Social Security Work Incentives

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Social Security Work Incentives
Presented on June 15th, 2006 by Scott Leonard
with KCDDD, and Joanne ONeill with the Arc of
King County Department of Community and Human
Services Developmental Disabilities Division
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Before we start

• This is part 3 of a three-part series.
• There will be specific opportunities throughout
  the presentation to ask questions.
• Commonly used acronyms and terms are marked in
  red.
• Whats in your folder.

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Work Incentives

• Brief overview

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What are Work Incentives?

• Congress has approved several Social Security
  Work Incentives to encourage people with
  disabilities to engage in employment.
• Work Incentives can help people maintain their
  benefits while working.
• Work Incentives can help people afford the costs
  of items and supports necessary for becoming
  self-reliant and successful on their job.

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Examples of Work Incentives

• 1619b status
• Individual Thresholds
• Student Earned-Income Exclusion (SEIE)
• Property Essential for Self Support (PESS)
• Blind Work Expenses (BWE)
• Subsidies and Special Conditions
• IRWEs
• PASS

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Work Incentives and Benefits

• Work Incentives impact Title II and Title XVI
  benefits differently!

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Brief Review SSI and SSDI / SSDAC

• SSI
• SSI amounts can rise and fall due to fluctuations
  in income.
• SSDI/DAC
• All-or-nothing
• Earnings over SGA (860 2006) can result in
  losing benefits.
• To be eligible for both Title II and/or Title XVI
  benefits, you must be earning below SGA at the
  time of application.

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Subsidies and Special Conditions
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Subsidies SSDI / SSDAC

• Social Security is required to consider the true
  value of someones work when determining if that
  person is earning above or below SGA.

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Subsidies and Special Conditions

• A subsidy exists when an employer pays an
  employee more in wages than the true value of
  actual services performed.
• Evidence of subsidies include
• Extra support and supervision on the job,
• Additional time to complete job duties,
• Lower productivity, and
• Completion of fewer work tasks
• when compared to unimpaired workers performing
  similar work.

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Subsidy Example

• Lai receives SSDAC. She is working at a Library,
  and due to a recent raise, she is now earning
  1,000 gross / month.
• Based on this wage information alone, Lai would
  appear to be over SGA and at jeopardy of losing
  her SSDAC benefits.

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Subsidy Example

• However! Lais work is subsidized
• She requires the ongoing support of a job coach
• She is unable to accurately re-shelve books as
  such, this task has been taken away from her
  position
• Due to her disability, she requires longer breaks
  than her coworkers.

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Subsidy Example

• The employer and the job coach decide that the
  actual value of Lais work, compared to other
  coworkers without disabilities, is about 70.
  (The employer is subsidizing Lais wages by 30.)
• Lai lets Social Security know!
• SSA now only looks at 70 of her wages to
  determine if she is earning above or below SGA.
• 70 x 1,000 700
• The true value of Lais work is 700. As 700 is
  less than SGA - 860 - she is NOT performing
  SGA.
• Lai will keep her benefits.

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Where Did That 70 Figure Come From?

• Lais job coach and her employer filled out a
  form that helps determine a numerical value for
  Lais overall work productivity.
• This form is in your packet
• This form is not an official SSA form.
• Subsidies are open to subjective interpretation.
• Social Security makes the final determination.

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Letting Social Security Know About Subsidies

• Notice of subsidy can be submitted to Social
  Security in letter-form. Consider
  hand-delivering it and getting a receipt.
• Social Security may ask an individual for subsidy
  information when conducting a CDR.
• Social Security may contact the employer to
  confirm the subsidy is still in place.
• The employer may receive an SSA Work Activity
  Questionnaire.
• SSA is not required to inform you whether or not
  a subsidy has been approved.

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Subsidies, SSDI/DAC Additional Information

• With Title II benefits, subsidies can only be
  looked at when the TWP has ended.
• Subsidies can be back-dated, up to an allowable
  period of time.

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Subsidies and SSI

• Subsidies only impact SSI during the time of
  initial application.
• If a person applying for SSI is working and
  earning over SGA, indication of a subsidy may
  lower countable earnings below SGA and allow for
  SSI eligibility.

