Work Incentives For Individuals Receiving SSDI or SSI Payments

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1 Work Incentives For Individuals Receiving SSDI or SSI Payments SSDI Work Incentives * Continuation of Benefits While in a Rehabilitation Program * Continuation of Medicare Coverage * Exemption of Scholarships and Grants * Extended Period of Eligibility * Impairment-Related Work Expenses * Special Rules for Blind Persons * Subsidies * Trial Work Period Continuation of Benefits While in a Rehabilitation Program (SSDI and SSI) SSDI and SSI benefits usually stop if SSA finds that an individual no longer has a disabling impairment due to medical improvement. However, if the beneficiary is in a vocational rehabilitation program, he or she may continue receiving benefits until the rehabilitation program ends. Continuation of Medicare Coverage (SSDI) Medicare Part A pays for inpatient hospital care and certain follow-up care. Medicare coverage continues during the nine-month trial work period and is available for up to 39 months after the end of the trial work period, no matter how much you earn during this period. When coverage stops at the end of the 39-month period, and if you are still medically disabled, you can purchase Medicare coverage. Since many private health insurance companies may not offer coverage to people with a disability, this becomes a valuable protection. As a result of the Work Incentives Improvement Act, premium-free Medicare Part A (Hospital) coverage will be increased an additional 54 months, beginning October 1, Medicare Part B pays for doctors services and a variety of other medical services and supplies that are not covered by Part A. Medical insurance is voluntary and financed in part by monthly premium payments paid by the beneficiary. Some people with disabilities who have returned to work may purchase continued Medicare coverage, after premium-free Medicare coverage ends due to work, as long as you remain medically disabled. If the person becomes medically disabled again within five years (seven years for widow(er)s and disabled adult children) after the prior period of disability ends, he or she does not have to serve another five-month waiting period to get benefits or Medicare. For more information about this work incentive, visit the Red Book on Work Incentives. See the Medicare section of the Red Book on Work Incentives for more information on this subject. Exemption of Scholarships and Grants (SSDI and SSI)

2 Scholarships and grants used for tuition, books, and other expenses directly related to getting an education are exempt. Extended Period of Eligibility (SSDI) For 36 months after a successful trial work period, a beneficiary who is blind or disabled and receiving SSDI may receive a disability benefit for any month that his or her earnings are below the substantial gainful activity (SGA) level. (As of July 1999, SGA is $700 for people who are disabled. SGA for people who are blind was increased from $1,110 to $1,170 on January 1, Note: As a result of the Work Incentives Improvement Act law that was signed by President Clinton on December 17, 1999, the Extended Period of Eligibility will be increased from 36 months to 60 months, effective January 1, See the Red Book on Work Incentives for more information about the trial work period. Impairment-Related Work Expenses (SSDI and SSI) Certain expenses for items a person with a disability needs to work because of his or her impairment may be deducted when counting earnings to determine if the person is performing SGA. Additional information about Impairment-related Work Expenses can be found in the Red Book on Work Incentives. Special Rules For Persons Who Are Blind (SSDI and SSI) Several special rules apply to working beneficiaries who are blind. First, the SGA level for persons who are blind is considerably more ($1170) than for non-blind individuals ($700). Second, the SGA level for beneficiaries who are blind is readjusted annually based on general wage levels. Third, self-employed persons who are blind are evaluated for SGA based on the sole criterion of earnings. A separate evaluation of the time spent in the business is not made as it is for non-blind self-employed persons. Fourth, after attaining age 55, if earnings exceed the SGA guidelines but the work done requires a lower level of skill and ability than that done before age 55, benefits are only suspended, not terminated. Fifth, SSI recipients can deduct Blind Work Expenses (BWE) from earned income to determine their total countable income. Blind Work Expenses only apply to SSI recipients. This rule allows blind persons to exclude any part of his or her earned income that is used to pay expenses that enable the person to work. Sixth, Blind Work Expenses do not have to be directly related to the person s impairment. SSDI recipients who are blind may deduct the same Impairment-Related Work Expenses as non-blind persons from their earned income to determine total countable income. Additional information about special rules for blind people can be found in the Red Book on Work Incentives. Subsidies (SSDI and SSI) Subsidies are the support a person receives on the job that could result in a person receiving more pay than the actual value of the services the person performs. SSA deducts the value of subsidies when determining whether a person has achieved substantial gainful activity. Additional information about subsidies can be found in the Red Book on Work Incentives. Trial Work Period (SSDI)

3 A period of nine months (not necessarily consecutive) during which earnings of a Social Security beneficiary who is blind or disabled do not affect his or her benefits. (The nine months of work must occur within a 60-month period.) More information about the trial work period can be found in the Red Book on Work Incentives.

