SOCIAL SECURITY DISABILITY BENEFITS: INFORMED DECISION MAKING. Today s Webinar is Sponsored By

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1 SOCIAL SECURITY DISABILITY BENEFITS: INFORMED DECISION MAKING Today s Webinar is Sponsored By

2 Listening to the Webinar The audio for today s webinar is being broadcast through your computer. Please make sure your speakers are turned on or your headphones are plugged in. You can control the audio broadcast via the audio broadcast panel If you accidentally close the panel, you can re-open it from the top menu item: Communicate > Join Audio Broadcast 2

3 Listening to the Webinar, continued If you do not have sound capabilities on your computer or prefer to listen by phone, dial: (Toll-Free Number) Meeting Code: You do not need to enter an attendee ID.

4 Captioning Real-time captioning is provided during this webinar. The captions can be found in Media Viewer panel, which appears in the lower-right corner of the webinar platform. If you want to make the Media Viewer panel larger, you can minimize other panels like Chat, Q&A, and/or Participants. 4

5 Submitting Questions For Q&A: Please use the chat box or Q&A box to send any questions you have during the webinar to Katie Metz or Nakia Matthews and we will direct the questions accordingly during the Q&A portion. If you are listening by phone and not logged in to the webinar, you may also ask questions by ing questions to Please note: This webinar is being recorded and the materials will be placed on the National Disability Institute website at 5

6 Technical Assistance If you experience any technical difficulties during the webinar, please use the chat box to send a message to the host Nakia Matthews, or you may also nmatthews@ndi-inc.org. 6

7 Today s Moderator Elizabeth Jennings Deputy Director National Disability Institute

8 Today s Agenda Welcome Financial Wellness and Individuals with MS Qualifying for Social Security Disability Insurance (SSDI) The Impact of Work on SSDI Benefits Where to Turn for Assistance Questions & Answers Suggested Next Steps & Wrap Up 8

9 Special THANK YOU to our sponsor Acorda Therapeutics 9

10 National Disability Institute A national research and development organization with the mission to promote income preservation and asset development for persons with disabilities and to build a better economic future for Americans with disabilities.

11 What is Financial Wellness? We define financial wellness as the state of a person s finances with the intent of working towards financial behaviors that limit stress and the impact of stress on one s daily life. 11

12 Financial Wellness Understanding Public Benefit rules Building and Maintaining Assets Being Financially Literate Accessing Affordable Financial Services Accessing Available Healthcare Subsidies Understanding work and long-term disability options Utilizing Favorable Tax Provisions Budgeting 12

13 National Poverty Estimates Individuals ages For individuals without disabilities, 11.9% had income below the poverty level over the past 12 months. For individuals with disabilities, almost 3x that rate 30.9% had income below the poverty level. Source: U.S. Census Bureau, 2012 American Community Survey 13

14 For millions of working age adults with disabilities a dependence on public benefits for income, health care, food, and housing becomes a trap that requires staying poor to stay eligible 14

15 The Americans With Disabilities Act The Nation s proper goals regarding individuals with disabilities are to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for such individuals; 42 U.S.C. 1201(a)(8) (2005) the continuing existence of unfair and unnecessary discrimination and prejudice denies people with disabilities the opportunity to compete on an equal basis and to pursue those opportunities for which our free society is justifiably famous, and costs the United States billions of dollars in unnecessary expenses resulting from dependency and non-productivity. 42 U.S.C. 1201(a)(9) (2005) 15

16 Why is Financial Wellness Important? Impacts mental and physical health. Positively impacts self-concept. Changes status with other community stakeholders. Directly impacts quality of life. 16

17 Financial Wellness and MS A recent survey conducted by MSAA and NDI involving individuals with MS indicated: 55.1% of households earn less than $35k annually, 16.4% earn less than $50k but more than $35k annually. When asked about the ability to pay all of their bills in a typical month, 32% have a very difficult time paying their bills in a typical month, 46.9% reported a somewhat difficult time. 43% of respondents reported that their financial status has affected their ability to access medical care at some point. 17

18 Financial Wellness and MS A recent survey conducted by MSAA and NDI involving individuals with MS indicated: 71.7% of respondents do not have enough savings to cover 3 months expenses. 67.1% of respondents reported that their finances were worse since their MS diagnosis. 73.7% of Respondents reported that they were not aware of/have not used financial stability programs (EITC, IDA, FSS, PASS you will learn about these in subsequent webinars) 18