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Questions?
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IRWEs

• What is an IRWE?
• IRWEs and SSI
• IRWEs and SSDI/DAC

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IRWE

• IRWE is an acronym for Impairment-Related Work
  Expense.
• If a disabled person pays out-of-pocket for items
  and services that are
• related to his/her disability, and
• necessary for employment,
• those expenses may qualify as
  Impairment-Related Work Expenses.

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IRWE Examples

• Examples of IRWEs include
• Supported Employment Services
• Attendant Care Services if performed at work, or
  in the process of helping someone prepare for
  work or return from work
• Certain transportation costs, including mileage
  for approved vehicles
• Routine drugs and medical services
• Work-related equipment.

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IRWE Criteria

• For an IRWE deduction to be allowable, the
  following criteria must be met
• Expenses must be directly related to the persons
  impairment and enabling the individual to work
• Costs must be paid by the individual and not be
  reimbursable from other sources
• Expenses must be paid in a month in which the
  individual is, or was, working
• Expenses must be reasonable.

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IRWE and SSDI / SSDAC

• The cost of certain impairment-related items and
  services required by individuals in order to work
  may be deducted from gross earnings in
  calculating SGA.

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IRWE and SSDI / SSDAC Example

• Kirk is working, earning 950 gross / month. He
  is also eligible for 650 SSDI, and his TWP ends
  next month.
• Based on wages alone, Kirk would lose SSDI due to
  earning over SGA.

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IRWE and SSDI / SSDAC Example

• Kirk pays out-of-pocket for job coaching
  services, a monthly ACCESS pass, and a medication
  each month for a total of 200 / month.
• Kirk lets Social Security know by providing
  receipts and a brief explanation.
• The IRWEs are approved by SSA.

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IRWE and SSDI / SSDAC Example

• SSA subtracts the IRWEs from Kirks wages to
  determine the true value of his work
• 950 gross wages
• - 200 IRWEs
• 750 adjusted earnings
• 750 is less than SGA (860 2006) therefore,
  Kirk remains eligible for SSDI benefits.

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IRWE Example 2

• Colonel has an SSDI benefit of 700. He is now
  earning 1200 / month gross. He is paying 400 /
  month for job-coaching.
• George has an SSDI benefit of 700. He is now
  earning 1400 / month gross. Generals job
  coaching is being paid for by another source.
• Which person will have a higher monthly income
  (wages plus benefits)?

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IRWE Example 2

• Colonel will have higher monthly income.
• Colonel George
• 1200 Gross General is earning
• - 400 IRWE over SGA and will
• 800 lose his SSDI
• 700 SSDI benefits.
• 1500 Total 1400 Total

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Questions?
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IRWE and SSI

• If you are a recipient of SSI, and you have an
  approved IRWE, you can be reimbursed up to 50 of
  the IRWE amount on your SSI check.

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IRWE and SSIExample 1

• Olaf is working, receiving 885 gross / month.
  He also receives SSI in the amount of 203.
• Olaf needs a job coach to remain successful at
  his job.
• The job coach is negotiated to cost 200 / month.
  Olaf will pay for this service himself.
• Olaf lets SSA know about the IRWE, and it is
  approved.

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IRWE and SSIExample 1

• SSA calculates his new SSI
• 885 gross wages
• - 85 exclusion
• 800
• 800
• - 200 IRWE
• 600
• 600 / 2 300 Countable Income
• 603
• - 300
• 303 SSI

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IRWE and SSIExample 1

• Without an IRWE, Olaf receives
• 885 wages 203 SSI 1088 total income / mo
• With an IRWE, Olaf receives
• 885 wages - 200 job coaching 303 SSI 988
• Olaf is paying 200 out-of-pocket for his IRWE,
  but his total income is only reduced by 100.

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IRWE and SSIExample 2

• June is receiving 485 gross / month in wages.
  She is 19 yrs old and a full-time student.
  Because of the Student Earned-Income Exclusion,
  her SSI is not being reduced.
• June is paying 150 / month for therapies not
  covered by Medicaid. They are related to her
  disability, and they are necessary for work.
• Can June submit an IRWE and receive up to half of
  the 150 back on her SSI?

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IRWE and SSIExample 2

• No. SSA is unable to reimburse June any of the
  IRWE costs because she is already receiving the
  maximum SSI amount available.

