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TRANSCRIPT
Introduction
to
Social Security Work
Incentives
2015 APD SE Pre-service Training - Part II
Your Presenter
Type Trainer’s Name Here
APD Certified Trainer
Type Trainer’s Email Address Here
Type Trainer’s Phone # Here
3
Why are you here today?
What’s your name?
What’s your job?
Do you work for an agency or on your
own?
Why did you come to this training?
4
Please mute cell phones
Please return from lunch and breaks on time
You must attend the entire class both days
Your complete attention and active
participation is expected
Ground Rules
5
Score of 70% or higher to pass the test (until the
Medicaid Waiver Handbook is amended)
Timed – 30 minutes allowed to take test
Administered on site
No books, notes, or talking permitted
Certificate of Successful Completion (if pass test),
or Certificate of Attendance issued
Test
6
Please
complete
evaluation form
Go to the
7
FEAR of the System
What if …?
“…I earn too much money?”
“…I don’t earn enough money?”
“…I get sick again?”
“…I can’t get my benefits back?”
Knowledge Is Power
You Are Here to Learn
Exciting New Ways to Help
Others or Yourself!
8
Review Agenda
Section 1: Introduction
Section 2: Advocacy
Section 3: Eligibility
Section 4: Effects of Earned
Income on SSDI
Section 5: Effects of Earned Income on SSI
Section 6: SSDI and SSI Work Incentives
Section 7: Resources
Section 8: Glossary/Acronyms/Websites9
“Must Learn” - ACRONYMS
“SSA” – Social Security Administration
“SSDI” – Social Security Disability Insurance
“SSI” – Supplemental Security Income
10
Section 1
Introduction
11
High unemployment rate for people with
disabilities = up to 80% unemployed
Unemployment and under-employment among
working-age Americans with disabilities
continues to be a problem
One of the most significant barriers to
employment is the fear of losing benefits
(SSA benefits and attached health care)
Barriers
12
13
FEAR of the System
What if …?
“…I earn too much money?”
“…I don’t earn enough money?”
“…I get sick again?”
“…I can’t get my benefits back?”
14
Information provided in the training is one tool
for making good decisions about employment
Good decisions are the result of good
planning
The training is based on the philosophy of
self-determination and person-centered
planning
Training Principles
Freedom
Self-Determination
Building Blocks
Authority
Support
Responsibility
Confirmation
15
Person Futures Planning
MAPS/PATH
Circles of Support
Essential Lifestyle Planning
Person-Driven Planning
16
Section 2
ADVOCACY
One that supports or promotes the
interests of another
~Merriam Webster
17
Rules Of Engagement
“Before any rules are discussed,
all parties must be clear what benefits
a person is receiving from all sources,
private and public, before information is
exchanged.”
Sharon Brent,
National Disability Institute
18
What law will be
80
years old this year?
19
The Social Security Act
20
21
Overview
SSDI (Title II) (Soc. Sec. Disability Insurance)
FICA
Medicare
(federal rules)
SSI(Title XVI) (Supplemental Security Income)
General Revenue
Medicaid
(state rules)
V
E
R
S
U
S
Expert?
You do NOT need to be the expert!
You do need to know how
valuable this information is.
You do need to educate people.
You do need to know about the
tools at your disposal.
22
Checklist for Success
When you call SSA (1-800-772-1213):
Date
Name of person you spoke with
What you asked
What they told you
Make copies
Don’t lose them!
23
Checklist (continued)
Report Pay monthly to SSA
If receiving SSI and SSDI, must
report separately to each program
Promptly open and read all mail
Respond on time
If you don’t understand, seek help
Keep wage records in your file
24
If person receives SSI and/or Medicaid,
keep all resources/assets below
$2,000/individual and $3,000/couple in
any month (The law since 1974!!)
*But are there exceptions to the above?
Always report major life changes to SSA
immediately (address, marriage,
employment, loss of job, divorce, etc.)