19 Financial Wellness Strategies Exist Financial Literacy Budgeting Credit Repair Getting Banked Use of work incentives Use of tax incentives Volunteer Income Tax Assistance Earned Income Tax Credit State Medicaid Buy-In Programs Family Self-Sufficiency Programs Individual Development Accounts Assistive Technology Loan Funds Student Loans Retirement Accounts Post-secondary Education Employment Self-employment Micro-Enterprise Home Ownership Protection and Advocacy, Taxpayer Advocates, Credit Counseling Volunteer Income Tax Assistance, Work Incentive Planning & Assistance 19

20 Kevin Nickerson Manager, Financial Empowerment & Employment National Disability Institute

21 SSA Disability Benefits The Social Security Administration has two programs to support individuals with disabilities with an inability to work at a substantial level. Social Security Disability Insurance (SSDI) Supplemental Security Income (SSI) Many people with disabilities who receive SSDI and/or SSI, want to work or return to work but are unsure what will happen to their benefits when they do, or have been misinformed about the impact of work and earnings. SSA policy includes work incentives that make it possible for individuals to test their ability to work and continue to receive some or all of their cash and health benefits.

22 SSA Eligibility Individuals must prove the following to be eligible for SSDI: 1. Prove that they have a documented medical disability that will last 12 months or longer or result in death. 2. Meet SSA s definition of disability: The inability to engage in Substantial Gainful Activity (SGA, which is paid work) by reason of any documented medical impairment (physical or mental) that will lasts 12 months or longer and/or result in death. Individuals who are blind do not have to prove that they are unable to work. They only have to prove that they meet SSA s level of blindness.

23 Substantial Gainful Activity (SGA) SGA is a basic test used by SSA to establish disability status, and continued eligibility for cash benefits SGA is the performance of significant mental and/or physical duties for profit. It is usually determined to be gross earnings (before taxes) of a set amount of money determined each calendar year based on the National Average Wage Index. To meet this test a person must not be working, or if working, earning less than the established SGA amount SGA for non-blind individuals = $1070/month 2014 SGA for blind individuals = $1800/month

24 Required Work Credits in FICA DAC Disabled Adult Children Disability Prior to Age 22 SSDI Eligibility Not Legally Married to non Title II beneficiary Insufficient FICA or higher parent amount Parent must be Retired, Disabled or Deceased Medical Insurance - MEDICARE 24 month wait upon eligibility for cash benefits Part A-Free, Part B/D-Premium 5 Month Waiting Period for cash benefits to start SSA pays close attention to SGA rule during and after eligibility No asset limit (entitlement based on insured status )

25 Continuing Disability Review Process The Social Security Administration (SSA) is required by law to periodically determine whether beneficiaries continue to be disabled and therefore continue to be eligible for either SSI and/or SSDI Under SSA s medical improvement standard, generally, once individuals are receiving benefits, substantial evidence must show that medical improvement related to the ability to work and perform SGA has occurred. This must be developed before SSA can determine that individuals are no longer eligible to receive benefits. 1. CDR s involve an interview at the local SSA office 2. Filling out a form about current medical information (similar to initial eligibility process) 3. SSA will forward form to Disability Determination Service (DDS) for review and medical determination.

26 Important Points - SSDI SGA continually monitored after eligibility $1070/month (non-blind individuals) $1800/month (blind individuals) As you work and earn SGA, SSA reviews your work effort and will take a person off the roles if they show a pattern of being able to work and earn at the Substantial Gainful Activity level. No asset limit NOTE: 2014 SGA amounts provided in this slide

27 Chart pulled from The Benefits Planner, volume 2, Issue 4:

28 Work Incentives Comparison Chart Social Security Disability Insurance Trial Work Period Extended Period of Eligibility Impairment Related Work Expense Subsidies Unsuccessful work attempt Unincurred Business Expenses (self-employed only) Continuation of Medicare Section 301 Expedited Reinstatement Ticket to Work Medicaid Buy-In Supplemental Security Income Student Earned Income Exclusion Impairment Related Work Expense Blind Work Expense 1619 (a) 1619 (b) Property Essential For Self Support Plan for Achieving Self-Support Subsidies (only at time of application) Section 301 Reinstatement without new application Expedited Reinstatement Ticket to Work Medicaid Buy-In

29 SSDI Work Incentives Today we will discuss some of the SSDI work incentives SSA offers: Trial Work Period = $770/Month 2014 Extended Period of Eligibility Impairment Related Work Expenses Special Condition/Subsidies Extended Medicare Coverage Expedited Reinstatement 29