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Letting Social Security Know About IRWEs

• Notice of an IRWE can be submitted to Social
  Security in letter-form. Include any receipts
  for payment.
• Consider hand-delivering it and getting a
  receipt.
• Keep copies of everything!
• SSA is not required to inform you whether or not
  a subsidy has been approved.

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More Info on IRWEs

• There are no time limits on how long individuals
  can use an IRWE.
• It is not necessary that an IRWE be a monthly
  recurring expense.
• In cases of one-time large expenses, an
  individual may choose to have the IRWE prorated
  over (up to) a 12 month period.

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More Info on IRWEs

• IRWEs can be backdated as long as there is proof
  of payment.
• IRWEs can be used in conjunction with a subsidy.
• IRWEs can be used to make a person eligible for
  SSDI or SSI (by earning below SGA).

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King County DDD Assistance

• A KC DDD Employment Resource Coordinator can help
  you
• Identify an IRWE or Subsidy
• Write a letter of explanation to be submitted to
  SSA
• If you are paying for job coaching, act as fiscal
  intermediary for IRWEs and produce all necessary
  receipts.

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Questions?Break?
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PASS

• Who can use PASS?
• What is a PASS?
• How does it work?
• Whats in it for SSA?
• FAQs

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Who can use a PASS?

• Anyone who is receiving SSI or could be eligible
  to receive SSI AND who has resources or income
  other than SSI may utilize a PASS.
• PASS works for many people, but it doesnt work
  for everyone.

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What is a PASS?

• PASS stands for Plan for Achieving Self Support.
• PASS is a Social Security Work Incentive Program.
  
• PASS is a great tool for people who are serious
  about employment and need support to be
  successful.
• PASS plans are as unique as the individuals who
  choose to utilize them.

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What is a PASS?

• PASS is a tool that helps people afford to pay
  for items and services they need to reach a
  specific work goal.
• In short, when a person is utilizing a PASS, he /
  she sets aside money to pay for the outlined
  items and services, and SSA responds by
  reimbursing the person some or all of the money
  via an SSI check.

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What is a PASS?

• PASS is a sheltering mechanism. It shelters
  money in two ways
• When income is set aside for a PASS, that money
  is sheltered when Social Security computes the
  persons SSI amount.
• Money in a PASS account is sheltered from the
  2,000 SSI / Medicaid resource limit.

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How does it work?

• A PASS template is filled out and submitted to
  SSA.
• In this plan, the person identifies a work goal,
  the steps it is going to take to reach that goal,
  and all the costs involved with that process.
• Once approved, PASS allows individuals to set
  aside and shelter money. This money is used to
  pay for all the items and services listed in the
  PASS.

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Accounts Marked for PASS

• A separate bank account under the individuals
  name must be used for all PASS funds.
• Only funds associated with the PASS can be placed
  in this account.

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What money can be sheltered and used in a PASS?

• Any money other than SSI can be set aside in a
  PASS.
• Resources (savings) can be set aside in a PASS.
  This money is sheltered from the 2,000 resource
  limit of SSI and Medicaid.
• Income, both earned (wages) and unearned (Social
  Security check, child support, etc.), can be
  sheltered in a PASS.
• PASS may allow a person not receiving SSI and
  Medicaid to become eligible for those benefits.

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The Quick Version of How It Works

• A person with an approved PASS plan sets a
  portion of his/her own income aside monthly in a
  separate bank account to pay for the items
  listed.
• Social Security responds by reimbursing the
  person that set-aside amount on his/her SSI
  check.

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Example 1 - SSI

• Nigel receives 685 gross / month wages and 303
  SSI for a total of 988 / month.
• Based on his wages, Nigels SSI is being reduced
  by 300.
• Nigel wants to change jobs and earn more money.
  He writes a PASS to pay for the things he needs
  to reach this work goal. The PASS is approved.

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Example 1 SSI The Sheltering Mechanism

• Nigel will take 300 of his
  hard-earned money and
• set it in a special account dedicated to
  the PASS.
• In return, SSA will reimburse Nigel the 300 on
• his SSI check.
• w/o the PASS 685 wages 303 SSI 988
• w/ the PASS 685 wages - 300 PASS 603 SSI
• 988 ( 300 PASS)

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SSA and

• If Social Security is just reimbursing me for the
  things that Im paying for, wouldnt it be easier
  for SSA to just pay for everything Ive written
  in the PASS?
• Sure. But then you really wouldnt have any
  ownership in the plan.