Checklist (continued)
25
Free if request is made by:
1. Beneficiary or Rep Payee
2. Work Incentive Planning and
Assistance (WIPA)
A program that employs
Community Work Incentive
Coordinators (CWICs) to provide
free benefits counseling, planning
and technical assistance to SSA
recipients who work or plan to work
Benefits Planning Query
26
Benefits Planning Query
• First step in planning!
• Analysis of an individual’s disability and work status
(BPQY)
27
28
Florida is a 1634(d) State
Social Security Act
Section1634(d)
allows Florida to use the same
eligibility criteria for SSI eligibility as
for the state’s Medicaid Program
Eligibility
Section 3
29
SSI/SSDI Initial Eligibility
- Contact SSA
- Complete application forms
- Collect information
- Make and keep appointments
- SSA coordinates with state’s disability
determination office (Florida Department of Health)
• SSA sends letter of eligibility determination
30
Forms & Checklist
Review SSA application
Review SSA’s definition of disability
Gather evidence
Know process and timelines31
SSA’s Definition of Disability
For SSI and SSDI:
The inability to engage in
Substantial Gainful Activity (SGA)
by reason of any medical impairment
(physical and/or mental)
Note: SSA’s definition of disability differs from
the ADA’s definition and other laws’ definitions
of disability.
32
Substantial Gainful Activity
Performance of significant mental or physical
duties for profit
• To meet this part of the disability test, individuals
must not be working or, if working, earning less
than the annual SGA amount
SGA is:
a basic test used by SSA
to determine disability status
33
SGA
2015
SGA Non-Blind - $1,090
SGA Blind - $1,820
34
SGA (continued)
• For people on SSDI, SGA is looked at
by SSA during initial eligibility process
and while continuing to receive SSDI
• For people on SSI, SGA is looked at by
SSA during initial eligibility process only
35
SSA Requirement
Periodic eligibility re-determination
for both SSI and SSDI
Does the beneficiary continue to be disabled?
Continuing Disability Review (CDR)
36
37
CDR Process
1. Interview at the local SSA office
2. Completion of form about current medical
information (similar to initial eligibility process).
3. SSA forwards form to DDS for review and
medical determination
4. Occurs every 3, 5, or 7 years. If you have a
condition not expected to improve, SSA will
review your case, but not as often
Required Work Credits in F.I.C.A.
5 Month Waiting Period
SGA
•12 prior months
•Factor during EPE and beyond
Medical Eligibility
• Medical eligibility defined
SSDI: Eligibility of Benefits
DAC – Disabled Adult Child• Disability prior to age 22• Never legally married to non-
Title II person• Insufficient FICA or higher
parent amount• Parent FICA opens
(Dies; Retires; Disabled)• Possible continuation of
Medicaid• Pickle Amendment
MEDICARE (Medical Insurance)• 24 months upon eligibility• Part A - free in most cases • Part B/D - premium
38
39
SSDI
Title II (1935)
F.I.C.A.
Waiting Period
SGA
Eligibility
DAC/CDB
Medicare (1960’s)
Who was Frances Perkins?
What did she do?
and what she did?
40
Frances Perkins
(1880-1965)
Secretary of U.S. Dept. of Labor
1933-1945
The woman behind FDR’s New Deal,
promoter of the Social Security Act and
a champion of rights for the
American work force
41
Frances Perkins’ Legacy:
Social Security
Unemployment Insurance
Minimum Wage
What is Florida’s Minimum Wage?
