The Ticket to Work and SelfSufficiency Program

1
The Ticket to Work andSelf-Sufficiency Program

• Training for Employment Networks and State
  Vocational Rehabilitation Agencies
• January 2007

2
Module 3

• Social Security
• Administration
• Employment Supports

3
Learning Objectives

• List the incentives for SSDI beneficiaries
• List the incentives for SSI beneficiaries
• Describe Medicare and Medicaid options
• Calculate Countable Income
• Calculate cash benefits for SSI beneficiaries

4
SSDI Benefit Process
5
Social Security Disability Insurance (Title II)

• Applies to beneficiaries who
• Have a work history
• Have paid into the Social Security Trust Fund
• Are unable to engage in substantial gainful
  activity (SGA) as a result of medical or mental
  impairment expected to last longer than 12 months
  or that will result in death

6
SSDI Eligibility

• To qualify for SSDI payments, a person must have
  worked and paid Social Security taxes for enough
  years to be covered under Social Security
  insurance, some of the taxes must have been paid
  in recent years, and the beneficiary must be
• The worker or the workers adult child or
  widow(er)
• Considered medically disabled, and
• Not working, or working but earning less than SGA

7
SSDI Employment Supports
8
Trial Work Period

• Begins with the first month a beneficiary is
  eligible for SSDI benefits
• Cash benefits continue regardless of income
• Any month in which a beneficiary earns more than
  640 counts as a services month
• Allowed 9 non-consecutive services months
  within a 60 month period

9
Extended Period of Eligibility

• If disability benefits stop after successful
  completion of the Trial Work Period because SGA
  was achieved, benefits are automatically
  reinstated without a new application for any
  months in which earnings drop below the SGA
  level.

10
Extended Period of Eligibility

• Begins after the Trial Work Period (TWP)
• Lasts for 36 consecutive months
• Provides cash benefits during months when
  countable income is less than SGA level
• Prepares beneficiary to live off earnings through
  Cessation and the Grace Period

11
Cessation and Grace Period

• Cessation
• The first month after the Trial Work Period that
  the beneficiary demonstrates SGA. The beneficiary
  receives his/her cash benefit regardless of
  earnings.
• Grace Period
• The two months immediately following Cessation,
  during which the beneficiary receives his/her
  cash benefits regardless of earnings.
• Cessation and the Grace Period usually occur
  during the EPE, but might not necessarily,
  depending on the beneficiarys earnings.

12
SSDI Employment Support Process
13
Expedited Reinstatement of Benefits

• Working beneficiaries may be eligible for
  Expedited Reinstatement of Benefits if benefits
  have been terminated due to income.
• Benefits will start immediately
• Benefits will continue for six months while
  reinstatement is processed
• If reinstatement is denied, beneficiary will not
  have to return the cash benefits received during
  the processing period

14
Extension of Medicare Coverage

• Premium free Medicare hospital insurance coverage
  continues for 93 months (7 years, 9 months) after
  the end of the Trial Work Period
• After premium-free Medicare coverage ends,
  Medicare hospital and medical insurance can be
  purchased if disability continues

15
SSI Benefit Process
16
SSI Eligibility

• Financially Needy
• Based on income level and other resources
• Aged
• Aged 65 or older
• Blindness
• 20/200 vision or less
• Disabled
• Unable to engage in SGA by reason of medically
  determinable impairment expected to result in
  death, or that has lasted or can be expected to
  last for a continuous period of 12 months

17
Federal Benefit Rate (FBR)

• The maximum dollar amount a person can receive in
  federal SSI cash benefits on a monthly basis,
  provided his/her countable income and resources
  are less than the SSI limits
• SSI pays the difference between the FBR and
  countable income
• 623/month for individuals 934/month for
  couples

18
SSI Employment Supports
19
1619(a) and (b) Status and Eligibility
Requirements

• SSI recipients who work still receive benefits
  despite earning at or above SGA level provided
  they remain disabled
• Income disregards formula used to reduce cash
  benefits as earnings increase
• Disabled beneficiaries are eligible for Medicaid
  despite earning above the break even point

20
Income Exclusions

• Some income is excluded when determining SSI
  eligibility. These steps include
• General 20 income exclusion is applied to
  unearned income
• A monthly deduction of 65 is applied to earnings
• If there is no unearned income a monthly
  deduction of 85 is applied to earnings
• Half the earnings over the first 85 is deducted

21
Student Earned Income Exclusion

• Excludes up to 1,150 of earnings per month, to a
  maximum of 6,100 per year
• Applies before deducting the 20 general
  exclusion or the 65 earned income exclusion