4 SSI Work Incentives * Continuation of Benefits While in a Rehabilitation Program * Continuation of Supplemental Security Income (SSI) * Exemption of Scholarships and Grants (SSDI and SSI) * Impairment-Related Work Expenses (SSDI and SSI) * Plan for Achieving Self-Support (PASS) (SSI) * Property Essential to Self-Support (SSI) * Section 1619 Work Incentives (SSI) * Continuation of Medicaid Eligibility (SSI) * Reinstating Eligibility Without a New Application (SSI) * Special Benefits for Section 1619 Recipients Who Enter a Medicaid Facility (SSI) * Special SSI Payments for People Who Work (SSI) * Special Rules for Blind Persons (SSI) * Student Earned Income Exclusion (SSI) * Subsidies (SSDI and SSI) Continuation of Benefits While In a Rehabilitation Program (SSDI and SSI) SSDI and SSI benefits usually stop if SSA finds that an individual no longer has a disabling impairment due to medical improvement. However, if the beneficiary is in a vocational rehabilitation program, he or she may continue receiving benefits until the rehabilitation program ends. Continuation of Supplemental Security Income (SSI) Working SSI recipients who are blind or disabled may continue to receive SSI payments until countable income exceeds SSI limits. See the Red Book on Work Incentives for more information about the continuation of Supplemental Security Income. Exemption of Scholarships and Grants (SSDI and SSI) Scholarships or grants used for tuition, books, and other expenses directly related to getting an education are exempt. Impairment-Related Work Expenses (SSDI and SSI) Certain expenses for items a person with a disability needs to work because of his or her impairment may be deducted when counting earnings to determine if the person is performing substantial gainful activity. Additional information about Impairment-Related Work Expenses can be found in the Red Book on Work Incentives. Plan for Achieving Self-Support (PASS) (SSI) If you are receiving monthly SSI payments and have an idea that will help bring you closer to independence, SSA can help you. First, you have to develop your idea into what is call a Plan for Achieving Self-Support (PASS). A PASS can help a beneficiary pay for an education or training program or to start a business. This rule only applies to SSI recipients; however, a beneficiary receiving SSDI payments may develop a PASS to become eligible for SSI. More information about PASSs can be found in the Red Book on Work Incentives.

5 Property Essential to Self-Support (SSI) This provision allows a person to exclude certain resources that are essential to the person s means of self-support. Property which is used in a trade or business or used by a person for work as an employee is totally excluded as of May 1, For example, prior to May 1, 1990, the total exclusion only applied to property which was required by an employer. Up to $6,000 of equity value of non-business income-producing property which is used to produce vegetables or livestock solely for consumption by the person s own household). Also, up to $6,000 of equity value of non-business income-producing property is excluded provided that the property yields an annual rate of return of at least 6 percent. This $6,000/6 percent rule also applies to property used in a trade or business for periods prior to May 1, Section 1619 Work Incentives (SSI) * Continuation of Medicaid Eligibility (Section 1619b) (SSI) * Reinstating Eligibility Without a New Application (SSI) * Special Benefits for Section 1619 Recipients Who Enter a Medicaid Facility (SSI) * Special SSI Payments for People Who Work (Section 1619a) (SSI) Continuation of Medicaid Eligibility (SSI) Medicaid is a medical assistance program run by the States with partial Federal Government funding. Most people who qualify for SSI also qualify for Medicaid. In most cases, your Medicaid will continue while you are working, even if you earn too much to receive a monthly SSI payment. The Work Incentives Improvement Act gives States the option of providing Medicaid coverage to more people between the age of 16 and 64 with disabilities who work. See the Medicaid section of the Red Book on Work Incentives for more information on this subject. Reinstating Eligibility Without a New Application (SSI) This provision enables people to regain eligibility for SSI cash payments or continued Medicaid coverage after a period of ineligibility without filing a new application. A person who is eligible for continued Medicaid coverage under section 1619(b) can begin receiving SSI cash payments at any time earnings drop below the break-even point. A person who is ineligible for continued Medicaid coverage because earnings exceed the threshold can regain eligibility for SSI cash payments and Medicaid coverage if his or her income drops below the break-even point within 12 months. Special Benefits for Section 1619 Recipients Who Enter a Medicaid Facility (SSI) Individuals eligible under section1619 can receive cash benefits for up to 2 months while in a Medicaid facility or a public medical or psychiatric facility. Usually, when an SSI recipient enters a Medicaid facility (i.e., a facility where Medicaid pays more than 50 percent of the cost of care), the SSI payment is limited to $30 per month minus any countable income. However, if the person is eligible under section 1619, the benefit will

6 be figured using the full Federal Benefit Rate for up to 2 months. For this provision to apply, the facility must enter into an agreement with the Social Security Administration allowing the person to keep all of the SSI payment. Special SSI Payments for People Who Work (Section 1619a) (SSI) SSI recipients may continue to receive SSI cash payments even when their earned income (gross wages and/or net earnings from self-employment) exceeds the SGA level. Note: This does not apply to SSI beneficiaries who are blind because the SGA requirement has never applied to them. For more information about this Work Incentive, view the Red Book on Work Incentives. Special Rules For Blind Persons (SSDI and SSI) Several special rules apply to working beneficiaries who are blind. First, the SGA level for persons who are blind is considerably more ($1170) than for non-blind individuals ($700). Second, the SGA level for beneficiaries who are blind is readjusted annually based on general wage levels. Third, self-employed persons who are blind are evaluated for SGA based on the sole criterion of earnings. A separate evaluation of the time spent in the business is not made as it is for non-blind self-employed persons. Fourth, after attaining age 55, if earnings exceed the SGA guidelines but the work done requires a lower level of skill and ability than that done before age 55, benefits are only suspended, not terminated. Fifth, SSI recipients can deduct Blind Work Expenses (BWE) from earned income to determine their total countable income. Blind Work Expenses only apply to SSI recipients. This rule allows blind persons to exclude any part of his or her earned income that is used to pay expenses which enable the person to work. Sixth, Blind Work Expenses do not have to be directly related to the person s impairment. SSDI recipients who are blind may deduct the same Impairment-Related Work Expenses as non-blind persons from their earned income to determine total countable income. Additional information about special rules for blind people can be found in the Red Book on Work Incentives. Student Earned Income Exclusion (SSI) This exclusion allows a person who is under age 22 and regularly attending school to exclude up to $400 of earned income per month. The maximum annual exclusion is $1620. See the Red Book on Work Incentives for more information about the Student Earned Income Exclusion. Subsidies (SSDI and SSI) Subsidies are the support a person receives on the job that could result in a person receiving more pay than the actual value of the services the person performs. SSA deducts the value of subsidies when determining whether a person has achieved substantial gainful activity. Additional information about subsidies can be found in the Red Book on Work Incentives.

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