BENEFITS AND WORK INCENTIVES

BENEFITS AND WORK INCENTIVES

Supplemental Security Income and Social Security Disability InsuranceADD NAME AND CONTACT INFOADD DATERemember to add your name and contact info (if you are doing this for other than DRS staff) and the date!1You are not here merely to make a living.

You are here to enable the world to live more amply, with greater vision, and with a finer spirit of hope and achievement.

You are here to enrich the world.

You impoverish yourself if you forget this errand.

President Woodrow Wilson2Sound Familiar?If I go to work I will lose my benefits.

I can only make $1,040 a month or I will lose my benefits.

I cant get the skills and experience I need for a career without losing my benefits.

If I go to work and then stop working, I wont be able to get back my cash benefits or Medicaid/Medicare back.

If I go to work Social Security will send me a letter asking for a lot of money back.

These are the common myths.

Go through them one at a time and see if the audience has heard them before.

Ask for others not listed.

If somebody says something that will not be addressed in this presentation, agree but tell them it wont be covered. 3Lets Bust Those Myths!Reduce fear and misunderstanding about the effect of working on benefits.

Prevent crises that can result when change occurs.

Improve employment and economic outcomes through:

Increased employment rates;

Increased earnings; and

Decreased medical expenses.

REDUCE FEAR AND MISUNDERSTANDING: People are making decisions all the time based on misunderstandings of how the rules really work. For example, you may have consumers on SSI who are afraid to work anything but part-time for fear of losing Medicaid. But that fear is unfounded.

PREVENT CRISIS: People react much better when they understand their environment and can expect certain things to happen. Overpayments from SSA are always so devastating because they come as such a surprise. But, if the consumer knows if and when they are supposed to be paid, then when an overpayment occurs, they are ready for it.

IMPROVE EMPLOYMENT: Knowledge works. People should work more when they understand the rules.4SOME BASIC TERMS YOU WILL NEED TO KNOWSSA: Social Security Administration

SSI: Supplemental Security Income

SSDI: Social Security Disability Insurance

SGA: Substantial Gainful Activity. $1,040 non-blind, $1,740 blind (2013).

WORK INCENTIVES: Both federal and state-specific programs that are available to people with disabilities in return to work efforts.

HUD: Department of Housing and Urban Development

Audience members may be familiar with these terms already, but it is good to remind them.

It is also good to say Supplemental Security Income, or SSI and Social Security Disability Insurance, or SSDI several times before you start referring to them as just SSI and SSDI.5LETS START WITH SUPPLEMENTAL SECURITY INCOME!6SUPPLEMENTAL SECURITY INCOMEHow Does Supplemental Security Income Really Work?

7SUPPLEMENTAL SECURITY INCOMESupplemental Security Income = Title XVI (16) or SSI

Needs based program that provides a cash benefit and/or Medicaid.

To qualify:

Meet all five steps of the Social Security Administrations (SSA) sequential evaluation;

and

Have resources of $2,000 or less for an individual or $3,000 or less for a couple. Standard exclusions apply such as home you own and one car.

SSI is known as Title 16 by SSA employees SSI by everybody else.Needs based program, which basically pays when nobody else is.

Purpose of SSI is to help you obtain food and shelter. Any factor impacting this (who you live with, how much you make, how much you have, etc.) may impact SSI. Strict asset and income guidelines.

Countable income includes both earned and unearned income. Any money coming in could count, even gifts!

Also considers the income of other relatives in certain cases (deeming).

Long list of exclusions from the resource limit, the most well known are the home in which person resides and one car. There is a complete list of all resource exclusions on your cd.

8SUPPLEMENTAL SECURITY INCOMESSA SEQUENTIAL EVALUATION

The Five Steps:

Is the consumer working at Substantial Gainful Activity (SGA) or above? If the answer is no, go to step two.

Does the consumer have a severe medically determinable physical or mental impairment that meets the duration requirement* or a combination of impairments that is severe and meets the duration requirement? If the answer is yes, go to step three.

Does the consumer have a disability that meets one of the listings in the SSA Blue Book(www.ssa.gov/disability/professionals/bluebook/)? If the answer is yes, the consumer gets benefits. If the answer is no, go to step four.

Is the consumer able to do the work that was at substantial gainful activity level done in the 15 year period prior to the disabling condition, and that lasted long enough for the person to learn to do that job? (This step may be skipped if evidence about past relevant work is not sufficient to make a finding.) If the answer is yes or no, go to step five.

Taking into account the consumers medical conditions, age, education, past work experience and any transferable skills, can the consumer do any other type of work? If the answer is no, the consumer qualifies for Social Security Disability Benefits (either SSI or SSDI).

* DURATION REQUIREMENT = Unless condition is expected to result in death, it must have lasted or must be expected to last for a continuous period of at least 12 months SSI uses a 5 step process to decide if you meet disability definition. Tell story of disability check. It is not a disability check. It is a disability impacts my ability to do substantial gainful activity check. It all relates back to not just having a disability but how that disability impacts what you can do.

Step 1 kicks people out who are already working. You may have a disability, but if you are earning SGA, it is not a disability that impacts your ability to do SGA!

Step 2: You gotta have something medical going on. Otherwise you filled out the wrong app.

Step 3: Takes the most clear cut cases and allows benefits. You have the symptoms listed, we will assume you cannot do SGA work and you will be awarded benefits.

Step 4 and 5: Really messy..where they ask all sorts of questions and gather all sorts of info of what you can and cannot do to see if there is work you can do.9SUPPLEMENTAL SECURITY INCOMEBASIC WORK RELATED ACTIVITIES INCLUDE:

Ability to exert physically for various work-related activities (such as sitting, standing, walking, lifting, carrying, pushing, pulling).

Do manipulative and postural activities (such as reaching, handling large objects, using fingers, feeling, stooping, balancing, climbing stairs or ladders, kneeling, crouching, crawling).

Tolerate certain environmental conditions (such as temperature extremes, wetness, humidity, noise, hazardous working conditions like moving machinery or heights, dust, fumes, odors, gases, poor ventilation, vibrations).

See, hear, and speak.

Maintain concentration and attention at work.

Understand, remember and carry out instructions.

Respond appropriately to supervisors, co-workers, and usual work situations.

Cope with changes in the work setting.

Here are the types of things they will be looking at to see if your disability impacts your ability to do SGA work.10SSI MYTH NUMBER ONEI WILL LOSE MY SSI IF I GO TO WORK

FACT: WORK INCENTIVES LET CONSUMERS KEEP SSI CASH CHECK OR STATUS WHEN THEY WORK!

Plan to Achieve Self Support (PASS)

Impairment Related Work Expense (IRWE)

Blind Work Expense (BWE)

Student Earned Income Exclusion (SEIE)

1619(b) Medicaid

SUPPLEMENTAL SECURITY INCOMEHere is a list of deductions from income that can increase the check amount in the end..but before we get there, lets talk about what you get immediately when you receive SSI.11SUPPLEMENTAL SECURITY INCOMEIMMEDIATE SSI WORK INCENTIVES

Cash benefit of up to $710 a month (individual) or $1,066 (couple) a month in 2013.

Medicaid health insurance.

There is no waiting period for Medicaid. Once a consumer is determined eligible for SSI he/she receives Medicaid.

Generally, Medicaid is now provided through Star + Plus managed care unless the consumer is in a Medicaid Rural Service Area.

Consumers who receive Home and Community Based Waiver (Tx Hml, CLASS, HCS, DBMD, etc.) get their acute care (Medicaid) services from STAR managed care.

Once a person gets SSI, he/she has a little money and health insurance.

Having these two things can help free the consumer to start thinking about work, rather than just how they are going to pay for the Doctor or pay the rent.12SUPPLEMENTAL SECURITY INCOMEPLAN TO ACHIEVE SELF SUPPORT (PASS)

Designed to help consumer reach an employment goal.

Time limited (48 months; can be extended).

Not a comparable benefit.

Must have earned or unearned (e.g. SSDI) income to create plan.

Must be able to live on amount left after putting money into PASS.

All purchases in plan must be related to employment goal.

