basic boot camp for understanding benefits & work
DESCRIPTION
BASIC Boot Camp for Understanding Benefits & Work. Presented by: Supported Employment Consultation & Training (SECT) Center 1100 Broadway Anderson, IN 46012 www.sectcenter.org U:\My Music\03 Boogie Woogie Bugle Boy (Form Company B).mp3. Fall In! Your in Boot Camp now!!! - PowerPoint PPT PresentationTRANSCRIPT
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(Benefits Boot Camp)- SECT
BASIC Boot Camp for Understanding Benefits & Work
Presented by: Supported Employment Consultation
& Training (SECT) Center1100 Broadway
Anderson, IN 46012www.sectcenter.org
U:\My Music\03 Boogie Woogie Bugle Boy (Form Company B).mp3
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(Benefits Boot Camp)- SECT
Fall In! Your in Boot Camp now!!!
Sergeants: Payne & SuffrinA.K.A. Dennis Born & Denise Norris as your Boot
Camp Commanders
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(Benefits Boot Camp)- SECT
The purpose of your “BASIC” Training
To give a brief overview of eligibility requirements for Title II and Title XVI Social Security and Medicaid programs.
To provide tools for calculating the impact of work income on Social Security and Medicaid.
Identify 2009 entitlement changes.
To identify educational resources available to individuals, case managers, and families.
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(Benefits Boot Camp)- SECT
How Does Work Affect Benefits?
“…subjects reject competitive employment …in view of the fact that the working person loses money from his/her pension check and risks
losing the disability pension altogether if work continues for long.
Warner and Polak, Community Mental Health Journal, Vol. 31, No. 5, Oct. 1995
67% of unemployed individuals with disabilities indicate the reason they are not working because the increase income from work may cause a loss
or decrease in healthcare benefits.Indiana Medicaid Action Coalition, Healthcare Barriers to Employment Survey, 2000
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(Benefits Boot Camp)- SECT
Social Security Administration:
Two Disability Programs: Title XVI
SUPPLEMENTAL SECURITY INCOME (SSI)
Title IISOCIAL SECURITY DISABILITY INSURANCE (SSDI)/SOCIAL SECURITY DISABLED ADULT CHILD (SSDAC)
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Obtaining SS Information:
Obtain Completed SSA Consent Forms for Release of a Benefits
Planning Query (BPQY) to an Authorized 3rd Party
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Benefits Planning Query (BPQY)Confidential Social Security Data
NAME: SSN:
Social Security Disability Insurance (SSDI)
Supplemental Security Income(SSI)
RECORD See Below See Below
CASHType of Benefit
Current Status
Statutory Blindness
Date of Disability Onset
Date of Entitlement
Full Amount
Net Amount
Others Paid on This Record
Total Family Cash Benefit
Overpayment Balance
Monthly Amount Withheld
Disabled Adult Child
Current Pay
No
8/31/91
08/91
$167.00
$78.00
No
$167.00
$0.00
$0.00
Disabled Individual
Current Pay
No
08/01/04
08/04
$456.50
$456.50
No
$0.00
None
MEDICAL REVIEWSNext Medical Review
Medical Re-exam Cycle
06/11
7+ years
09/23/07
3+ years
REPRESENTATIONRepresentative Payee
Authorized Representative
Yes
No
Yes
No
SSA-2459 Date Produced: 8/7/06July 2001 Page 1 of 2
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(Benefits Boot Camp)- SECT
NAME: SSN:
HEALTH INSURANCE MEDICARE MEDICAID
Type PART A PART B PART C/D State determination
Start 08/1993 10/2004 01/2006
Stop
Buy-In or Subsidy No No 100%
SSI WORK EXCLUSIONS
Blind Work Expense
Impairment Related Work Expenses
Student Earned Income Exclusion
PASS Exclusion
SSDI WORK ACTIVITY
Trial Work Months Start: End: Used: 0 Months
Month of Cessation N/A
Current SGA Level $860.00
RECENT EARNINGS ON RECORD
YEAR EARNINGS YEAR EARNINGS MONTHS EARNINGS MONTHS EARNINGS 1989 $481.56 1990 $0.001991 $1,100.59 1992 $37.411993 $0.00 1994 $365.791995 $50.00 1996 $53.441997 $114.18 1998 $0.001999 $0.00 2000 $0.002001 $0.00 2002 $0.002003 $0.00 2003 $742.86
SSA-2459 Date Produced: 8/7/06July 2001 Page 2 0f 2
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SSI:A federal program that provides monthly payments to
persons with disabilities on a needs basis
Eligibilityo Have little or no unearned incomeo Be considered medically disabledo Initially not be working or working and earning less
than the Substantial Gainful Activity (SGA) level ($940 in 2008) $980 in 2009
o Have limited countable resources ($2,000 for an individual and $3,000 for an eligible couple in 2009)
2009 Federal Benefit Rate (FBR)o $674 (individual)/ $637 in 2008o $1,011.00 (eligible couple)/ $956 in 2008
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(Benefits Boot Camp)- SECT
SSI & Work Incentives:
EXCLUSIONS General
