” is support provided by an employer that may result in

receiving more pay than the actual value of the services performed. What are special conditions?

• “Special conditions” refers to support and on the job assistance

provided by an employer, or by someone other than the employer, for example, a vocational rehabilitation agency. Because of this support, a person may receive more pay than the actual value of the services performed.

Subsidies and Special Conditions

SocialSecurity.gov

We deduct the cost of certain impairment-related items and services that are needed to work from gross earnings when we decide if your work is SGA.

• The beneficiary must pay for the item themselves (no reimbursement from 3rd

party)

• The claimant must pay cash (no in-kind payments)
• Examples include wheelchairs, certain transportation costs and specialized

work-related equipment. Example: Beneficiary is earning $1200.00 per month in gross wages. His monthly co-pay for his medications is $75.00. $1200 - $75 = $1125 - This is countable income when determining SGA.

Impairment-Related Work Expenses (IRWE)

SocialSecurity.gov

Impairment-Related Work Expenses (IRWE)

Type of Expense Example

Transportation Costs

The cost of structural or operational modifications to vehicle that is needed to travel to work. The cost of driver assistance or taxicabs if public transportation is not available or not accessible.

Attendant Care Services

Services performed in the work setting. Services performed to help prepare for work, the trip to and from work and after work.

Service Animals

Expenses paid in owning a guide dog or other service animal who enables beneficiary to overcome functional limitations in order to work.

Medical Devices

Deductible devices include wheelchairs, dialysis equipment, pacemakers, respirators, traction equipment, and braces.

Prosthesis

Artificial hip, artificial replacement of an arm, leg, or other parts of the body.

Residential Modifications

Employed outside of home- modifications to exterior to permit access to the street or transportation. Self-employed at home- modifications inside to create workspace to accommodate impairment.

Prescription Drugs

Regularly prescribed medical treatment or therapy that is necessary to control disabling condition. This includes co-payments and insurance deductibles.

Other Items and Services

Assistive technology that people with disabilities use for employment–related purposes; such as software applications, computer support services, and special tools which have been specifically designed to accommodate the person’s impairment

SocialSecurity.gov

What is a PASS?

• A PASS allows an individual to set aside other income besides SSI and/or

resources for a specified time period to pursue a work goal that will result in the reduction or elimination of SSI or SSDI benefits. How does it work?

• We do not count the income set aside under the PASS when we figure

the SSI payment amount. We do not count the resources set aside under the PASS when we determine initial and continuing eligibility for SSI. Who can have a PASS?

• If a person receives SSI or could qualify for SSI after setting aside income
• r resources to pursue a work goal, a person could benefit from a PASS.

Plans to Achieve Self-Support (PASS)

SocialSecurity.gov

What kinds of expenses can a PASS help pay for?

• School or training expenses- tuition, fees, books and supplies
• Uniforms, special clothing, safety equipment, tools
• Attendant care of child care expenses
• Transportation for work
• Employment services such as a job coach
• Supplies to start a business

Plans to Achieve Self-Support (PASS)

SocialSecurity.gov

A Sample PASS (SSDI Only) Example – SSDI Being Excluded under an approved PASS

• Maria wants to go to school and become a paralegal.
• She receives $800 in SSDI benefits
• Maria’s employment goal needs to be expected to generate enough income to

eliminate SSDI. (Have expected earnings over $1,180 per month SGA for 2018)

• Maria determines she needs $780 per month for tuition, books, and

school

• supplies. We can deduct the $780 in school expenses from her SSDI

benefit and deduct the remaining $20 (general SSU exclusion) so that her SSDI benefit is not countable income and she is eligible for the full SSI payment of $750 (for 2018).

• Maria must use the SSI payment of $750 for living expenses and use the PASS

funds of $780 for approved plan expenses.

Plans to Achieve Self-Support (PASS)

SocialSecurity.gov

• An innovative program for persons with disabilities who want to

work and participate in planning their employment.

• Increases your available choices when obtaining employment

services, vocational rehabilitation (VR) services, and other support services you may need to get or keep a job.

• It is a free and voluntary service.
• You can use the Ticket if you choose, but there is no penalty for

not using it.

Ticket to Work (TTW)

SocialSecurity.gov

For more information on the TTW Program, including a list of approved ENs, call: 1-866-YOURTICKET (1-866-968-7842) OR TTY 1-866-833-2967 between 8 a.m. to 8 p.m. Eastern time Monday through Friday.

Ticket to Work (TTW)

socialsecurity.gov/work

SocialSecurity.gov

What is EXR?

• EXR is a safety net for people who successfully return to work and lose

their entitlement to SSDI and/or SSI benefits because of work and earnings.

• Allows individuals to request benefits be reinstated without filing a new

application (if request made within 5 years from the month benefits ended) How does EXR help you?

• The EXR provision allows an individual to receive up to 6 months of

temporary cash benefits while we conduct a medical review to decide if we can reinstate benefits. An individual may also be eligible for Medicare and/or Medicaid during this provisional benefit period.

Expedited Reinstatement (EXR)

SocialSecurity.gov

Continuation of Medicare Coverage

• Although cash benefits may cease due to work, continued health

insurance is possible.

• Most beneficiaries who work will continue to receive at least 93

consecutive months of Part A; Part B (if enrolled); and Part D (if enrolled). There is no premium for Part A.

• The 93 months start the month after the last month of the TWP.
• To qualify, beneficiary must already have Medicare and be working

at SGA level but not medically improved.

SocialSecurity.gov

After premium-free Medicare coverage ends due to work, a disabled individual may buy continued Medicare coverage as long as he/she remains medically disabled. To qualify, the individual:

• Must be under age 65; and
• Continue to have a disabling impairment; and
• Medicare stopped due to work.