Money in PASS must be spent on what is in plan or consumer will get overpayment notice.

SSA will review PASS once a year at a minimum.

Good DRS candidates: students and people who want to start business.

First off, SSI people can put money away in what is called a PASS and SSI ignores it.

It is a way to avoid or decrease the reducing the SSI check because normally that money would count.

People put things like work income, assets, or even Social Security Disability Insurance payments into a PASS.

Here is a general overview of PASS.13SUPPLEMENTAL SECURITY INCOMEPLAN TO ACHIEVE SELF SUPPORT (PASS)continuedSSA Area Work Incentive Coordinator (AWIC) approves and reviews all PASS.

PASS form is located at:http://www.ssa.gov/online/ssa-545.html or on your cd.

Anyone may help consumer complete PASS form, but plan must be submitted by consumer.

Consumer is responsible for all expenditures and progress in PASS.

PASS plans are fairly complicated,. Although you (VRC) could write PASS, they do take up a lot of time, and we still have people who can write these plans for our consumers: the Community Work Incentive Coordinators, or CWICs.

We will talking more about the Community Work Incentive Coordinators, or CWICs a little later on.

We will also talk a little later about the Social Security Administration employee known as the Area Work Incentive Coordinator, or AWIC and how building a relationship with your AWIC is important to our consumers on SSI or SSDI.14SUPPLEMENTAL SECURITY INCOMEIMPAIRMENT RELATED WORK EXPENSE (IRWE) A plan that has expenses for items or services which are directly related to enabling a consumer to work.

Services or items have to be things that cannot be paid through another source, and the cost must be reasonable. Any service or item an agency such as DSHS or DARS, or someone else pays for will not be approved as an expense in the IRWE.

Up to the money put aside for expenses in an IRWE comes back to the consumers SSI check.

Helpful in reducing income to under SGA when applying for SSI.

Impairment Related Work Expenses also help bring back some SSI.

If you can show you are using some of your earnings for expenses related to your disability and working, SSI will take that into account.15SUPPLEMENTAL SECURITY INCOMEIMPAIRMENT RELATED WORK EXPENSE (IRWE) No SSA form. See cd for sample IRWE application.

Send application to the local SSA Work Incentive Liaison or SSA Area Work Incentive Coordinator.

May be asked for proof of need (e.g. medical records, doctors prescription).

Must provide proof on monthly basis that items or services were paid by filling out SSA Form 795 (http://www.ssa.gov/online/ssa-795.pdf or on your cd) and copies of cancelled check(s), or paid receipt(s). Must include statement on SSA-795 that no reimbursement was or will be received for the IRWE, and that no agency or other source is underwriting the expense for the consumer.Remember that whatever goes into an IRWE has to be related to employment AND disability.

Putting the cost of taking a bus or taxi to work would be considered an IRWE only if those were the only modes of transportation that could accommodate the persons disability .

If the person takes the bus because they dont own a car, the cost of the bus wouldnt be an IRWE.

If the person takes a taxi because they dont own a car or drive, and because there is no public transportation, but they cannot prove that a taxi is the only mode of transportation that can accommodate their disability, the cost of the taxi is not an IRWE.16SUPPLEMENTAL SECURITY INCOMESTUDENT EARNED INCOME EXCLUSION (SEIE)

Under age of 22.

Regularly attending school.

$1,730 a month or $6,960 maximum a year is forgiven from SSI check.

Must be requested. No student receiving SSI is automatically considered for this work incentive-not even someone in public high school!

No SSA form. See cd for template.

The purpose of SEIE is to encourage getting work experience..and to not dissuade students from taking those summer internships and other jobs that will build up resumes and lead to better employment outcomes after graduation.17SUPPLEMENTAL SECURITY INCOMESTUDENT EARNED INCOME EXCLUSION (SEIE)continued

Regularly Attending School means:Grades 7-12: at least 12 hours a week orCollege or university: at least 8 hours a week orIn a training course to prepare for employment for at least 12hours a week (15hours a week if the course involves shop practice); orFor less time than indicated above for reasons beyond the students control, such as illness.

GED counts if hours meet above guidelines!

Will have to provide proof of attendance. For high school:http://www.hslda.org/hs/state/tx/Verification_of_Enrollment.pdf or on your cd. (This is the form required by DPS for students in drivers education or those trying to obtain a driving permit before the age of 18. )

18SUPPLEMENTAL SECURITY INCOMESTUDENT EARNED INCOME EXCLUSION (SEIE)continued

If consumer is home taught, he/she may be considered regularly attending school if:

Consumer is instructed in grades 7-12 for at least 12hours a week, and

The instruction is in accordance with Texas home school regulations.

If consumer is home taught because of a disability, he/she may be considered regularly attending school by:

Studying a course or courses given by a school (grades 7-12), college, university or government agency,

Having a home visitor or tutor who directs the study, and

The instruction is in accordance with Texas home school regulations.

19SSI MYTH NUMBER TWOIF I GO BACK TO WORK, I WILL LOSE MY MEDICAL

FACT: CONSUMERS CAN KEEP MEDICAL WHEN THEY WORK!

SSI/Medicaid through1619(b)

Individualized Threshold

Texas Medicaid Buy-In after you earn off

SUPPLEMENTAL SECURITY INCOMEThis is probably the biggest myth out there and something we cannot say enough:

SSI BENEFICIARIES HAVE SEVERAL AVENUES TO KEEP MEDICAID EVEN IF THEY ARE EARNING MORE THAN THE STANDARD ELIGIBILITY AMOUNTS!20SUPPLEMENTAL SECURITY INCOME1619 (b) MEDICAID

When a consumers SSI cash check goes to $0 he/she will still receive Medicaid through 1619(b).

Receipt of Medicaid will continue until the consumer reaches the (2013) Texas threshold of $32,387.00.

Although transfer to 1619(b) is an automatic electronic behind the scenes transfer, it is advisable that the consumer check with both the local SSA and HHSC or Your Texas Works benefits offices to ensure Medicaid coverage continues. There is no SSA form for 1619(b).

1619(b) is required in Texas by federal and state regulations.

Look at that number. $32,387.

That right there should be enough for most of the people you work with.are you getting a lot of SSI beneficiaries jobs at salaries higher than this?

If you are, there are other answers.

But our guess is, this rule alone covers most of the folks you work with.21INDIVIDUALIZED THRESHOLDAfter the consumer earns over the Texas state threshold of $32,387.00 gross (2013), he/she can request an Individualized Threshold from SSA.

The individualized threshold begins with the base amount from the state threshold and adds:

The higher of the consumer's actual Medicaid expenditures or the average per capita Medicaid expenditure shown (per capita Medicaid expenditures in 2012 for Texas were $14,327);

The higher of the State supplement rate for the consumer's actual living arrangement or a living alone rate;

Any IRWE or BWE the consumer has;

Amounts of income excluded under an approved PASS; and

The value of publicly-funded personal/attendant care which the consumer receives.

SUPPLEMENTAL SECURITY INCOMEHere is one way to go even higher than $32,387.

People who need personal attendant services, or people with severe and persistent mental illness who take a lot of medications each month should definitely look into the individualized threshold as they are probably using more than the average per person Medicaid expenditure.22SUPPLEMENTAL SECURITY INCOMEMEDICAID BUY-IN

A great resource for consumers who received SSI, but have exceeded the state threshold (earned off1619(b)) and do not qualify for an individualized threshold.

Consumers who recently earned off SSI are presumptively eligible for Medicaid Buy-In!

For Buy-In application go to: http://www.dads.texas.gov/forms/H1200-MBI/ or on your cd.And here is a third way..23SSI MYTH NUMBER THREEIF WAGES CAUSE SSI CASH BENEFIT TO STOP, THERES NO WAY TO GET THAT CASH BENEFIT BACK

FACT: CONSUMERS CAN STAY IN ELIGIBILITY STATUS EVEN WHEN THEY DONT GET A CASH CHECK!

1619(b)

Expedited Reinstatement

SUPPLEMENTAL SECURITY INCOME

Even after your earned income causes your cash check to go to $0 you can keep Medicaid until you earn above $32,387 (2013) gross in a year.