42
Florida’s
2015 Minimum Wage
$8.05 per hour
43
44
SSDI
You may
receive this
benefit if:
You have a work
history and are
disabled
Disabled before 22
and receiving
childhood disability
CDB or DAC*
Medicare is usually
associated with this
benefit
* Disabled Adult Child
Medicare
Federal Health Insurance Program
For people 65+
People <65 with certain disabilities
People with end-stage renal disease
45
46
Medicare (Components)
Part A - Hospital Insurance
Part B - Medical Services
Part C - Private Insurance
Part D - Prescription Drug Coverage
47
Medicare: Part A
Covers inpatient care in hospitals, skilled nursing facilities, hospice care and some home health care
Most people don’t have to pay because they or a spouse paid Medicare taxes while working
48
Medicare: Part B
• Covers Doctor’s services
Outpatient care
Medically necessary physical and
occupational therapy and some
home health care
• Part B has a premium that
changes January 1st of each year
with an annual deductible
($104.90 per month/$147
deductible)
Medicare Part C combines Part A and Part B
options and must cover all medically needed
services
• The difference is that private insurance
companies that are approved by Medicare
provide this type of coverage
• In most cases, Part C is a lower-cost
alternative to the Original Medicare Plan,
and providers usually offer extra benefits
and include prescription drug coverage
(Part D)
Medicare: Part C
49
Prescription Drug Coverage
• Most people will pay a monthly premium –
Medicaid will pay premium, if on
• 1/1/06 – available to everyone on Medicare
• 2015 Medicare Costs at a Glance:• http://www.medicare.gov/your-medicare-
costs/costs-at-a-glance/costs-at-glance.html
Medicare: Part D
50
SSI
Title XVI (1974)
General Revenue
Needs Based
No Waiting Period
Looks at Earned and
Unearned Income
Resources Count
Medicaid 51
SSI - Resources
May Be Countable by SSA
• Cash, Savings Accounts, CD’s, IRA’s, etc.
• Land (owned by recipient but not lived on)
• Anything owned which can be converted to cash
and used for purchasing food and shelter (including
utilities)
• Resources of a spouse
• Resources of a parent if beneficiary is under 18
53
SSI - Resources:
May Be Excluded
• Home and household goods
• Burial space and burial funds up to a certain
amount
• Retroactive SSI or SSDI amount for up to 9 months
• Property in Specific Special Needs Trust Approved
by SSA
• One automobile, regardless of value (as of March
2005)
54
55
A bank account for Plan to Achieve Self-Support
(PASS)
An Individual Development Account (IDA)
Property Essential for Self-Support (PESS)
One automobile, regardless of value (as of March
2005)
More SSI Resources
May Be Excluded by SSA
Special Needs Trusts
Purpose
1. To benefit individuals with disabilities
2. Maintain eligibility for public assistance programs
3. Provides funds for supplemental needs
56
Special Medicaid Groups
Protected Medicaid
special continuation provisions
Section 1619(b) of the Social Security Act
Title II COLA (Pickle Amendment)
CDB/DAC
Widower's (ARF)
Drug/Alcohol Addiction
57
Section 1619 (b)
Individuals utilizing 1619(b) are not receiving
SSI payments due to the level of their
countable earnings.
But, they remain deemed by law to be SSI
eligible for Medicaid purposes.
58
The Pickle Amendment
July 1,1977, Medicaid eligibility was
protected for SSI recipients who had lost
SSI due to COLA increases of SSDI
checks
– Beneficiaries who lost SSI now eligible to continue receiving Medicaid as an “SSI eligible”
– Will continue to be “SSI recipients” for Medicaid purposes
59
When determining Medicaid eligibility
for these special former SSI
recipients, state Medicaid agencies must
exclude the portion of the individual’s
applicable Title II disability cash benefit
that caused their ineligibility for
SSI payments.
The Exclusions
60
If, by excluding the appropriate portion of the Title II
benefit, the individual would otherwise be eligible
for an SSI cash benefit, the person is lawfully
“deemed eligible” for Medicaid.
These individuals are deemed SSI recipients for
Medicaid purposes, though they are NOT entitled
to SSI monetary benefits and are not listed on the
Social Security Administration’s SSI rolls.
What They Get
61
State Medicaid agencies or their designees
– In FL, AHCA delegated function to DCF
– SSA does provide information about why SSI
was lost and the amount of Title II payment
that caused the loss
Who Determines Eligibility?
