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2.3.5 Other Work Related Social Security Programs |
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Louisiana Statewide Transition Project and Louisiana: Healthy and Ready to Work Fact Sheet Series |
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06/18/99 |
I. WHY IS THIS IMPORTANT?
The Social Security Administration (SSA)
recognizes the importance of work to individuals with disabilities. With this
in mind, the SSA has instituted various Work Incentive programs in order to
provide support and assistance while benefit recipients return to work or enter
the workforce for the first time. In addition to providing Work Incentives to
benefit recipients so they may retain needed benefits while working, the SSA
also provides help with vocational rehabilitation and specific supports to
individuals who are blind.
II. KEY POINTS
This section describes various SSA programs
available to Supplemental Security Income (SSI) and Social Security Disability
Insurance (SSDI) recipients. It is important to remember that each of the
programs described have specific eligibility and application procedures. For
more information on the programs listed, see the Resources/Contacts section of
this fact sheet.
SSI Work Incentives:
Earned Income Exclusion: The Earned Income Exclusion provision is a
Work Incentive that allows a portion of an individual's earned income,
including pay received in a sheltered workshop or work activity center, to be
excluded when figuring the SSI payment amount. The SSA excludes the first $65
of earnings in a month plus one-half of the remainder. This means that less
than one-half of an individual's earnings are counted when figuring his/her SSI
payment amount. The Earned Income Exclusion should not be confused with
another Work Incentive called the Student Earned Income Exclusion (for
more information, see the fact sheet 2.3.4 Student Earned Income
Exclusion).
Property Essential to Self-Support
(PESS): This provision allows
individuals to exclude certain resources that are essential to their means of
self-support. Property used in a trade or business, or that is used by an
individual for work as an employee can be totally excluded. For example, the
value of tools or equipment needed for work is totally excluded when
calculating cash benefits.
Section 1619, Continued Medicaid
Eligibility for People Who Work: Section
1619 allows most individuals to keep Medicaid benefits even if they earn
too much to receive monthly SSI cash payments. In order to be eligible for this
program, individuals must:
·
meet all the SSI
eligibility requirements except for the earning amount limits;
·
not have sufficient
earnings to replace SSI cash benefits, Medicaid benefits, and publicly-funded
personal or attendant care that would be lost due to exceeding the earning
amount limits.
SSDI Work Incentives:
Trial Work Period: The Trial Work Period lets SSDI recipients test
their ability to work or run a business for at least 9 months, without
affecting their disability benefits. They can continue to get full benefits
during the trial work period no matter how much they earn. When the individual
participating in the Trial Work Period program has earned over a
designated monthly amount for nine months (not necessarily consecutive) during
a sixty-month period, the Trial Work Period is completed. This
designated monthly amount is called "Substantial Gainful Activity" or
SGA ($700, or $1100 if blind). After the Trial Work Period, the SSA
reviews the case. If the individual is earning below SGA, SSDI benefits
continue. If the individual is earning above the SGA level, the SSA usually
determines that he/she is able to work despite the presence of a disability.
When this happens, cash benefits continue for three more months (this is known
as the "grace period"), then they stop. The individual then enters
the Extended Period of Eligibility.
Extended Period of Eligibility: The Extended Period Of Eligibility is a
consecutive 36-month period during which cash benefits will be reinstated for
any month the individual does not work at the SGA level ($700, or $1100 if
blind). Benefit checks can be started again without a new application,
disability determination, or waiting period. This reinstatement of benefits
saves critical time for the individual and replaces any loss of earnings for a
given month within the 36-month period. The Extended Period Of Eligibility reassures
the individual that SSDI benefits can be paid after the Trial Work Period if
he/she is unable to perform SGA anytime during the 36 months.
Continuation of Medicare Coverage: SSDI recipients can receive at least 39 months of
Medicare benefits after the Trial Work Period. This provision allows
health insurance to continue when an individual goes to work and is engaging in
SGA. Although cash benefits may cease, the individual has the assurance of
continued health insurance during the 39-month period of continued Medicare
coverage.
Medicare for People with Disabilities Who
Work: Some individuals who receive
SSDI benefits as a former employee and have returned to work may purchase
continued Medicare coverage after premium-free Medicare coverage ends. In order
to be eligible for this program, the individual must meet certain requirements,
including having Medicare stopped due to work. If the individual becomes
medically disabled again within 5 years (7 years for widows/widowers and
dependent, unmarried adult children of a person eligible for SSDI benefits)
after the prior period of SSDI ends, he/she does not have to serve another
5-month waiting period to get benefits or Medicare.