SSI has expedited reinstatement as well. From the time you are terminated from SSI (no longer receiving cash check or Medicaid) you have anywhere from twelve months to five years depending on the circumstances to go back into the SSA office and request reinstatement without reapplying for benefits.

The redetermination process is really very quick-you usually get back on within two months.241619(b)1619(b) is a stop payment status, NOT a suspension status.

1619(b) protects reinstatement rights under all SSI provisions including cash benefits.

Consumers eligible under section 1619(b) are reinstated to cash benefit status if countable income drops below the applicable breakeven point and all other eligibility criteria are met.

Reinstatement is possible at all times in all States, unless the consumer's eligibility is terminated.

SUPPLEMENTAL SECURITY INCOMEMost people never leave 1619. So they never leave the SSA rolls.

Change in circumstances? Just report it and SSA will adjust!

This can go on forever, although a long work history in 1619 will probably lead to SSDI eligibility.25SUPPLEMENTAL SECURITY INCOMEEXPEDITED REINSTATEMENT

A consumer ineligible for SSI payments due to work may be able to restart SSI cash payments again.

If the consumer has been ineligible for SSI and/or Medicaid for any reason other than work or medical recovery SSI cash payment and/or Medicaid coverage could resume within 12 months without a new application.

If cash payment and Medicaid benefits ended because of work and earnings, and the consumer stops work within 5 years of when benefits ceased, SSA may be able to start benefits again under Expedited Reinstatement.

There is no form for Expedited Reinstatement. Contact SSA office and request Expedited Reinstatement of SSI benefits. Consumer may receive six months of provisional cash benefits and/or Medicaid while SSA makes their determination.Rarely used in SSI because people never leave 1619.but it could happen.26SSI MYTH NUMBER FOURWorking always results in overpayments

FACT: THERE ARE STRATEGIES TO PREVENT OVERPAYMENTS! Report regularly.

Consumer should get a receipt from SSA to document that he/she reported.

Know the overpayment rules! If the overpayment is $1,000 or under it can be automatically waived. No matter what the amount is, the consumer should request reconsideration, a waiver, or negotiate a low, low re-payment plan.

SUPPLEMENTAL SECURITY INCOMEAn overpayment does not have to be a devastating crisisFirst, make sure your consumers are prepared.

And second, there is always a reasonable way to resolve it.27SUPPLEMENTAL SECURITY INCOMEREPORTING EARNED INCOME

Find out how your SSA office wants earned income reported if you can. But, report every single time pay is received-no matter how little that pay is, and regardless of how often the SSA office has told the consumer to report!

Consumers receiving SSI can use telephone reporting by calling 1-866-772-0953, using Form SSA-821-BK (http://www.ssa.gov/online/ssa-821.pdf or on cd) or by taking or mailing in check stubs to the local SSA office.

Best ways to report? 1) Take pay stub in person. 2) Mail certified return receipt requested. 3) Mail in. If mailing be sure to include letter requesting receipt each time!

REPORT! REPORT! REPORT! REPORT!

REPORT!Reporting is really important.

It is good to have a relationship with the local SSA office and find out how they like people to report income.

Some SSA offices will tell people only to report when they make over SGA; other SSA offices will say that the person only has to report when they start working and then only when there is a change in income after that.

To be on the safe side, we tell consumers to report every time they get paid unless you, as a VRC, have established a relationship in the local SSA office and can tell the consumer the specific way that office likes to have income reported.28SUPPLEMENTAL SECURITY INCOMEOVERPAYMENT NOTICES

Overpayment notices are almost a sure thing. Beneficiary does not have to pay entire amount by check, money order or credit card within thirty days. Do not ignore the letter!

Overpayments under $1,000 can be waived.

Over $1,000 file request for reconsideration using SSA Form SSA-561-U2 (http://www.ssa.gov/online/ssa-561.pdf or on your cd) orRequest for Waiver of Overpayment Recovery Or Change In Repayment Rate using SSA Form 632 (http://www.ssa.gov/online/ssa-632.pdf or on your cd) or write letter.

In most cases repayment will never be more than 10% of monthly SSI check.29SSI MYTH NUMBER FIVEI lose my SSI cash benefit if I make over $1,040 a month

FACT: CONSUMERS CAN MAKE MORE THAN $1,040 AND STILL GET AN SSI CASH CHECK!

SSI cash check does not go to $0 until consumer makes $1,505 in 2013 (with no other deductions from work incentive programs).

SUPPLEMENTAL SECURITY INCOMEEverybody is looking for that magic number..and SSI just doesnt work that way.

SSI works on a formula that could eventually result in $0 benefits until the formula puts you there.

(May want to remind audience that the person still gets Medicaid even after their SSI cash check goes to $0).30SUPPLEMENTAL SECURITY INCOME

AND NOW FOR THE MAGIC PORTION OF OUR PRESENTATION.31UNEARNED INCOME (SSDI) $0General Income Exclusion (GIE)- $0TOTAL COUNTABLE UNEARNED INCOME = $0STEP ONE: COUNTABLE UNEARNED INCOMESUPPLEMENTAL SECURITY INCOMEStart with the unearned income.

You subtract $20, and count the rest.32GROSS EARNED INCOME $1,040.00 Student Earned Income Exclusion (SEIE)- 0= $1,040.00 GIE (if not used above)- 20.00 Earned Income Exclusion (EIE)- 65.00 Impairment Related Work Expense (IRWE)- 0= $ 955.00 Divide by 2= $ 477.50Blind Work Expense (BWE)- 0TOTAL COUNTABLE EARNED INCOME= $ 477.50STEP TWO: COUNTABLE EARNED INCOMESUPPLEMENTAL SECURITY INCOMENow start with gross earnings.

Here we have no work incentive deductions.

So, we subtract $20, if not used on unearned income, subtract $65 and divide by 2. 33TOTAL COUNTABLE UNEARNED INCOME $0TOTAL COUNTABLE EARNED INCOME + $477.50PASS Deduction- $0TOTAL COUNTABLE INCOME= $477.50STEP THREE: TOTAL COUNTABLE INCOMESUPPLEMENTAL SECURITY INCOMEHere, we add up the countable earned and unearned income.34BASE SSI RATE FOR THIS INDIVIDUAL/COUPLE $710.00TOTAL COUNTABLE INCOME- $477.50ADJUSTED SSI AMOUNT= $232.50STEP FOUR: ADJUSTED SSI AMOUNTSUPPLEMENTAL SECURITY INCOMENow we subtract it from the federal benefit rate and get the new SSI amount.35UNEARNED INCOME0General Income Exclusion (GIE)- 0TOTAL COUNTABLE UNEARNED INCOME = $ 0GROSS EARNED INCOME $1,040.00 Student Earned Income Exclusion (SEIE)- 0= $1,040.00 GIE (if not used above)- 20.00 Earned Income Exclusion (EIE)- 65.00 Impairment Related Work Expense (IRWE)- 0= $ 955.00 Divide by 2= $ 477.50Blind Work Expense (BWE)- 0TOTAL COUNTABLE EARNED INCOME= $ 477.50TOTAL COUNTABLE UNEARNED INCOME $0TOTAL COUNTABLE EARNED INCOME + $477.50PASS Deduction- 0TOTAL COUNTABLE INCOME= $477.50BASE SSI RATE FOR THIS INDIVIDUAL/COUPLE $710.00TOTAL COUNTABLE INCOME- $477.50ADJUSTED SSI AMOUNT= $232.50SUPPLEMENTAL SECURITY INCOMEHere is the whole thing!36SUPPLEMENTAL SECURITY INCOMESomeone making Substantial Gainful Activity in gross earnings in 2013 ($1,040) would get an SSI check of $232.50, for a total of earned and unearned income of $1,272.50

Take 25% away from earned income of $1,040.00 for FICA, etc. for an estimated take home (net) of $780.00

Add the net earned income of $780.00 to the SSI check of $232.50 for a total monthly income of $1,012.50.

Thats $302.50 MORE than just the SSI check of $710!