62
There are many current SSDI
Beneficiaries who lost SSI years ago
who are potentially eligible for Medicaid
under the Pickle provisions!
Eligibility can be established ANY time –
there is no “statute of limitations” or sunset date time
Always ask SSDI beneficiaries about former SSI
eligibility and check for Pickle Medicaid eligibility.
Watch for Pickle People!
63
1. Requires States to consider Title II Childhood Disability
Beneficiaries (CDBs) who lose SSI eligibility as if they were
still SSI recipients for Medicaid purposes – (keep Medicaid)
- as long as they would have remained otherwise eligible
for SSI benefits but for their entitlement to (or increase in)
their SSDI (Title II) payment.
(CDB = “DAC” or Disabled Adult Child)
Childhood Disability Beneficiary
64
A “DAC” or “CDB” may also be
an adopted child
a step-child
a grandchild
a step-grandchild
65
Childhood Disability Beneficiary
EFFECTS OF
EARNED INCOME
ON
SSDI
Section 4
66
WAGE FORMULA
1. Number of hours x rate of pay = weekly gross income
2. Take the weekly gross income x 4.3/weeks in a month
GETTING STARTED
67
SSDI Work Incentives
Trial Work Period – 9 months w/earnings of $780 or
more within a 60-month rolling window of time
Extended Period of Eligibility – 36 months
Grace Period – a 3-month period which runs once upon
1st earning SGA during or after EPE
Extension of Medicare Coverage – 93 months
68
Unless medical recovery is determined, SSDI beneficiaries are
entitled to a nine-month Trial Work Period (TWP) for testing
work skills while maintaining the monthly SSDI cash benefits.
During this TWP their full benefit checks will continue regardless
of the amount of money earned.
The nine months of TWP do not need to be consecutive or
earned “in a row.”
TRIAL WORK PERIOD - SSDI
69
TWP months are counted when an individual earns a specific amount of income. (Determined January 1 each year by SSA)
2015 = $780.00/month
The TWP ends only when an individual has 9 trial work months within a 60-month consecutive period or “rolling window” of time (5 years).
Once all 9 months of TWP have been earned within a 60-month window a person then enters the Extended Period of Eligibility (EPE).
TRIAL WORK PERIOD
SSDI
70
• Applies only to SSDI
• Trial Work Month = Earnings over $780.00 gross (2015)
• Nine months - do not have to be consecutive
• All 9 must occur within a rolling 60-month period
• Can earn any amount of money and still get DI cash benefit
• One TWP per SSDI eligibility
• EPE begins automatically once TWP has been earned
• Tracking TWP is imperative!
Trial Work Period
71
The “EPE” Begins the month immediately following the TWP
Lasts 36 consecutive months – (3 years in a row)
Benefits continue if earnings are below SGA
No cash benefit when earnings are above SGA
Extended Period of Eligibility
72
The first month of SGA (cessation month) benefits
continue. Next two months are considered grace
months and even if SGA is earned benefits continue.
(Total of 3-month grace period.)
1 2 3
EPE: Grace Period
73
When the three-year EPE is completed, (has run its course), a person earning gross wages below SGA will continue to receive an SSDI benefit check.
– Receives the whole check
If a person is earning SGA or above, a person is no longer eligible for a cash benefit.
– Receives no check
EPE (continued)
74
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.
(See Work Incentive Subsidies and Impairment Related Work Expenses)
EPE (continued)
75
Extended Medicare coverage is available for
SSDI beneficiaries who lose their cash benefit
due to performing SGA
Coverage is for a minimum of 3 years following the TWP
Coverage continues (Part A – Free) for an additional 4 ½ years
Individuals can buy into Medicare once coverage is exhausted
Extended Medicare Coverage
76
Continuation of Medicare
Continuation of Medicare-SSDI Only
Receive at least 93 consecutive months
The 93 months start the month after the last
month (the ninth month) of your TWP.