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Example 2 SSDI/DAC

• Rebecca receives 680 SSDI. Rebecca writes and
  submits a PASS, and it is approved!
• Rebecca is not receiving SSI because she has too
  much SSDI.
• With a PASS, Rebecca shelters her SSDI into an
  account marked for the PASS. Now that the SSDI
  is sheltered, it looks as if she has no unearned
  income, and she becomes eligible for SSI!

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Example 2 SSDI/DAC The Sheltering Mechanism

• Rebecca must put her entire SSDI minus a 20
  exclusion into the PASS account 680 - 20
  660 into the PASS.
• In return, she gets reimbursed 603 SSI.
• w/o a PASS 680 / month
• w/ a PASS 603 SSI 20 excl. / month
  (660 PASS)

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SSA is kicking in their own money. What do they
get out of it?

• SSA wants people to be successfully employed, pay
  taxes, and rely less on their system.
• One goal of the PASS must therefore be for the
  participant to have a reduction in benefits by
  the end of the PASS (unless the PASS is for only
  for a vocational assessment)

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SSA is kicking in their own money. What do they
get out of it?

• If you receive SSI, you must, by the end of the
  plan, demonstrate that you are receiving less
  SSI.
• If you are a beneficiary of SSDI / SSDAC, you
  must demonstrate that you will stop receiving
  these benefits by the end of the plan. (Remember
  SSDI and SSDAC are all-or-nothing benefit
  checks.)
• If your goal is to earn over SGA, then PASS makes
  sense if you are unable to earn over SGA and
  lose SSDI/SSDAC, you cannot write a PASS.

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Frequently Asked Questions

• I have SSI and no other income and resources.
  Can I write a PASS?
• No. However, as soon as you begin working, you
  may have enough wages to set aside in a PASS.

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Frequently Asked Questions

• I am not eligible for SSI because I have 5,000
  that my grandmother left me in her will. Could
  I use this money in a PASS?
• Yes. If you put that 5,000 into the PASS, it
  will be sheltered from the 2,000 resource limit,
  and you will become eligible for SSI. It will be
  expected that you use that money for items listed
  in your PASS.

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Frequently Asked Questions

• I would like to work, but I dont have any idea
  what my work goal might be. Can I still write a
  PASS?
• Yes. You can write a PASS to pay for items and
  services necessary to explore and decide upon an
  attainable work goal. (This is called a VR
  Evaluation on the PASS template.) You do not
  need to rely less on the system by the end of
  this plan. It is not necessary that you follow
  up with a new PASS, though that is often a
  logical next step.

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Frequently Asked Questions

• I am working right now, and Im pretty stable on
  my job. Can I write a PASS?
• Yes, but remember, you would need to demonstrate
  that by the end of the plan, you will rely less
  on the system than you are currently. You can
  write a PASS if your goal is to earn more money
  at your current job or to obtain new employment
  with higher wages.

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Frequently Asked Questions

• I dont want to change jobs or earn more money.
  I just need to pay for a job coach to come in now
  and then to help me out.
• Then a PASS would not be the appropriate SSA Work
  Incentive for you to use. It might make better
  sense to establish an IRWE while paying for this
  job coach support.

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Frequently Asked Questions

• I am a under 22 years of age, and I am a
  full-time student. I understand that there is a
  Student Earned-Income Exclusion where my SSI may
  not initially decrease with wages. Can I still
  use a PASS?
• No. With a PASS, you are reimbursed through SSI.
  If your SSI is not going down, then there is no
  room by which you can be reimbursed.

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Frequently Asked Questions

• How long can my PASS last?
• As long as necessary for you to reach your work
  goal. Plans do not run indefinitely. You
  identify your work goal, and the PASS continues
  until you have reached that goal.

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Frequently Asked Questions

• How many plans can I have in my lifetime?
• As many as you want or need. Of course, SSA will
  have the final decision on whether or not to
  approve each plan.

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Frequently Asked Questions

• Do I establish a PASS with my local field office?
• No. You submit a PASS with the PASS Cadre,
  located in downtown Seattle. The PASS Cadre will
  conduct all audits and monitor the PASS.
• You must still report wages on a monthly basis to
  your local SSA office!