And dont forget that the consumer may qualify for the Earned Income Tax Credit (EITC) at tax time. and get all, or a lot of the money taken out for taxes back in their pocket!

The only thing the person will lose entirely is SNAP. Almost everything else, including housing either reduces gradually or does not end.

With this formula, you always end up with more money..you cannot put a number in here and end up with less!37And then you hear..If I go to work I am making $1,040 and only bringing home $1,012.50. I am really losing my SSI Cash benefit and thats not fair I am entitled to that!

And your answer is:

Your Consumer Someone who works with your Consumer

Nets approximately $780 after taxes;Gets free health comprehensive insurance, no dental (Medicaid);Gets SSI cash benefit of $232.50;Has work incentives available to access necessary items and services for work and get more money back in SSI cash benefit;Has the ability to work enough and also get SSDI and Medicare; and Gets all taxes done for free and paid back through EITC.Nets approximately $780 after taxes;Has no health insurance, no dental unless he/she purchases it at high cost;Has to purchase everything necessary for doing the job and gets nothing in return;Gets all taxes done for free and paid back through EITC.

38SUPPLEMENTAL SECURITY INCOMETHAT (UN) MAGIC NUMBER

When a consumer says to you I cant make over $1,040 a month because I dont want to lose my SSI cash benefit", you can tell them that $1,040 is NOT the number they are looking for.

The un-magic number they are looking for in 2013 is $1,505.00 a month. Why is $1,505 un-magic?

39UNEARNED INCOME0General Income Exclusion (GIE)- 0TOTAL COUNTABLE UNEARNED INCOME = 0GROSS EARNED INCOME $1,505.00 Student Earned Income Exclusion (SEIE)- 0= $1,505.00 GIE (if not used above)- 20.00 Earned Income Exclusion (EIE)- 65.00 Impairment Related Work Expense (IRWE)- 0= $1,420.00 Divide by 2= $ 710.00Blind Work Expense (BWE)- 0TOTAL COUNTABLE EARNED INCOME= $ 710.00TOTAL COUNTABLE UNEARNED INCOME 0TOTAL COUNTABLE EARNED INCOME + $710.00PASS Deduction- $0TOTAL COUNTABLE INCOME= $710.00BASE SSI RATE FOR THIS INDIVIDUAL/COUPLE $710.00TOTAL COUNTABLE INCOME- $710.00ADJUSTED SSI AMOUNT= $0THIS LOOKS LIKE $1,505 IS THE MAGIC NUMBER TO ME!SUPPLEMENTAL SECURITY INCOME40If work incentive programs are used earnings can be much higher.

Even if work incentive program arent used, the consumer can earn up to $32,387 gross (2013) and still retain Medicaid health insurance through 1619(b) and maybe more if he/she qualifies for an individualized threshold!SUPPLEMENTAL SECURITY INCOME41SUPPLEMENTAL SECURITY INCOMENow lets see what happens when a consumer uses just one work incentive!

42UNEARNED INCOME $0General Income Exclusion (GIE)- $0TOTAL COUNTABLE UNEARNED INCOME = $0GROSS EARNED INCOME $1,505.00 Student Earned Income Exclusion (SEIE)- 1,505.00= 0 GIE (if not used above)- 20.00 Earned Income Exclusion (EIE)- 65.00 Impairment Related Work Expense (IRWE)- 0= 0 Divide by 2= 0Blind Work Expense (BWE)- 0TOTAL COUNTABLE EARNED INCOME= 0TOTAL COUNTABLE UNEARNED INCOME 0TOTAL COUNTABLE EARNED INCOME + 0 PASS Deduction 0TOTAL COUNTABLE INCOME= 0BASE SSI RATE FOR THIS INDIVIDUAL/COUPLE $710.00TOTAL COUNTABLE INCOME- 0ADJUSTED SSI AMOUNT= $710.00STUDENT EARNED INCOME EXCLUSION (SEIE)SUPPLEMENTAL SECURITY INCOMEHere, we use the Student Earned Income Exclusion and SSI does not go down.43SUPPLEMENTAL SECURITY INCOMEIn this example, a student under the age of 22 regularly attending school earns gross $1,505.00 each month.

The student can deduct this amount until gross earnings reach $6,960 for the year.

For four months the student will get FULL SSI check plus earnings.

The fifth month the student will be able to deduct $940.00 from the gross earnings and get an adjusted SSI check of $470.00

The sixth month, assuming the student still makes $1,505.00, his SSI cash check will be $0.STUDENT EARNED INCOME EXCLUSION (SEIE)For this example, the student works all 12 months of a year at a gross monthly salary of $1,505.

This slide breaks down exactly how long the student would continue to get an SSI check, and in what amounts.44SUPPLEMENTAL SECURITY INCOMEWHY IS THAT A GOOD DEAL?

Using SEIE, the student will have gross annual earnings of $18,060.00, or an approximate net of $13,545.00.

For four of those months the student will get full SSI check of $710.00 for total of $16,385.00 (earned approximate net of $13,545.00 plus SSI total ($710 x 4) of $2,840.00).

The fifth month the student will get adjusted SSI check of $470.00 for a new grand total of $16,855.00. The student gets a $0 SSI check for the rest of the year.

If the student had just received an SSI check for the full year he would have gotten a total of $8,520.00

Were talking a difference of $8,335.00 and thats some money!(and dont forget about EITC!)This is particularly important when speaking to consumers and their families who rely on the SSI check for the familys rent and food. You can show the family how the student (And they) will come out ahead if the student works.

If the student files an income tax return, he/she will get most or all of the taxes that were taken out back through the Earned Income Tax Credit. Consumers mistakenly think that because they make so little income and may not be required to file taxes that it is a good thing to NOT file.

Since we have the Volunteer Income Tax Assistance programs that will complete most consumers tax returns for free, and because they will get an income tax refund through the Earned Income Tax Credit, all our consumers should be filing a tax return, whether they are required to or not!45SUPPLEMENTAL SECURITY INCOMEWHATS THE CATCH?

For one thing, the resource limit has to be kept down to $2,000.00.

So then what good is that extra $8,335.The student could start a PASSor Individual Development Account...or a 529 to save for college, and the money would be protected from SSI resource limits.

There are lots of possibilities that a Community Work Incentive Coordinator or DRS Benefits Subject Matter Resource Staff can help you think through.

46THE HARSH REALITY

50 % towards rent $ 355.00

20 % towards food, essential household items 142.00

15 % Car Insurance, Gasoline, and repairs 106.50

15 % toward utilities 106.50

Total $ 710.00

This does not take into account that the consumer can get SNAP.

This consumer will have to get Section 8 Housing Choice Voucher or Public Housing assistance and energy assistance to be able to afford the roof over his/her head and heat/air conditioning.

SUPPLEMENTAL SECURITY INCOME47SOCIAL SECURITY DISABILTY INSURANCESO WHAT DO I REALLY NEED TO KNOW ABOUT SSI?

Let the consumer that SSI is a formula: the more money a person makes in earned income will always result in more money in their pocket, even after taxes.

SSI has lots of different work incentive programs that allow a person toto work without losing Medicaid and/or cash benefits for a long time.

Encourage the consumer to consider working at the maximum number of hours and for the most money he/she is able to earn.

Make sure that any information you give is accurate. Check with your DRS SMR or other professionals before giving the answer!

If this is tough for you to understand, imagine how impossibly difficult it is for the consumer to understand. Patience, encouragement and commitment to finding out the right answer goes a really long way!

48SUPPLEMENTAL SECURITY INCOMELiving on SSI is living in poverty.

The first step is to destroy the illusion.

It isnt magic-or impossible, its just math and factsand knowledge.

If you dont bust those myths and assist the person in taking that first step, the journey can never begin.

49NOW LETS MOVE TOSOCIAL SECURITY DISABILITY INSURANCE!50SOCIAL SECURITY DISABILTY INSURANCEHOW DOES SOCIAL SECURITY DISABILITY INSURANCE WORK?