You must continue to work and perform
SGA, but not improve medically.
You must satisfy Medicare’s (24 month)
waiting period. 77
Work Incentives (continued)
Rules For Individuals Who Are Blind-SSDI
• See Definition of blindness (SSA Redbook)
• Has lasted or is expected to last 12 months –
(no duration requirement)
• Higher SGA
• If self employed and blind, SGA solely based on
earnings, not time spent/services rendered
78
79
Work Incentives
Comparison ChartSocial Security Disability Insurance Supplemental Security Income
Trial Work Period Continuation of SSI
Extended Period of Eligibility Student Earned Income Exclusion
Continuation of Medicare Blind Work Expense
Special Rules for the Blind (SGA) 1619 (a)
1619 (b)
Property Essential For Self-Support
Plan for Achieving Self-Support
Work Incentives for Both SSDI and SSI
Impairment Related Work Expense (IRWE)
Subsidies
Section 301 (Not Ticket Rules)
Expedited Reinstatement
Ticket to Work
\
Effects of
Earned Income
on SSI
Section 5
80
• Must be under the age of 22 and regularly attending school.
• Can exclude earned income up to a certain amount (changes annually)
• Amount earned looked at monthly, with a yearly maximum
• This exclusion applies before any other exclusion
• Can carry the balance over the following month
Student Earned Income Exclusion
(SEIE) - SSI
81
SEIE - 2015
2015
$1,780.00 per month
$7,180.00 per year
82
Report the following to the SSI claims representative:
– Proof of regularly attending school at least one month
during the current calendar quarter or expectation to
attend school at least one month in the next quarter and
– Pay stubs showing the amount of earned income while
considered a student and under the age of 22.
SEIE – SSI
83
When a person’s primary diagnosis is blindness, SSI will not count any earned income which is used to meet any expense reasonably attributed to earning that income.
Just a few examples of Expenditures:
Guide Dog
Transportation to and from work
Meals during work hours
Child Care
Blind Work Expense
(BWE) SSI Work Incentive
84
Enables a person
to still receive an SSI cash
payment when earnings exceed SGA
Section 1619(a)
SSI Work Incentive
85
• Eligibility for SSI will continue as long as requirements are met.
• SSA will continue to calculate income as before.
• A person continues being eligible for Medicaid.
• This happens automatically when wages are reported to SSI monthly.
Section 1619(a)
SSI Work Incentive
86
When a beneficiary earns enough income to no longer
receive an SSI monthly cash payment, 1619(b)
provides for the continuation of Medicaid.
There are Qualifications:
– Eligibility
– Disability
– Need Medicaid
– Under State Income Threshold
1619(b)
SSI Work Incentive
87
State Income Threshold
There is a “state income threshold amount” used to
measure if earnings are high enough to replace
SSI and Medicaid.
2015 Florida Annual Income
Threshold Amount:
$30,594
1619(b)
88
Income Threshold Calculation
2 x the FBR + 85 x 12 = the base amount (the annual
amount of earned income it takes to reduce the
annual SSI Federal Benefit to zero)
$733x2 = $1,466+85 = $1,551 x 12 = $18,612
$18,612 + (Average per capita Medicaid expenses in
Florida of $11,982)
Equals Florida’s Income Threshold Amount: $30,594
89
90
If a person has:
• Impairment Related Work Expenses (IRWE) Work
Incentive
• Plan For Achieving Self-Support (PASS) Work
Incentive
• Medicaid-funded Personal Assistance Services
(PSA)
• Medical expenses above the average state per
capita amount
Individualized Income Threshold
• Is an income/resource exclusion
• Allows a person to set aside income and/or resources for purposes of achieving an occupational objective
• Helps an individual to establish or maintain SSI eligibility
Plan for Achieving Self-Support
(PASS) = SSI
91
92
Can increase or help maintain the individual’s SSI
payment amount as the person gains the capacity
for self-support.