o Excludes first $20 of incomeo Applies to unearned or earned income
Earnedo Excludes first $65 of earned incomeo Excludes one-half (1/2) of remaining gross
earnings
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(Benefits Boot Camp)- SECT
SSI & Work Incentives
PLAN FOR ACHIEVING SELF-SUPPORT
STUDENT EARNED INCOME EXCLUSION
Property Essential to Self-Support (PESS)
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(Benefits Boot Camp)- SECT
Other SSI Work Incentives
1619 a & b StatusPublic Law 99-643 - will not lose SSI eligibility due to exceeding SGA
Reinstatement of Eligibility Without a New Application
Section 301: Continued Payment under a Vocational Rehabilitation Program
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Both SSI & SSDI Work Incentives
IMPAIRMENT RELATED WORK EXPENSE
SSI
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SSDI/SSDACAn earned entitlement that enables former workers, who due
to a disability are unable to work, to receive monthly cash benefits and Medicare insurance
Eligibility (SSDI)o Have worked and paid Social Security taxeso Be considered medically disabledo Not be working, or working and earning less than the
Substantial Gainful Activity (SGA) level ($980 in 2009/ $940 in 2008)
Eligibility (SSDAC)o Be a dependent of an insured worker who is disabled, retired,
or deceasedo Under age 18, or 18 years of age or older and who has become
totally and seriously disabled before age 22o Not be working, or working and earning less than the
Substantial Gainful Activity (SGA) level ($980 in 2009/ $940 in 2008)
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(Benefits Boot Camp)- SECT
SSDI/SSDAC & Work
Trial Work Periodo Allows an individual to continue to receive their
check regardless of the amount of money they earn
• $700 in 2009/ $670 in 2008• 9 months - do not need to be consecutive – in a 60
month rolling period
Extended Period of Eligibilityo Protects an individual’s eligibility but not
his/her checko 36 consecutive monthso Earnings over SGA will affect check
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(Benefits Boot Camp)- SECT
Other SSDI Work Incentives
Impairment Related Work Expenseo Allows an individual to deduct the cost of certain
items/services from their gross wages in order to keep earnings below SGA
Subsidy & Special Conditions
Section 301: Continued Payment under a Vocational Rehabilitation Program
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(Benefits Boot Camp)- SECT
Medicaid
A federal/state funded medical assistance program
administered by the Indiana Family and Social Services
Administration (FSSA)
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(Benefits Boot Camp)- SECT
Medicaid EligibilityMust be substantially impaired per the definition of disability in State law:
• A physical or mental impairment, disease, or loss • Appears reasonably certain to last twelve (12) months or
more• Substantially impairs the person’s ability to perform labor
or services or to engage in useful occupation• Determination of disability is based on the individual’s
age, education, work experience, and functional limitations
Must meet certain income and resource limits:• 2009 Income Standard is $674 (individual) and $1,011.00
(couple) * will most likely follow SSA guidelines for 2009
• 2009 resource limits are $1,500 (individual) and $2,250 (couple)
Must be a resident of Indiana
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Medicaid & Work
Spend-downo Enables recipients to qualify for
some Medicaid when their income exceeds the Medicaid Monthly Income Standard
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Medicaid & Work
1619 Status “the big gun!!!”o1619 (a)• Must receive SSI & Medicaid• Protects an individual’s Medicaid
eligibility without a spend-down when earning exceed SGA
o1619 (b)• Must receive SSI & Medicaid• Protects an individual’s Medicaid
eligibility without a spend-down when his/her SSI check is reduced to zero (0) due to earnings
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Medicaid & WorkMedicaid for Employees with Disabilities (MED Works)
o Eligibility• Meet state definition of disability• Between ages of 16 and 65• Be engaged in a substantial and reasonable work effort• Have monthly income that exceeds the spend-down income
standardo 2009 Income Limit = $3,159 (as of 3/1/09)o 2009 Resource Limits
• $2,000 (single)• $3,000 (couple)
o Monthly premiums • Must pay premium based on gross monthly income• Zero (0) premium for single persons earning less than $1,353 or
married couples earning less than $1,821 (as of 3/1/09)
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Example: Joe receives $850.00 SSDI each month. He obtains a job as an Auto Technician working 20 hours a week. He earns $7.00 an hour.