51SOCIAL SECURITY DISABILTY INSURANCESocial Security Disability Insurance= Title II (2) or SSDI

Insurance program that provides cash benefit and/or Medicare

To qualify:

Meet all five steps of the Social Security Administrations (SSA) sequential evaluation;

and

Meet recent work and duration of work tests. (Certain blind workers have to meet only the duration of work test).

No resource limits!SSDI is known by 2 names.

Not only do you need to meet the definition of disability, but you also need a work history52SOCIAL SECURITY DISABILTY INSURANCERECENT WORK TEST

Before age 24: 6 credits earned in the 3-year period ending when disability starts.

Age 24 to 31: Working half the time between age 21 and the time of disability. Example: At age 27 consumer needs credit for equivalent of three full years of work (12 credits) out of the past 6 years (between ages 21 and 27).

Age 31 or older: In general must have earned at least 20 of the credits in the 10 years immediately before onset of disability.

First Quarter: January 1 through March 31Second Quarter: April 1 through June 30Third Quarter: July 1 through September 30Fourth Quarter: October 1 through December 31 Maximum of four credits per year. Earned credits are not restricted to one per quarter.53SOCIAL SECURITY DISABILTY INSURANCEYEAREARNINGS1978$25019792601980290198131019823401983370198439019854101986440198746019884701989500199052019915401992570YEAREARNINGS1993$590199462019956301996640199767019987001999740200078020018302002870200389020049002005920200697020071,000YEAREARNINGS2008$1,05020091,09020101,12020111,12020121,13020131,160SSDI QUARTERLY CREDITS BY YEAR54SOCIAL SECURITY DISABILTY INSURANCEDURATION OF WORK TEST

Work does not have to fall within a certain period of time

Before age 28 : 1.5 years of workAge 48: 6.5 yearsAge 30: 2 yearsAge 50: 7 yearsAge 34:3 yearsAge 52: 7.5 yearsAge 38: 4 years Age 54: 8 yearsAge 42: 5 yearsAge 56: 8.5 yearsAge 44: 5.5 yearsAge 58: 9 yearsAge 46: 6 yearsAge 60: 9.5 years

55SOCIAL SECURITY DISABILTY INSURANCE SSDI WORK INCENTIVES

Cash benefit based on earnings after five month waiting period.

Medicare after 24 month waiting period (after five month waiting period).Certain family members may be eligible for a check from an individuals SSDI account includingSpouse any age caring for a child of beneficiary younger than 16 or disabled.Unmarried child, including adopted, or, in some cases, stepchild or grandchild younger than 18, or younger than 19 if in elementary or secondary school full time.Unmarried child, age 18 or older, if he or she has a disability that started before age 22. (The childs disability must meet the definition of disability for adults.)

For more information on what other family members can draw off an SSDI beneficiarys account and information/fact sheets on all SSA benefits and retirement programs go to:www.ourfamilysecurity.com.

Here are the benefits of SSDI..which can also be seen as a work incentive as it sets up the consumer to begin the return to work process.56SOCIAL SECURITY DISABILTY INSURANCESSDI CASH BENEFIT

There is a maximum SSDI cash benefit. In 2012 it was $2,513 a month. Payments received from worker's compensation, a public disability benefit, or a pension based on earnings not covered under Social Security may reduce the amount of cash benefit.

The five month waiting period exists to permit disability to be corrected, or for consumer to show signs of probable recovery within less than 12 months after the onset of disability.

An eligible spouse or child can get a monthly benefit up to one-half of beneficiarys monthly benefit. There is a Family Maximum (Fmax) limit. Fmax varies, but is typically between 150% and 180% of consumers amount.

Here you can give an example of somebody who had a disability in December 2009 but worked and earned above SGA.

In January, that disability kept them from continuing to work. This would be their onset.

But, they cannot receive a check for January, February, March, April or May because that is their waiting period.57SOCIAL SECURITY DISABILTY INSURANCEMEDICARE HEALTH INSURANCE

Receive 24 months after first cash check

Medicare Part A: Hospitalization, limited skilled nursing facility care, home health care, hospice care and blood.No monthly premium costs there are deductibles or copayments.

Medicare Part B: Doctors services, outpatient medical, hospital and surgical services, clinical laboratory services, home health care, blood and various preventive services. Premium is $104.90 per month in 2013.

Medicare Part D: prescription drug coverage. Costs vary based on plan and medications.

Medicare Part C or Medicare Advantage Plan.Covers A and B and generally have lower copayments than traditional Medicare.

You get Medicare after 24 from when the check should have started (not necessarily received).58SSDI MYTH NUMBER ONEI WILL LOSE MY SSDI IF I GO TO WORK

FACT: THERE ARE SSDI WORK INCENTIVES THAT LET CONSUMERS KEEP THEIR CASH CHECK OR STATUS WHEN THEY WORK!

Trial Work Period (time limited)

Impairment Related Work Expenses (IRWE)

Subsidy/Unincurred Business Expense

And More!

SOCIAL SECURITY DISABILTY INSURANCEWe wont go into details today about all of SSDIs work incentive programs.

What is important is that you know that there are good, solid work incentive programs for SSDI beneficiaries that are available to you and are designed to give you plenty of time-and when I say plenty, I mean years and years and years- to try out work or decide if you can or want to go back to work full time and get off benefits entirely.

There is never a need to be scared of getting cut off from the SSDI system.

Once you know about these work incentive programs the only way your SSDI benefits will be terminated is if you want them to be terminated.59SOCIAL SECURITY DISABILTY INSURANCESSDI WORK INCENTIVES

Plan to Achieve Self Support (Only before application or in 12 month period after receiving SSDI and loss of SSI)

Unsuccessful Work Attempt Trial Work PeriodImpairment Related Work Expense Subsidy/Special Conditions

Unincurred Business Expense (self-employment) Grace Period Extended Period of Eligibility Expedited Reinstatement Extended Medicare EligibilityMedicaid Buy-In

Medicare Buy-In for the Working Disabled (after extended Medicare eligibility ends)

60SOCIAL SECURITY DISABILTY INSURANCEPLAN TO ACHIEVE SELF SUPPORT (PASS)

Used to reduce SSDI in order to get SSI and get/retain Medicaid.

Time limited (48 months; can be extended).

Not a comparable benefit.

Must have earned income to create plan.

Must be able to live on amount left after putting money into PASS.

All purchases in plan must be related to employment goal.

Money in PASS must be spent on what is in plan or consumer will get overpayment notice (on SSI side).

SSA will review PASS once a year at a minimum.

PASS form is located at: http://www.ssa.gov/online/ssa-545.html or on cd.

PASS is the same as SSI hereyou just may have to put away some of your SSDI to get SSI as PASS is still just an SSI work incentive!61SOCIAL SECURITY DISABILTY INSURANCETRIAL WORK PERIOD (TWP)

Made up of nine months. Trigger amount that will tell you consumer is using or has used a TWP is earnings of $750 (2013) or more in one month. Earn income below $750 (2013) a month and no TWP month is used.

TWP months do not have to be used consecutively.

It is possible to use some months of a TWP but to never complete TWP.

Once consumer uses nine months during any rolling sixty month period the TWP ends.

During TWP months the consumer can make any amount of money and will still receive full SSDI cash benefit.

Cannot use IRWE or Subsidy until TWP ends.Allows beneficiary to try working at any amount without it impacting SSDI.

You get one of these in a period of disability.

Don t leave here thinking If my consumers earn under $750, none of this confusing mess happens so that is what I am going to tell them to do!

TWP is a time for experimenting and really getting out there and doing something with no impact.

Why not use it?62GPGPGPJANFEBMARAPRMAYJUNJULAUGSEPTOCTNOVDEC20082345672009101112131415161718201022232425262728293031323320113435363738394041424344452012464748495051525356572013585960TWPTWPTWPTWPTWPTWPTWPTWPTWPSocial Security Disability Insurance (SSDI) TRIAL WORK PERIOD (TWP)189192021545563GPGPGPJANFEBMARAPRMAYJUNJULAUGSEPTOCTNOVDEC2008200934567891011201015161718192021222324252620112728293031323334353637382012394041424344454649502013515253555657585960TWPTWPTWPTWPTWPTWPTWPTWPSocial Security Disability Insurance (SSDI) TRIAL WORK PERIOD (TWP)121213145448TWPTWP47TWP64GPGPGPJANFEBMARAPRMAYJUNJULAUGSEPTOCTNOVDEC20086789101112200913141516171819202122232420102526272829303132333435362011373839404142434445464748201249505152535455562013TWPTWPTWPTWPTWPTWPSocial Security Disability Insurance (SSDI) TRIAL WORK PERIOD (TWP)25758TWP159TWP60TWP345This is an example of why it is so important to get the Trial Work Period months used straight.