SSI will not count the income or resources that are
set aside in a PASS when they figure your SSI
payment amount.
PASS - SSI
Requirements:
a. Must be approved by SSA PASS Cadre
b. Will be reviewed periodically to assure plan is working
c. Money set aside in a PASS will not be
considered a resource by SSI, Medicaid, HUD,
Food Stamps, etc.
d. Recommend utilizing the SSA 545 Form
PASS - SSI
93
e. Must be in writing on the SSA-545 form
f. Must have a specific work goal and plan to
reach that goal
g. Must contain a reasonable time frame
h. Must need training, items or services not paid
for by any other source
i. Must use income other than SSI, or use an
excess resource
PASS - SSI
94
j. Must include a business and marketing
plan
k. What will the business do?
l. Include Profit/Loss projections
m. How will the business be funded?
n. Plan must have a reasonable time frame
o. Materials needed
PASS - Self Employment
SSI will not count certain resources
that are essential to a person’s
means of self-sufficiency
Utilized when initially applying for SSI
Maintains resource eligibility for SSI/Medicaid
Property Essential for Self-Support
PESS - SSI
97
• Property used for work as an employee
(required tools, equipment, transportation
etc.)
• Property used in a trade or business
(inventory, business owned property)
PESS (SSI)
98
• SSI will NOT count up to $6,000 of equity
value of non-business income-producing
property if the property yields an annual
rate of return of at least 6%:
a) Rental Property
b) Produce grown on land for sale
PESS (SSI)
99
Work Incentives for
both
SSI and SSDI
PURPOSE: IRWE is used to enable beneficiaries of:
SSI – IRWE is used to reduce gross income –
Why?
SSDI - IRWE is used to reduce countable
earnings below SGA – Why?
What is the difference between “gross income”
and “countable earnings?”
Impairment Related Work Exp.
IRWE = SSI
100
101
Due to out of pocket expenses that support a
disability to allow a person to earn income, even
if those items or services are also needed for
non-work activities.
I - Impairment
R - Related
W - Work
E - Expense
IRWE
Examples:
Transportation
Medications
Medical Devices
PCA
IRWE
102
How To Apply
1. Submit, the first month in writing, the reason,
cost, receipts and pay-stubs to SSI and/or SSDI.
2. Each month expense is necessary, submit
receipts and pay-stubs to SSI and/or SSDI.
3. The SSI/SSDI claims representative will review
and adjust SSA benefit(s) accordingly.
IRWE (continued)
103
Without IRWE
*First Step $785 Earnings *Last Step
- $20 General Income Excl. $383.00 SSI Income
- $65 Earned Income Exclusion +$785.00 Earnings
$700 New Countable Income $1,168.00 Total Income
*Second Step
Divide by 2 the “new countable income” amount of $700
$700 /2 = $350.00 New Countable Income
*Third Step$733 FBR (Maximum SSI Benefit Payment)
- $350.00 Newest Countable Income Above
$383.00 Adjusted SSI Monthly Payment 104
With IRWE
$ 785 Earnings Last Step
- $20 General Exclusion $483.00 SSI Check
- $65 Earned Income Exclusion +$785.00 Earnings
$700 New Countable Income $1,268.00 Total Income
- $200 Medications(IRWE)
$500 New Countable Income
Divide by 2 = $500/2 = $250.00 New Countable Income
$733 FBR
-$250.00 New Countable Income
$483.00 New SSI Payment
105
What’s the Difference?
Without IRWE – $1,168.00
With IRWE
Total monthly income:
$1,268.00
106
Subsidies
Applies to SSI during initial eligibility only
Applies to SSDI during the initial eligibility process
as well as keeping a beneficiary below SGA to
maintain SSDI eligibility
Financial Value
The dollar amount of the subsidy is subtracted
from gross monthly earnings, potentially reducing
gross wages below the SGA level
Subsidies: SSI and SSDI
107
108
Evidence of receiving a subsidy• Extra Support• Supervision• Lower productivity level than co-workers
having similar jobs
A Subsidy can only be Employer Sponsored.