30 Trial Work Period - TWP Once determined eligible, SSDI beneficiaries are entitled to a 9 month Trial Work Period (TWP) to test work skills while maintaining monthly cash benefits. During the TWP your full benefit checks will continue regardless of the amount of money earned. The 9 months of Trial Work do not need to be earned in a row. TWP months are counted when an individual earns a specific amount of income. (Determined January 1 each year by SSA) In 2014, the TWP amount is $770 per month The TWP ends when an individual has accumulated 9 months of Trial Work within a 60 month consecutive period of time (5 years) Once 9 months of the TWP have been earned within the 60 month window a person enters Extended Period of Eligibility (EPE)

31 Benefits Planning Query - BPQY A BPQY provides information about your disability cash benefits health insurance scheduled continuing disability review cycle representative payee, and work history, including use of Trial Work Period months SSA provides BPQYs to beneficiaries, their representative payees and their authorized representatives of record upon request. 31

32 Requesting a BPQY Beneficiaries can request a BPQY by contacting their local SSA office or by calling SSA s toll free number, between 7 a.m. and 7 p.m., Monday through Friday. People who are deaf or hard-of-hearing may call our toll-free TTY/TDD number, , between 7 a.m. and 7 p.m. Monday through Friday. If someone other than the beneficiary, representative payee, or appointed representative (a benefits counselor, for example) wishes to receive a BPQY, they must submit two SSA-3288 forms (Consent for Release of Information) that have been signed by the beneficiary. One is to authorize the release of Social Security records The other is to authorize the release of Internal Revenue Service earnings records. Both releases must contain the beneficiary s Social Security number or the claim number. Copies of the SSA-3288 are available at 32

33 Benefits Summary Analysis After requesting a BPQY, if you are working with a certified Work Incentive counselor, they will typically assist you by preparing a written report about your plans and benefits

34 Extended Period of Eligibility - EPE After the last Trial Work Period month has been used, the next part of your Work Incentive will begin, called the Extended Period of Eligibility (EPE) The EPE is a 36 month period Unlike the TWP, once the EPE begins, it will end in 36 months The EPE is another protective period, to help you in the transition to work, and protects your eligibility status, not necessarily your monthly cash benefits SSA evaluates your gross wages each month, and during the EPE - If you are earning more than the SGA amount, you may not receive your cash benefit that month

35 Extended Period of Eligibility - EPE Cessation - When countable wages first exceed the SGA level (cessation month), the individual should remain eligible for a 3-month grace period - the cessation month plus the next 2 months (regardless of earnings). Countable wages above SGA beyond the cessation month and grace period may result in loss of SSDI cash benefit eligibility Termination - When the EPE is complete, a person earning gross wages below SGA will continue to receive a benefit check as long as medical eligibility continues. If a person has countable wages above SGA after the EPE is completed, benefits may terminate For self-employment, an individual determination of SGA will be established during EPE. An SSDI claims representative will look at hours and income when making SGA determination Reminder - The 36 month EPE begins in the month following the 9 month TWP whether a person is working or not!

36 Overview SSDI Timeline Grace/Cessation Period Can occur anytime AFTER the TWP is completed 3 more months that act like TWP! TWP 9 Months of Trial Work available Count if over $770/month Make any amount and retain cash benefits! EPE 36 Months for Extended Period of Eligibility Based on S.G.A. $1,070/month (non-blind rate), or $1,800/month (blind rate) NOTE: 12 MONTHS TO EARN AS MUCH AS YOU CAN! Note: 2014 Rates

37 Impairment Related Work Expenses (IRWE s) for SSDI Beneficiaries In order to account for the additional expenses workers with disabilities might experience related to the return to work, SSA has provided another Work Incentives called an IRWE An IRWE exists when:» You pay for the item or service out of pocket» The item or service is related to your disability» You would NOT be able to work, if you did not purchase the item or service, therefore, it is necessary to maintain employment What does this do for you?» The amount of an approved IRWE will be deducted from your GROSS wages, leaving what SSA considers Countable Wages, which is used to determine either continued eligibility, and/or eligibility for cash benefits (if in EPE)

38 Examples of IRWEs Transportation Costs Attendant Care Services Medical Devices Prosthesis Residential Modifications Drugs & Routine Medical Services Diagnostic Procedures Non-Medical Appliances & Devices Expendable medical supplies; for example, incontinence pads, elastic stockings, and catheters. The cost of a service animal including food, licenses, and veterinary services.