If we were to tell the consumer in August of 2012 that they have nine months of TWP to make any amount of money wed be giving them really bad information and advice! (The trigger for the TWP in 2008 was $670.)

65SOCIAL SECURITY DISABILTY INSURANCEIMPAIRMENT RELATED WORK EXPENSE (IRWE) Exactly same rules as SSI IRWE. The difference is that IRWE is used in SSDI to reduce earned income to below SGA after completion of TWP.

No SSA form. See cd for sample IRWE application.

Send application to the local SSA Work Incentive Liaison or SSA Area Work Incentive Coordinator.

May be asked for proof of need (e.g. medical records, doctors prescription).

Must provide proof monthly that items or services were paid by filling out SSA Form 795 (http://www.ssa.gov/online/ssa-795.pdf or on cd)and copies of cancelled check(s), or paid receipt(s). Must include statement on SSA-795 that no reimbursement was or will be received for the IRWE, and that no agency or other source is underwriting the expense for the consumer.

66SOCIAL SECURITY DISABILTY INSURANCESUBSIDY OR SPECIAL CONDITION

A special employment situation that exists where employer subsidizes earnings of employee by paying more in wages than the reasonable value of the actual services performed.Examples: Job coach; extra breaks related to disability; works at slower pace than other employees in similar position; carved or restructured job duties so that person does less tasks than employees in similar positions.

Used to reduce consumers earnings to under SGA after completion of TWP.

Use SSA Form 3033 (http://www.ssa.gov/online/ssa-3033.pdf or on your cd; or employer can write letter: see cd for example letters and calculation sheet for figuring out amount of subsidy).

Use the example of the two secretaries with 15 job duties and $1500 in earnings.

One is on SSDI, one is not.

The one on SSDI only does 9 of the 15 duties but still works there.

Therefore, she really only earns $900 of her earnings by the fruit of her own labor.67SOCIAL SECURITY DISABILTY INSURANCESUBSIDY OR SPECIAL CONDITION (continued)

Look for possible Subsidy with these consumers (if they are making SGA or above):

The nature and severity of the impairment indicates that the employee probably receives unusual help from others in doing the work.

Childhood Disability Beneficiary (CDB)-previously known as Disabled Adult Child or DAC.

Diagnosed with a severe and persistent mental illness.

Appears to be a marked difference between the amount of pay and the value of the services.

The employer, employee, or other interested party alleges that the employee does not fully earn his/her pay (e.g., the employee receives unusual help from others in doing the work).

The employee is involved in a government-sponsored job training and employment program.

The person is in the military service.

Works in sheltered workshop.

These are the groups of people SSA tells their staff may be eligible for a subsidy.

When reviewing reported earned income on SSA Form 821, the SSA claims representative is supposed to be looking at pay, disability and circumstances to determine if the beneficiary could be eligible for a subsidy.68SSDI MYTH NUMBER TWOIF WAGES CAUSE SSDI CASH BENEFIT TO STOP, THERES NO WAY TO GET THAT CASH BENEFIT BACK

FACT : CONSUMERS CAN STAY IN ELIGIBILITY STATUS EVEN WHEN THEY DONT GET A CASH CHECK!

Extended Period of Eligibility

Expedited Reinstatement

SOCIAL SECURITY DISABILTY INSURANCE69GPGPGPJANFEBMARAPRMAYJUNJULAUGSEPTOCTNOVDEC200820092010201120122013TWPTWPTWPTWPTWPTWPTWPTWPTWP$700$700$700$750$750$750$900$1750$1750EPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPE EPEEPEEPEEPEEPEExR runs for 60 months and Medicare continues for 93 months after TWP ends!$750$750$750$750$750$1500STOP$2500$900$950$1000$1035$1035CHECKCHECKCHECKNONONONONONONONONONONONONONONONONONONONONOEPE$2500EPEEPEGPGPGPSocial Security Disability Insurance (SSDI)2008 TWP = 6702009 TWP = 70070GPGPGPJANFEBMARAPRMAYJUNJULAUGSEPTOCTNOVDEC200820092010201120122013TWPTWPTWPTWPTWPTWPTWPTWPTWP$700$700$700$750$750$750$900$1750$1750EPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPEEPE EPEEPEEPEEPEEPEMedicare continues for 93 months after TWP ends!STOP$750$750$900$1035$1035$900$900$900$0EPE$2500EPEEPEGPGPGPSocial Security Disability Insurance (SSDI)$0$0$950$950$950$950$950$950$950$950$0$0$0$0$0$0$0$0$0$0$0$0$0$750$750$750$1035$2500$2500$1035$1035$1035$1035$1035 ExR runs for 5 years!2008 TWP = 6702009 TWP = 70071SOCIAL SECURITY DISABILTY INSURANCEGRACE PERIODThree months of full SSDI check. Starts the first month in which the consumer makes SGA or above after all nine months of TWP have ended. Could happen during EPE or afteror never.

Runs consecutively; if consumer makes above SGA one month and then loses job he/she will still use final two months of the Grace Period.

EXTENDED PERIOD OF ELIGIBILTY (EPE)Runs for consecutive 36 months (three years). Begins immediately after the TWP ends, no matter what earnings are, or are not, in those 36 months! May never happen if consumer does not complete TWP.

Consumer will receive full SSDI cash benefit check in any month he/she makes below SGA during EPE. Consumer will not receive an SSDI cash benefit check at all in any month he/she makes above SGA during EPE.

EXPEDITED REINSTATMENT60 month period that begins the first month after the EPE ends, or whenever the consumer receives last SSDI cash benefit (whichever is later). During this time the consumer can get back onto SSDI without going through initial application stage and receive six months of SSDI cash benefit (usually in amount of last cash benefit received) while SSA re-determines eligibility for SSDI.

Six months of SSDI cash benefits do not have to be repaid if consumer determined ineligible.

There is all this time where you can go back to SSDI.

It is a special privilege afforded to workers.

During the EPE, they either get a check or dont based on earnings above or below SGA.

During EXR period, they have a special entrance back into the system.

Bottom line: They are connected to SSDI cash for at least 8 years and 9 months!72SSDI MYTH NUMBER THREEIF I GO BACK TO WORK, I WILL LOSE MY MEDICAL

FACT: CONSUMERS CAN KEEP MEDICAL WHEN THEY WORK!

Extended Medicare Eligibility

Medicare Buy-In for the Working Disabled

Texas Medicaid Buy-In

SOCIAL SECURITY DISABILTY INSURANCEAgain, biggest myth out there is no healthcare if I work. But Medicare continues forever or for a long time.73SOCIAL SECURITY DISABILTY INSURANCEEXTENDED MEDICARE ELIGIBILITY

If a consumer gets SSDI, he/she gets Medicare. If a consumer does not leave the rolls (continues to get SSDI), Medicare continues.

If the consumer leaves the rolls (SSDI is terminated), Medicare will continue for at least 93 months after the Trial Work Period.

Even after Extended Medicare ends, the consumer has the option to buy into Medicare.74SOCIAL SECURITY DISABILTY INSURANCEMEDICARE BUY-IN FOR WORKING DISABLED

Allows the working disabled to purchase Medicare coverage (during specified enrollment periods) after premium-free Medicare coverage ends.

Premium Hospital Insurance (Part A) is available at the same monthly cost that uninsured eligible retired beneficiaries pay, which is $441 a month in 2013.

Premium Supplemental Medical Insurance (Part B) is available at the same monthly cost that uninsured eligible retired beneficiaries pay, which is $104.90 in 2013.