A Special Condition may be:
• Agency sponsored
• Employer sponsored
• Self-employment supports
Subsidies/Special Conditions
Agency-sponsored Special Condition
Compare the time, energies, skills and
responsibilities of the workers with disabilities
to the workers without disabilities who are
performing the same or similar duties:
How do I compare these factors?…..
(see next slide)
Subsidies/Special Conditions
109
110
Estimate the proportionate value of the work
being done by the worker being supported
according to the pay scale for such work
Determine how frequently the agency
support monitors the worker and how
involved the support is with the actual
function of the job.
Subsidies/Special Conditions
111
There may also be continuing support being
given that is not as obvious.
Job coaching services are a strong
indication that the work is subsidized.
Subsidies/Special Conditions
Employers are requested by SSA to submit a
statement documenting the actual value of
employee’s services which will be less than the
dollar value ($) received in earnings.
1. Specific Subsidy: Employers
designate a specific dollar amount after
calculating the reasonable value of employee’s
services.
Employer-sponsored Subsidy
112
113
2. Non-specific Subsidy (if unable to designate
a dollar amount):
a. Compare the work in terms of time, skills,
and responsibilities with that of a person
without a disability performing similar work.
b. The proportional value of the employee’s
work can then be estimated according to
the prevailing pay scale.
Employer-sponsored Subsidy
Allows individuals who improve medically and are no
longer considered medically eligible through a
Continuing Disability Review (CDR) to continue
receiving a cash benefit if:
Participating in an approved vocational rehabilitation
program (public or private); or
While participating in an IEP (Effective July 2005)
Section 301
SSI and SSDI
114
When a person’s SSDI cash benefit stops due to wages, or Medicaid benefits stop due to wages, a request to reinstate the benefits without filing a new SSDI or SSI application can occur (effective January 1, 2001).
Beneficiaries must be unable to work (or earn SGA anymore) because of their medical condition.
Expedited Reinstatement
SSI and SSDI
115
The person must file the request for reinstatement with Social Security within 60 months from the month his SSDI cash benefits are terminated and SSI Medicaid benefits are terminated.
In addition, the person may receive temporary benefits, as well as, Medicare and/or Medicaid for up to six months while his case is being reviewed.
Expedited Reinstatement
116
SSDI—after Extended Period of Eligibility
completed and termination of SSDI cash
payment due to earnings
SSI—after one year suspension of Medicaid due
only to earnings (first year is a suspension, and
the next five years allow for Expedited
Reinstatement option)
Expedited Reinstatement
Both SSI and SSDI — 60-month period to request
expedited reinstatement following SSDI/SSI
termination due to working and earning wages
6-month provisional cash benefits payable while
SSA reviews reinstatement request
May also re-apply for new eligibility determination
Expedited Reinstatement
118
A voluntary program for people with disabilities
who want to work. A person who receives a
“ticket” will have:
Greater Choice
Increased Network of Vocational Service
Providers (ENs)
Not be subject to a Continuing Disability
Medical Review (CDR)
Ticket to Work
SSI AND SSDI Work Incentive
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What is an Employment Network?
• Certified Private Contractor with SSA to
provide vocational services
• State Vocational Rehabilitation is also a
required Employment Network
Ticket to Work
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Section 7
Resources
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State Agencies
APD – Medicaid Waiver; GR/IFS; EEP
DVR – Supported Employment Phase 1
Employment Related Services
NEW “Abilities Work” Help Desk
DEO Abilities Work Employment Portal
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Individual Development Accounts (IDA)
Corporation for Enterprise Development (CFED)
Housing and Urban Development (HUD)
Supplemental Nutrition Assistance Program (SNAP)
123
Thank you!
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