Note: Gross Monthly Earned Income: Hours X $ X 4.3 (weeks) = GMEI (20 X 7 X 4.3 = $602.00)
Unearned Income Only- Spend down
(Before Obtaining Employment)
Step 1 $ unearned income (e.g., SSDI)
- 15.50 general disregard $ total countable income
Step 2 $ total countable income
- 623.00 income standard $ spend-down
Earned and Unearned Income- Spend down
(Before MED Works)
Step 1 $ unearned income - 15.50 general disregard $ countable unearned income Step 2 $ gross monthly earned income - 65.00 earned income disregard $ revised earned income ÷ 2 divide by 2 $ countable earned income Step 3 $ countable unearned income + countable earned income $ total countable income Step 4 $ total countable income - 623.00 income standard $ spend-down amount
850.00
834.50
834.50
211.50
850.00
834.50
602.00
537.00
268.50
834.50268.50
1103.00
1103.00
480.00
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(Benefits Boot Camp)- SECT
2009 MED Works Premiums
GrossmonthlyIncome
as a
percentof FPG
<150% 150%≤175% >175%≤200% >200%≤250% >250%≤300% >300%≤350% >350%
Single
GrossMonthlyincome
$0-$1,353
$1,354-$1,580 $1,581-$1,8050
$1,806-$2,257 $2,258-$2,708 $2,709-$3,159 $3,160.+
MonthlyPremium $0 $48 $69 $107 $134 $161 $187
Married
GrossMonthlyincome
$0-$1,821
$1,822-$2,125 $2,126-$24292 $2,430-$3,036 $3,0374-$3,643
$3,644-$4250 $4,251+
MonthlyPremium $0 $65 $93 $145 $182 $218 $254
Please note: Gross monthly income must be at or below the high dollar figure within a given percentage range. For example, in a family size of one, an individual must earn $1,276.00 (gross monthly) or less to qualify for MED Works with no premium. If that same individual earns $1,276.01, earnings would be rounded up to the next income level of $1,277.00, resulting in a $48 monthly premium.
Note: To figure out the premium add gross earned income with unearned income to equal gross monthly income.
Example: $ 602.00 gross earned income (wages)+ 850.00 unearned income$1452.00 total gross monthly income premium cost: $ 48.00
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Medicare
A federally funded health insurance program for individuals:
Aged 65 or older
Have end-stage renal disease
Receiving SSDI/SSDAC benefits
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Medicare & WorkReceive at least 93 months of premium-free hospital insurance (Part A) after Trial Work Period even with earnings over Substantial Gainful Work Activity.
Medicare could continue if you never work over Substantial Gainful Activity.
Medicare Buy-Backo Purchase Medicare If it’s stopped due to worko Options
• Part A & Part B• Part A only
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(Benefits Boot Camp)- SECT
Other Entitlement Work Incentives
The Indiana Food Stamp Program
Section 8 Housing
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Acronyms
BPQY Benefits Planning QueryBWE Blind Work ExpenseCDR Continuing Disability ReviewDDS Disability Determination ServicesEPE Extended Period of EligibilityFBR Federal Benefit RateFPG Federal Poverty GuidelineIRWE Impairment-Related Work ExpenseMAD Medicaid for the Disabled – Full CoverageMADW Medicaid for the Disabled – Working IndividualMADI Medicaid for the Disabled – Medically ImprovedPASS Plan for Achieving Self-SupportPESS Property Essential to Self-SupportPMP Primary Medical ProviderSGA Substantial Gainful ActivitySSA Social Security AdministrationSSDAC Social Security Disabled Adult/ChildSSDI Social Security Disability Insurance (Title II)SSI Supplemental Security Income (Title XVI)TWP Trial Work PeriodUWA Unsuccessful Work AttemptWIPA Work Incentives Planning and Assistance BPAO Benefits Planning, Assistance, & Outreach
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(Benefits Boot Camp)- SECT
Contact Information
The Supported Employment Consultation and Training (SECT) Center
1100 BroadwayAnderson, IN 46012www.sectcenter.org
Dennis Born, S.E.C.T. Director Denise Norris
Trainer/Consultant Community Work Incentive Coordinator
765.641.8382 765.635.4439 [email protected] [email protected]