A person can buy Part A separately without Part B, but cannot buy Part B unless also buying Part A.

Premium Prescription Drug coverage (Part D) is also available.

Person may qualify for a reduction of Part A premium.

Depending on earnings person, person may qualify for assistance in paying for Medicare coverageMedicare Buy In is expensive, and the Medicaid Buy In could be a better alternative depending on the individuals medical needs.75SOCIAL SECURITY DISABILTY INSURANCEMEDICAID BUY-IN

A great resource for SSDI beneficiaries at any point in their SSDI journey when they are working and earning any amount of money.

SSDI beneficiaries are presumptively eligible for Medicaid Buy-In!

Medicaid Buy-In can wrap around Medicare and cover some services that Medicare wont!SSDI beneficiaries who work also now have access to Medicaid.

Medicaid can wrap around Medicare and sometimes covers things that Medicare wont!76SSDI (TEXAS) MYTH NUMBER FOURIF I START RECEIVING SSDI FROM MY PARENTS ACCOUNT, I LOSE MY MEDICAID AND MY HOME AND COMMUNITY BASED WAIVER

FACT: CONSUMERS CAN KEEP MEDICAID AND WAIVER STATUS WHEN THEY BECOME AN SSDI BENEFICIARY THROUGH THEIR PARENTS ACCOUNT!

SSA on federal level

Texas on state level

SOCIAL SECURITY DISABILTY INSURANCEWe are highlighting this because it is a specific issue that has caused a number of people to mistakenly lose Medicaid coverage and waiver services in Texas.77SOCIAL SECURITY DISABILTY INSURANCECHILDHOOD DISABILITY BENEFICIARIES

Consumer is over the age of 18 and disability occurred prior to age 22.

Mom or Dad retired, passed away or became disabled.

Consumer can draw off of Mom or Dads SSDI or RSDI account.

Be careful when consumer is SSI and becomes CDB-especially if consumer is in a Home and Community Based Waiver (like CLASS, HCS or TxHML).

Consumer gets to keep Medicaid under SI 01715.015 Special Groups of Former SSI Recipients

On the SSA end the only way to absolutely guarantee this will happen is to go into the SSA office with print out of SI 01715.015. (https://secure.ssa.gov/apps10/poms.nsf/lnx/0501715015 or on cd).78CHILDHOOD DISABILITY BENEFICIARIES

Currently the consumer should receive at least three letters.Two letters will be from SSA:

One letter will be a Notice of Action for Supplemental Security Income. This letter will inform the consumer of their termination of SSI due to drawing CDB.

The other letter will be a Notice of Award for Retirement, Survivors and Disability Insurance .This letter will show approval for CDB status and the amount of the new cash benefit the consumer will be receiving. The third letter will be from HHSC Centralized Benefits Services in Midland, Texas. This letter will terminate the consumer from Medicaid. IN ORDER TO CONTINUE RECEIVING MEDICAID THE CONSUMER MUST RE-APPLY IMMEDIATELY.SOCIAL SECURITY DISABILTY INSURANCE79CHILDHOOD DISABILITY BENEFICIARIES

Consumer must connect with Waiver Case Manager or Service Coordinator and let them know their current SSA and Medicaid status.

It is possible that the consumer will receive a letter terminating him/her from a Waiver. If this happens the consumer should file an appeal immediately. By the time the hearing is scheduled the issue should be straightened out.SOCIAL SECURITY DISABILTY INSURANCE80SSDI MYTH NUMBER FIVEWorking always results in overpayments

FACT: THERE ARE STRATEGIES TO PREVENT OVERPAYMENTS! Report regularly.

Consumer should get a receipt from SSA to document that they reported.

Know the overpayment rules! If the overpayment is $1,000 or under it can be automatically waived. No matter what the amount is, request reconsideration, a waiver, or negotiate a low, low re-payment plan.

SUPPLEMENTAL SECURITY INCOME81SOCIAL SECURITY DISABILTY INSURANCEREPORTING EARNED INCOME

Consumers receiving SSDI can only report using Form SSA-821-BK (http://www.ssa.gov/online/ssa-821.pdf or on cd) or by taking or mailing in check stubs to the local SSA office.

Find out how your SSA office wants earned income reported if you can!

Unless you have specific information from a person within a local SSA office on how and when your consumers should report, have them report. No matter how little someone makes, REPORT.

REPORT! REPORT! REPORT! REPORT!

REPORT!Because SSDI cannot call their earned income in as the SSI beneficiaries can, SSA will routinely tell SSDI beneficiaries to just report once on the 821 and then again only if there are any changes in earned income.

You have to consider if the individual consumer is someone who will actually remember to report when they received a 50 cent an hour raise, or if it is better for that consumer to go ahead and report all earnings, all the time.

We always advise reporting all earnings, all the time, unless you have a relationship with someone at the local SSA office who tells you a specific way in which they would like earned income reported.82SOCIAL SECURITY DISABILTY INSURANCESO WHAT DO I REALLY NEED TO KNOW ABOUT SSDI?

Let the consumer that there are a lot of safeguards in place to allow him/her to try working without losing Medicare and/or cash benefits for a long time.

Encourage the consumer to consider working at the maximum number of hours and for the most money he/she is able to earn.

Make sure that any information you give a consumer is accurate information. Check with your DRS SMR or other professionals before giving the answer!

If this is tough for you to understand, imagine how impossibly difficult it is for the beneficiary to understand. Patience, encouragement and commitment to finding out the right answer goes a really long way!

Remember that most consumers receiving SSDI did have a robust work history. They are most likely want to go back to work and get off benefits.

83LETS TALK ABOUT WHOS WHO IN THE TEXAS BENEFITS WORLD!84BENEFITS AND WORK INCENTIVESHOW AM I SUPPOSED TO FIGURE ALL THIS OUT??????

Good News!

There are folks right here in Texas who can help!

85DRS BENEFITS SUBJECT MATTER RESOURCE STAFF Available to DRS VRCs and other DRS staff for technical assistance regarding federal and state benefits and work incentives programs.

See complete list of DRS Benefits SMRs statewide on the Intranet under Counselors Toolbox, Benefits Planning section, or on your cd.

Contact a DRs Benefits SMR:If you work for DRS. Have a general question about federal or state benefits.If you are working with a consumer who receives SSI and/or SSDI and have questions about the impact work will have on Social Security benefits.Have specific questions about any of the SSI/SSDI work incentive programs.Have questions about which work incentive program might be right for the consumer with whom you are working.Have a question about the DRS Work Incentive of the Month.Have questions about state specific benefits and work incentives programs (e.g. MBI, energy assistance, housing).Want a benefits and work incentives overview training at your office.

86WIPA CWICsWHO ARE CWICs?

The Community Work Incentive Coordinators (Work Incentive Planning and Assistance Programs) were funded by an SSA grant that was terminated June 30, 2012.

DARS is now purchasing benefits services for consumers who receive SSI or SSDI from former (certified) CWICs.

DARS staff can use any CWIC in Texas. Current CWICs are listed on a separate document on your cd, and also in the Counselor Toolbox on the Intranet under Benefits Planning.

87GETTING YOUR CONSUMERSBENEFITS AND WORK INCENTIVES PLANNING SUPPORTS AND SERVICES

To find out more about how to purchase benefits services from a certified Community Work Incentive Coordinator, or how your consumers can get free general information about the affect of earnings on benefits:

Bring up the Intranet

On menu bar across the top go to Programs and select Vocational Rehabilitation Services (DRS) from the drop down box .

Go to menu list on right side of page and click on Counselor Toolbox. Counselor Toolbox is the sixth choice on this list.

Click on Benefits Planning. Benefits Planning is the fifth choice on this list.

*You will be using the MAPS code WIPA when purchasing these services88WIPA CWICsWHAT CWICs DO NOT DO:

Provide free services.

Assist with overpayments.

Trainings on benefits and work incentives programs.

Provide written detailed introductory information on affect of earnings on benefits.

Provide written Work Incentive Analysis Plan that details all federal and state benefits the consumer is receiving; how earned income will affect those benefits; and what work incentive programs might be used to retain health insurance and make an informed decision about their benefits.