Hospital Insurance (Part A) is available for $422.00 per month in 2018. Supplemental Medical Insurance (Part B) is available for $134.00 per month in 2018.

Medicare for Persons with Disabilities Who Work

SocialSecurity.gov

SSDI – What Happens When You Go to Work?

SocialSecurity.gov

• Earned Income Exclusion
• Student Earned Income Exclusion (SEIE)
• Special SSI Payments for Persons Who Work
• Section 1619(a)
• Medicaid While Working - Section 1619(b)

SSI Only Employment Supports

SocialSecurity.gov

• SSA does not count the first $65 of the earnings received in

a month, plus one-half of the remaining earnings. This means we count less than one-half of earnings when we figure the SSI payment amount.

• We apply this exclusion in addition to the $20 general income

exclusion.

• We apply the $20 general income exclusion first to any

unearned income received.

Earned Income Exclusion

SocialSecurity.gov

For individuals under age 22 and regularly attending school, we do not count up to $1,820 of earned income per month when we figure the SSI payment amount. The maximum yearly exclusion for 2018 is $7,350. “Regularly Attending School” means:

• In a college or university for at least 8 hours a week; or
• In grades 7-12 for at least 12 hours a week; or
• In a training course to prepare for employment for at least 12 hours a

week (15 hours a week if the course involves shop practice); or

• For less time than indicated above for reasons beyond the student’s

control, such as illness; or

• Home schooling, if instructed in grades 7-12 for at least 12 hours a week.

Student Earned Income Exclusion (SEIE)

SocialSecurity.gov

How does it work?

• Your eligibility for SSI will continue for as long as you meet the basic

eligibility requirements and the income and resource tests.

• We will continue to figure your SSI payment amount in the same way as

before.

• If your state provides Medicaid to persons on SSI, you will continue to be

eligible for Medicaid. Each state has a Medicaid threshold. Do you need to apply? You do not need to file a special application. Just keep us up to date on your work activity.

Medicaid While Working – Section 1619(b)

SocialSecurity.gov

• There is a special rule to help people who work and

receive Supplemental Security Income (SSI) based

• n blindness.
• This rule allows a blind person to exclude from

earned income all expenses that enable the person to work.

• The expense does not need to be related to the

blindness.

Special SSI Rule for Blind People Who Work

SocialSecurity.gov

Responsibilities When Beneficiary Returns to Work

Notify Social Security of any changes in work activity:

• Start or stop work;
• Work has been reported but

duties, hours or pay has changed;

• Start paying for expenses that

are needed in order to work due to the disability

• For SSI recipients:
• Automated wage reporting

telephone system

• Mobile wage reporting application
• For SSDI recipients:
• Report wages through your

personal my Social Security account. Report changes in work activity by phone, fax, mail or in person. Call our toll-free number 1-800-772-1213 between 7 a.m. and 7 p.m. Monday-Friday.

socialsecurity.gov/disabilityssi/ssi-wage-reporting.html

SocialSecurity.gov

The Best Guide to Work Incentives

The Red Book is available at: https://www.ssa.gov/redbook/

Need 2018 version

Benefits Planning

9/3/2019 Minnesota Department of Human Services | mn.gov/dhs 28

Beth Grube

Two Types of Support

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▪Health Care Coverage:

• Affordable health insurance for people with

disabilities and low income

• Helps pay for health care services and medical

services other insurance can’t, like personal care services ▪Cash Benefit Programs:

• Help pay for food, rent, and utilities

Common Cash Benefits

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• Social Security Disability Insurance (SSDI)
• Supplemental Security Income (SSI)
• MN Supplemental Aid (MSA)
• General Assistance (GA)
• Housing Support (formerly Group Residential Housing -

GRH)

• Supplemental Nutrition Assistance Program (SNAP)
• MN Family Investment Program (MFIP)

Common Health Care Benefits

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• Medical Assistance (MA)
• Medicare

Good News!

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All public benefits in MN now support work!

Work Incentives

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1. Let you get onto the benefit while working, or 2. Let you keep the benefit longer while working, or 3. Let you get the benefit back quickly if you work your way off but need it again

Work Incentives

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• Earned Income Disregards
• Increase asset limits
• MA-EPD
• Ticket to Work (SSI/SSDI)
• Trial Work Period (SSDI)
• Extended Period of Eligibility (SSDI)
• Expedited Reinstatement (SSI/SSDI)
• Impairment Related Work Expense (IRWE)

(SSI/SSDI)

• Subsidy (SSDI)
• Plan for Achieving Self Support (PASS) (SSI/SSDI)
• Section 301 (SSI/SSDI)
• Unsuccessful Work Attempt (SSI/SSDI)
• Blind Work Expense (SSI)
• Student Earned Income Exclusion (SSI)
• Property Essential for Self Support (PESS)

(SSI)

• 1619(b) (SSI)
• Extended Medicare (SSDI)
• HUD Earned Income Disregard
• Earned Income Tax Credit (EITC)
• ABLE Accounts
• Individual Development Accounts (IDA)

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Person-Centered

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Informed Choice

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• Solve problems
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• Plan for the future
• Overcome fears and barriers
• Decide needs and wants
• Make sure the money adds up
• Explore housing options
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866-333-2466 www.disabilityhubmn.org

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To make it easier to:

• Understand benefits
• Learn about work incentives
• Plan for work & set goals
• Build financial literacy
• Manage benefits while working
• Benefits information
• Tools
• Resources

www.db101.mn.org DB101 brings together:

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• Engage people in planning for housing
• Understand their housing options
• Access resources

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9/3/2019 Minnesota Department of Human Services | mn.gov/dhs 51