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Questions?
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PASS

• For what things can a PASS be used to pay?
• Amendments
• King County PASS Management
• FAQs

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What Kind of Things Can I Pay For With My PASS?

• Vocational Assessment
• Job coaching
• Transportation Costs
• Clothing
• Equipment (computers, modification at the work
  place, etc.)
• Home-support directly before and after work
• Education
• Cost of someones support with writing the PASS.
• Physical therapy / Counseling
• Etc., Etc. Etc.

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What Kind of Things Can I Pay For With My PASS?
(cont.)

• Essentially, if its necessary for you to reach
  your work goal, chances are pretty good that you
  can get it approved as part of your PASS.
• Here are some exceptions
• If youve already paid for it, you cant ask to
  be reimbursed
• If it can be paid for through another resource
  (i.e. grants, DVR funding), then it may not be
  covered by the PASS.
• There are cheaper alternatives.

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Example

• Lizettes dream is to become a clown.

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Example, cont.

• Lizette has requested the following items in her
  PASS
• Cost of tuition at Clown Community College (1
  year program)
• Job coaching
• 8 rubber chickens
• 1 pair bulbous red shoes, size 20
• Show-Pony
• 2005 Mercedes-Benz SL Roadster

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Example What Will Be Approved?

• Cost of tuition at Clown Community College
• This could be approved however, Lizette would
  need to demonstrate that she has researched
  possible grants and none exist (or she doesnt
  qualify for any).
• Job coaching
• This could be approved. Lizette would need to
  explain in detail how much job coaching she would
  need and why she needs this support.

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Example What Will Be Approved?

• 8 rubber chickens
• No problem, as long as SSA knows its a necessary
  item for a clown.
• Bulbous shoes
• Again, no problem, as long as SSA understands
  that it is part of a work uniform.
• Show-Pony
• This one would be pretty tough to get through.
  Why does she need one? Can she afford to take
  care of it? SSA will want to know.

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Example What Will Be Approved?

• Mercedes-Benz
• Not a chance.
• Actually, cars can be approved in a PASS.
  However, the burden falls on the user to prove
  that it is absolutely necessary. If you can take
  the bus to and from work, and that trip takes a
  reasonable amount of time, SSA is not going to
  help pay for a car.

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Amendments

• Rarely do plans move along precisely as
  originally predicted in the PASS. When
  deviations from the plan occur, you must notify
  the PASS Cadre.
• The PASS Cadre will review and either approve or
  not approve the amendment. They will send a
  letter explaining their decision.

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Suspension

• If major changes happen to the plan, i.e. you
  lose your job, you can request to suspend PASS.
• Suspensions can last for up to one-year. During
  this time, the PASS is simply frozen.

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The PASS Ends

• The PASS ends once the individual reaches her
  work goal and all debts have been paid.

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King County PASS Management

• King County can help people write and manage
  their PASS plans.
• Assist with writing the PASS
• Use virtual accounts for PASS funds
• KC DDD will help monitor the flow of funds
• KC DDD will produce all documents for audits
• KC DDD can assist with writing amendments.

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Frequently Asked Questions

• Im leaving the country, and I havent yet met my
  work goal. Will I owe all that money Ive spent
  back to SSA?
• Assuming that you were following the PASS
  honestly and according to plan, you probably will
  not owe SSA any money that you have spent for the
  PASS.
• Any money left in the account will go back SSA
  unless that money came from resources, not
  income.
• Technically, the money will go to you, and then
  SSA will request all or some of the money as an
  overpayment)

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Frequently Asked Questions

• If my PASS falls apart and is terminated, can I
  write a second PASS down the road when Im more
  ready?
• Yes. The PASS Cadre will make the decision on
  whether or not to approve it. If your PASS
  failed in the past, then they will want to know
  why, and how are things different this time
  around.

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Frequently Asked Questions

• Why would I want King County to help manage my
  PASS?
• Its free, our help could make the process a
  whole lot easier for you, and each employee for
  KC DDD is a pure joy to work with.

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Questions?
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Thank You!Please fill out the evaluation before
you leave.

• Department of Community and Human Services
• Developmental Disabilities Division