22
Plan for Achieving Self Support (PASS)

• Allows beneficiary to use personal income and/or
  things owned to reach a work goal that reduces or
  eliminates the need for SSI benefits
• Examples include setting aside money to return to
  school or get specialized job training
• Money set aside is not included when determining
  SSI eligibility

23
Property Essential to Self-Support

• Some resources needed for self support are not
  counted when determining eligibility
• Examples include tools and equipment needed for
  work or a businesss inventory, or if a business
  is owned, the property is not counted as a
  resource

24
Blind Work Expenses

• Earned income that a blind beneficiary uses to
  meet work expenses is not counted when
  determining SSI eligibility and payment amounts
• Expenses do not need to be related to blindness
• Includes earned income used to pay income taxes,
  meals during working hours, transportation, and
  guide dog expenses
• Items are treated as blind work expenses instead
  of impairment-related work expenses when
  determining payment amount

25
Continued Medicaid Eligibility

• Section 1619(b) enables beneficiaries to receive
  Medicaid coverage despite having income that is
  too high for an SSI cash payment

26
Reinstating Eligibility without a New Application

• If beneficiary has been ineligible for an SSI
  benefit for 12 months or less, a new application
  to reinstate benefits does not have to be filed

27
SSDI and SSI Employment Supports
28
Impairment Related Work Expenses (IRWE)

• The cost of certain impairment related expenses
  needed in order to work are excluded from
  determining earned income
• Available to SSDI and SSI beneficiaries

29
IRWE

• Attendant Care
• Transportation Costs
• Work Related Equipment and Assistants
• Prosthesis
• Residential Modifications Routine Drugs Medical
  Services
• Diagnostic Procedures

30
Subsidies and Special Conditions

• Supports received on the job that result in
  receipt of more pay than the value of the job
• Values are deducted from earnings when it is
  decided if SGA is reached
• Not deducted when SSI payment amount is figured
• Examples receiving more job supervision, having
  a job coach, etc.

31
Unincurred Business Expense

• Refers to self-employment business support that
  someone provides the beneficiary at no cost
• Is deducted from the net earnings
• Includes examples such as a friend working for
  free, receipt of computer used for work, etc.
• Not deducted when SSI payment amount is figured

32
Unsuccessful Work Attempt

• An effort by a person with a disability to
  perform substantial work that either stopped or
  produced earnings below the SGA level after 6
  months or less because of
• The individuals disabling condition, or
• Elimination of the special services or assistance
  that the individual needed in order to work
• Not deducted when SSI payment amount is figured

33
Continued Payment Under a VR Program

• If medical recovery is achieved and a beneficiary
  no longer meets the Social Security
  Administration definition of disability, monthly
  payments can continue if the beneficiary is
  actively participating in a VR program that is
  expected to aid in self-support

34
SSI Benefit Calculation

• Earned Income
• - 65 Earned Income Exclusion
• IRWE
• Divide by 2
• - PASS Exclusion
• Countable Earned Income

35
SSI Benefit Calculation

• Countable Earned Income
• Countable Unearned Income
• Countable Income
• 623.00 (FBR) - Countable Income
• Cash Benefit Amount

36
SSDI SSI Employment Supports
37
Cessation and Termination of Benefits
38
Last Month of Entitlement

• The last month of entitlement to benefits is
  whichever of the following occurs earliest
• Second month after the month in which the
  disability ceases
• The month before the worker attains age 65, or
• The month before the month the worker dies.

39
Termination of Benefits Requires Four Events

• TWP has ended 9 services months have occurred
  within 60 months
• EPE has ended36 months of EPE have occurred
• Cessation has occurred
• The next month of SGA the beneficiary is off the
  disability rolls termination occurs if all
  three other conditions have been met

40
Methods of Reporting Income and Managing Records
41
Beneficiaries Must Report Changes in Circumstances

• Reports of events/changes in circumstance are
  required if they affect a persons eligibility or
  SSDI/SSI cash benefit amount
• Report must be made within 10 days after the end
  of the month in which the change occurred
• Failure to report changes may result in penalty
  deduction in payments

42
Changes in the Following Conditions Must be
Reported

• Income
• Residence
• Marital status
• Absence from the US
• Disability improvement
• Eligibility for other benefits

43
Changes in the Following Conditions Must be
Reported (continued)

• School attendance
• Household composition
• Citizenship or alien status
• Criminal justice status
• Parole or probation violations

44
The Ticket to Work andSelf-Sufficiency Program

• Training for Employment Networks and State
  Vocational Rehabilitation Agencies
• January 2007