Provide assistance with applying for specific federal and state work incentive programs.

WHAT CWICs DO:89WIPA CWICsThe best way to interact with the CWIC and assist the consumer is:

Make sure you are referring consumers who are appropriate for CWIC services.

Have the consumer bring or send their Benefits Planning Query (BPQY) to the appointment with the CWIC whenever possible. A consumer can obtain a BPQY by calling and requesting it or using SSA Form 3288 (http://www.ssa.gov/online/ssa-3288.pdf or on your cd). Not doing this will delay delivery of the consumers Work Incentive Analysis/Plan.

Check the deliverable from the CWIC before you pay for quality and accuracyand to make sure both you and the consumer understand the information!

90Consumers may also contact a representative at SSAs Work Incentive Information and Referral Center (WIIRC) at 1-866-968-7842 (voice) or 1-866-833-2967 (TDD)

Representatives help consumers understand SSI and SSDI programs, Social Securitys work incentives, and the effects of earnings from work on cash benefits and health care coverage, including Medicare and Medicaid.

Services may include helping consumers select a TTW EN, developing Benefits Summary and Analyses (BS&As) and Work Incentive Plans (WIPs), counseling on state-specific benefits, offering guidance about reporting earnings in a timely manner, and referring them to community-based supports and financial services providers.

WHOS WHO IN THE TEXAS BENEFITS WORLD91SOCIAL SECURITY ADMINISTRATION STAFFWORK INCENTIVE LIAISONS (WIL)Each local Social Security Administration (SSA) office has a Work Incentive Liaison(WIL). Part of their job is to be a WIL. WILs provide advice and information about SSAs work incentive provisions and employment support programs to individuals with disabilities and outside organizations that serve those with disabilities.AREA WORK INCENTIVE COORDINATORS (AWIC)AWICs are SSA employees who provide assistance to the SSA personnel, beneficiaries, ENs, DRS and DBS, WIPAs and others in the community on employment support and outreach issues by:Training those working on SSA's employment support programs on the Ticket to Work program and work incentives (thats you all!).Helping to resolve work-issues in some cases.Presenting information about the Ticket to Work program and work incentives.Monitoring disability work-related activities and issues in their Federal region. Approving and reviewing all PASS plans.

Lists of current WILs and AWICs are on your cd.Remember that WILs will often not know that they have been assigned to be a WIL; that being a WIL is a very small part of their job; and that the people listed on your cd may no longer be the WIL in your local office as WILs turn over quite a bit.

AWICs do not want consumers calling them directly.

Nor do they want to be called with basic questions that you should be able to answer. If you have a basic question, you can contact your DRS Benefits SMR or call the SSA 800 Work Incentive and Referral line.

AWICs should be contacted only by professional staff who have a complicated case or question they need assistance with. 92Texas Benefits Counseling StaffTEXAS HEALTH INFORMATION COUNSELING AND ADVOCACY PROGRAM (HICAP) is a partnership of the Texas Legal Services Center and Departments of Insurance and Aging and Disability Services.

Housed in the 28 Texas Area Agencies on Aging (AAA), the Texas HICAP consists of both certified Regional Benefits Counselors and trained volunteers who assist people age 60 and older, as well as Medicare-eligible persons with disabilities of any age, with benefits planning.

Generally speaking, AAA benefits counselors provide information, counseling, assistance and advocacy regarding Medicare and Medicaid, benefits, entitlements and legal rights, including general SSI/SSDI information; help people get on benefits; and assist with appeals.

They may provide more or less detailed assistance with aspects of SSI/SSDI and state specific programs depending on the individual AAA. Contact your local AAA to find out exactly what your local Texas HICAP offers.

A list of the Texas AAAs and the counties they serve can be found on your cd.93Texas Community Center Consumer Benefits OfficersIn general, Texas Community Center Consumer Benefits Officers (CBOs) assist people with serious and persistent mental illness and intellectual and developmental disabilities who are receiving services through an MHMR in applying and getting qualified for SSI, SSDI and/or various Texas Health and Human Services Commission benefits.

Some CBOs work with consumers or other staff to ensure awareness of work incentives.

Each Texas Community Center (also known as MHMR) govern their CBOs differently.

You will need to contact your local Community Center/MHMR CBO to find out exactly what your closest program offers.

A complete list of Texas Community Centers is on your cd.94OTHER SOURCESSome Centers for Independent Living can provide packets by mail or general information by phone about benefits and work incentives.

Disability Rights Texas can provide packets by mail with general information about benefits and work incentives.95WAIT! WHAT ABOUT HOUSING?96HOUSING MYTH NUMBER ONEIF I WORK, MY RENT WILL GO UP

FACT: HUD HAS WORK INCENTIVES, TOO! Huds Earned Income Disregard (statewide)

Family Self-sufficiency Program (check with local Public Housing Authority)

HOUSINGEven when you earn income your rent wont go up for one year under the Earned Income Disregard.

In the second year it only goes up by 50% and after that it may go up to market value, but it may not.

ALL housing authorities must participate in this program, so you will definitely qualify if you live in housing covered by one of the HUD programs that qualify.

Family self-sufficiency programs offer everything from transportation to child care to job coaching assistance. Each family self sufficiency program differs in what it offers.

And, unlike Earned Income Disregard, it is up to each local housing authority to decide to offer a family self sufficiency program and exactly what services to offer.

Most local housing authorities in larger cities in Texas have this program.

You need to call your local housing authority to find out if they have the program and what services they offer. Your VRC can help you find your local housing authority.97EARNED INCOME DISREGARD

Consumers in the Section 8 Housing Choice Voucher, public housing programs and some other housing programs qualify for these programs!

Rent does not go up for one year if the individual was not working during the previous 12 months, or averaged less than 10 hours of work per week at minimum wage.

In the second year it only goes up by 50% and after that it may go up to market value, but it may not.

All housing authorities must participate in this program.

FAMILY SELF-SUFFICIENCY PROGRAMS

These programs offer everything from transportation to child care to job coaching assistance. Each family self sufficiency program differs in what it offers.

It is up to each local housing authority to decide to offer a family self sufficiency program, and what services to offer. Participation in this program is not mandatory.

Most local housing authorities in larger cities in Texas have this program.

Call your local housing authority to find out if they have the program and what services they offer. Find your closest housing authority at this link: http://portal.hud.gov/hudportal/HUD?src=/states/texas

HOUSING98ANYTHING ELSE?99BENEFITS AND WORK INCENTIVESTHE ANSWER? A LOT!

There are service/programs that support employment (beside us!) for consumers with physical disabilities, Intellectual and Developmental Disabilities (IDD) and Severe and Persistent Mental Illness (SPMI) including home and community based waivers.

There are different national programs the state runs like SNAP, TANF, energy assistance, Assistive Technology and 529 College Savings Programs.

There are different national programs that partners in the state run like the Volunteer Income Tax Assistance Program , Individual Development Accounts.

There are different national programs like the Earned Income Tax Credit

If its something the consumer needs to support them in employmentfrom computers to housing to child care to food to transportation, we can probably find it for you!100WHAT CAN YOU SAY?If you say any of the following you cant go wrong!

SSDI cash works in stages and has lots of safety nets for trying work, and even has provisions for getting back onto the system even if you are terminated from cash and health care benefits!

Medicare continues as long as you get a check and continues even after that for many years! You qualify for Texas Medicaid Buy-In if you receive SSDI and are working.

SSI cash amount is determined by a formula.you will always have more money if you work.

SSI Medicaid continues as long as you get any SSI, and even if you make up to $32,387 (2013) or higher each year!

101NOW THAT YOU KNOWStart the conversation with your consumers.

Attend follow up benefits trainings.

Read DARS Work Incentive of the Month that comes via e-mail.

Dont give up! Keep in touch, your DRS Benefits SMR is just a short walk down the hall or a phone call/e-mail away.

Benefits and Work Incentives can best be summed up by Lao Tzus proverb: Give a man a fish and you feed him for a day. Teach him to fish and you feed him for a lifetime

Dive in, the waters great!

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