39 Example: Impact of IRWE on SGA John is working, and is earning $1,200/month in gross wages, and is currently in his EPE John has some out of pocket expenses related to his disability, and his ability to continue working, as follows: John pays $150/month for paratransit transportation services (an alternate mode of public transportation services, which requires eligibility based on disability) How SSA would look at John s wages that month: Gross Wages = Minus IRWE $1,200/month - $150/month Equals Countable Wages = $1,050 Since Countable Wages are less than the current SGA amount, John would receive his cash benefit this month

40 Subsidies Subsidies allow you to deduct the value of extra support you receive at no cost. A Subsidy may exist when: An employer..» provides accommodations, support, or extra supervision» customizes a job to meet your individual needs» allows lower productivity for the same job at the same wage An agency» assists you in securing employment» provides you with accommodations you need on the job» supports you in getting to work» provides you with on-the-job supports Note: Subsidies apply to SSDI only and may be used during the initial eligibility process as well as when an individual is working and earning income. 40

41 Employer Subsidy Example Jake works for a restaurant, making $1,260/month, and is well liked by his employer. He has some physical limitations that prevent him from lifting the grills that are cleaned daily, and one of his co-workers handles this task daily. While this is a normal part of Jake s job requirements, the employer has accommodated Jake by having another employee take on this task. Jake is also allowed to arrive later than normal, as a family member drives him to work since he can t drive, and public transportation is not available. Jake has used his TWP, and a Grace Period has been established. He is mid-way through his EPE. In this example, Jake s $1,260/month is more than the 2014 SGA limit, based on his gross wages, he would not be eligible for cash benefits Lets examine how Subsidy will assist Jake

42 Employer Subsidy Example A Work Activity Questionnaire evaluates what percentage of work the employer subsidizes The following are areas that are examined in the Work Activity Questionnaire, that help SSA determine if a Subsidy exists: Using these categories helps an employer determine Jake s productivity, compared to his non-disabled co-workers, in similar positions SSA will deduct this amount from Jake s gross wages, to evaluate whether he is gainfully employed

43 Employer Subsidy Example In Jake s case, let s say it was determined that a 20% Subsidy exists, here s how SSA would look at his earnings: Monthly Wages = $1,260 Subtract Subsidy (20%, or, $252) = $1,008 (Countable Wages) Countable wages less than SGA = Jake eligible for cash benefits Here s a basic rule of thumb, for Work Incentives: Gross wages Work Incentives = Countable Wages SSA makes determinations, after the Trial Work Period, based on Countable wages

44 Reporting IRWEs and Subsidies 1. Reminder IRWE and Subsidy are used to reduce countable income for SSDI beneficiaries, and it is recommended that you work with a certified Benefits & Work Incentive Counselor to assist you 2. Both incentives will need to be reported to your local SSA field office and evidence will need to be submitted along with regular reporting of paystubs 1. IRWE bring along with the receipts and the reason for the costs. 2. Subsidy Documentation will be needed from the employer and/or agency supporting you. 3. The SSDI claims representative will review the earnings and work incentives and, if approved, adjust wages for SGA determinations accordingly. 4. The individual should discuss with the claims representative the frequency with which the claims rep wants the individual to report the IRWE expenses (Note: Subsidy determinations remain in place as long as the person remains at the same employer). 5. The individual should continue to report wages monthly and maintain documentation of IRWE expenses.

45 Extended Medicare Eligibility (effective October 1, 2000) An SSDI beneficiary is entitled to continued Medicare coverage during the Trial Work Period and for at least 93 months following the ninth Trial Work month. During this entire period, hospital coverage is automatic and cost-free. Outpatient coverage (Part B) continues to be optional and subject to premium payment NOTE: For 2014 Part B will be $ This means that SSDI beneficiaries that go to work can keep Medicare insurance for at least 102 months!

46 Expedited Reinstatement Period EXR EXR provides a significant level of protection to SSDI beneficiaries who return to work, and have their benefits terminated due to gainful work activity Note that when you are receiving proper Benefits, and Work Incentive advisement, benefits termination is a planned event WHO IS ELIGIBLE? SSDI beneficiaries can be reinstated without a new application if the person: Was eligible for SSDI; and Lost SSDI due to performance of substantial gainful activity (SGA); and Requests EXR within the consecutive 60-month period beginning with the month of entitlement termination

47 Understanding Wage Reporting

48 SSDI When Wages are Counted SSA counts wages for SSDI beneficiaries when the wages were earned This means you should NOT count wages in a month based on your pay-date, but rather, look at what month the wages were earned in The following slide will show you an example of how you can carefully track wages

49 End of pay period Example Joe earns $600 and is paid on a Friday, September 2 nd. This is for a two week pay period. For SGA purposes, wages would be broken into both months as follows: Day rate = $600/10 days = $60/day August = 8 days = $480 September = 2 days = $120