Other Work-Related Programs:
Continued Payment Under a Vocational
Rehabilitation Program: The SSA can
help individuals with disabilities get the vocational rehabilitation services
they need to go to work for the first time or return to work. SSA helps put
individuals in touch with agencies that provide job counseling, training, and
job placement, and also helps pay for these services when certain conditions
are met. In Louisiana the state agency that provides these services is
Louisiana Rehabilitation Services (LRS). If LRS is unable to serve an
individual, the SSA may refer him/her to another approved provider. Such
providers must be licensed, certified, or accredited to provide vocational
rehabilitation services within their state, as well as meet other SSA
requirements. The SSA pays these alternate providers for the costs of their services
under the same conditions that apply for state vocational rehabilitation
agencies. This service is available to both SSI and SSDI recipients.
How Social Security Helps Individuals Who
Are Blind: While there are general
rules that apply to most Social Security benefit recipients, there are some
that apply only to individuals who are blind. Many of these rules were designed
to make it easier for individuals who are blind to work. For example, effective
January 1, 1999, SGA for individuals who are blind is $1100 a month, which is
higher than the SGA level of $700 a month that applies to all other recipients.
(It is important to remember that these dollar amounts can change every year.)
Another provision for individuals who are blind is called the Blind Work
Expense provision. Individuals who are blind are allowed to exclude earned
income which is used to meet the expense of working, even if these expenses are
not related to blindness (including income tax payment, meals during work
hours, transportation costs). All other recipients may only exclude those
expenses related to their disability that are required to work. Finally, there
are a number of services and products specifically designed to ensure that
individuals who are blind are able to take advantage of their rights and
exercise their responsibilities under the Social Security program. These
include special mailing arrangements and accessible publications.
III. ROLES/NEXT
STEPS
Students/Young Adults: Young adults who would like to work but are afraid of
losing needed benefits should contact the Work Incentive Liaison at the local
Social Security office to ask about Work Incentives. The liaison can help
determine potential eligibility and answer questions.
When discussing the transition to employment
with those supporting them, young adults should ask for help exploring all
applicable Work Incentives.
Families: Families can encourage young adults to work by
learning about Work Incentives that can help them go to work and not lose
needed benefits. Families can assist young adults when contacting the Work
Incentive Liaison at the Social Security office.
When discussing the transition to employment
with agencies, families should ask about various Work Incentives for which
their son/daughter may be eligible. If incentives are identified, they should
help their son/daughter apply.
Agencies: Transition personnel in school and adult agencies
should become familiar with Social Security Work Incentives. Relationships
should be formed with staff in local Social Security offices who can assist
individuals with disabilities to work while retaining benefits as needed.
Sponsoring student/family workshops during which the Social Security Work
Incentive Liaison presents information and answers questions can be helpful to students
and families considering employment.
As requested, personnel from the SSA should
attend meetings at which transition to employment is discussed. They can also
serve on a local interagency transition team. By providing information to Local
Education Agencies, families, and young adults, SSA personnel can help young
adults plan for employment without the fear of losing needed benefits
prematurely.
IV. RESOURCES/CONTACTS
Social Security Administration
Phone: 1-800-772-1213 (voice) or
1-800-325-0778 (TTY)
Internet: http://www.ssa.gov
SSI Spotlight on Special SSI Rules for
Blind People Who Work. Available via
FAX by calling 1-888-475-7000 or via the internet at http://www.ssa.gov/pubs/140.htm
Red Book On Work Incentives: A Summary
Guide to Social Security and Supplemental Security Income Work Incentives
for People With Disabilities Available from SSA offices, or via internet at
www.ssa.gov/pubs.
V. REFERENCES
Social Security Administration. (1995). Red
Book On Work Incentives: A Summary Guide to Social Security and Supplemental
Security Income Work Incentives for People With Disabilities (SSA
Publication No. 64-030) [available via internet at http://www.ssa.gov/pubs].
Social Security Administration. (June, 1997).
We Can Help With Vocational Rehabilitation (SSA Publication, No.
05-10050) [available via internet at http://www.ssa.gov/pubs].
Social Security Administration. (June, 1996).
How We Can Help (SSA Publication, No. 05-10052) [Available via Internet
at http://www.ssa.gov/pubs].