50 Your Responsibilities when Returning to Work You should report new work activity to your local SSA Field Office, including the following: Name of new employer Number of hours/week you ll be working, and hourly wage Date you started your new job, and end date (if applicable) Your Social Security number (always, with any correspondence) Provide wage data to SSA monthly by providing a copy of pay check stubs (keep your originals!) Wage data may be FAXED, hand delivered, or mailed Be sure to write your S.S. # on pay check stubs, and your name if not already printed on check stubs

51 Supplemental Security Income (SSI)

52 SSI Resources For more information about SSI benefits and Work Incentives associated with this program, see the following archived training: Supplemental Security Income The Impact of Work on Benefits Individuals who receive Supplemental Security Income (SSI) may want to return to work but are worried about the impact of work on public benefits. With good information you can make the choice to work and you may still keep some or all of your cash and health benefits.

53 Additional Employment Supports

54 Medicaid Buy-In Programs Purpose of the Program: To provide an opportunity to purchase Medicaid coverage for persons with disabilities who are working. Sample Eligibility Criteria: 1. Between the ages of 16 and Have a permanent disability 3. Be employed (full or part time) 4. Meet the income and asset guidelines To learn more about Medicaid options in your state, visit:

55 Benefits & Work Incentive Advisement Work Incentive Planning and Assistance Provide benefit and work incentives planning and assistance, including: Decision to Work Effect of Employment on benefits Work Incentives and provisions Referral services Provide services to: SSDI/SSI Beneficiaries between the ages of 14 and 65 Parents/Guardian Service Providers Other Supporters List of Providers - Work Incentive Networks A number of states have chosen to train professionals to better understand SSA disability benefits and work incentives google Work Incentive Networks

56 Protection and Advocacy Protection & Advocacy for Beneficiaries of Social Security (PABSS) Advocates are available to provide assistance with the following at not cost: Access to Community Services Special Education and Transition Transportation, Housing, Health Care Disability Benefits and Work Incentives Rights and Conditions of employment Vocational Rehabilitation and preparation Rights, Responsibilities, and Reasonable Accommodations under the ADA Wage and hour issues Provider Search -

57 TICKET TO WORK A voluntary program for people on SSDI (or SSI) who want to work. Participating in the Ticket program provides: Greater Choice through an increased network of Vocational Service Providers Suspension of the Continuing Disability Review when actively using their Ticket The National Program Manager for SSA is MAXIMUS / (TTY/TDD) Employment Networks are: Contractors with SSA who are qualified to provide vocational services State Vocational Rehabilitation offices are also a required Employment Network Employment Network Locator:

58 State Vocational Rehabilitation (VR) The VR program is a state-federal partnership that promotes the employment of people with disabilities. VR counselors have extensive specialized training, to work with you to: Identify your employment goals Provide assessments to measure your skills and aptitude Provide access to assistive technology and other employment supports State Agencies and contacts - Click on Other Useful Contacts 58

59 Department of Labor American Job Centers The Workforce Investment Act of 1998 (WIA), which became effective July 1, 2000, established the One-Stop Career Center system (now called American Job Centers) Workforce Innovation and Opportunity Act (WIOA) signed into law on July 22, 2014 which reaffirms ongoing role of American Job Centers American Job Centers are community centers that provide employment, education and training services all in one place. To learn more and/or locate an American Job Centers near you use: 59

60 Independent Living Resource Centers Centers for Independent Living (CILs) are grassroots, advocacy-driven organizations run by and for people with disabilities. Independent Living Centers have four core services, 1. Individual and Systems Advocacy 2. Information and Referral 3. Peer Support 4. Independent Living Skills Training To locate an Independent Living Center near you: 60

61 Federal Hiring of People with Disabilities The Federal government provides employment opportunities for individuals with disabilities through Schedule A hiring. Schedule A is a hiring authority available to federal agencies to hire individuals with disabilities without competing for the job. To learn more:

62 Suggested Next Steps 1. Register with one of the employment support programs noted.» Vocational Rehabilitation - Department of Labor One Stop Centers - SSA Ticket to Work Program Meet with a Benefits Planner to make an informed choice about the impact of work on your benefits. 62

63 Suggested Next Steps 3. Review the previous Financial Wellness webinars to determine your earnings goal 4. Set a goal to complete items 1 and 2 and 3 over the next three months. 5. Share with us your experience.» We will send out s over the next few months to offer you a chance to share your experience. 63

64 Special THANK YOU again to our sponsor Acorda Therapeutics 64

65 Contact Information National Disability Institute Kevin Nickerson Elizabeth Jennings Add your question to the post-webinar survey. 65

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