working for recovery: quality work incentives planning jessica reed, ma, wibs [email protected]
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Everyone's Benefits Situation Is Different!
What is Benefits Counseling?
“Work Incentive Benefit Specialists (WIBS) assist people with disabilities by helping them wade through the complexities to make informed choices about the impact of work on their benefits. WIBS can provide a written and oral analysis of a person's services and benefits and how work will change their cash payments, medical coverage, and continued eligibility.”
http://www.wibsa.org/
Why should consumers use a Work Incentives Benefits
Specialist?• Work Incentives programs are complex
• Each situation is different
• Benefits Counseling is a specialty that requires continuing education and ongoing learning to provide accurate information
• When considering or planning for work
• Maintaining or improving healthcare
• Make informed choices about work and benefits, as well as know what safety nets are available
Why should consumers use a Work Incentives Benefits Specialist
Association (WIBSA) member?
• Lack of certification exam
• Peer Review
• Required continuing education
• Benefits programs and their rules frequently change
• Prevent or minimize overpayments
How can I find a WIBSA member?
Membership directory on Work Incentives Benefits Specialist Association website: http://www.wibsa.org/membership/membership-directory/
Why is it important to verify benefits?
• Consumers are sometimes mistaken about work incentives that are available, may have misinformation
• Every benefits situation is different
• Can be part of a demonstration project
• May have work incentives available to use you don’t know about, may be unable to use some
Social Security has two cash benefit programs for people with disabilities
• Social Security Disability Insurance (SSDI)
• Supplemental Security Income
They operate very differently when beneficiaries work for pay
What is SSDI?• Program for people with disabilities who have worked for pay and paid into the Social
Security Trust Fund through taxes.
• Childhood Disability Benefit (CDB) is a form of SSDI for persons determined to have a disability before age 22.
• CDB beneficiaries are able to draw on a parents’ record if the parent is:1. retired, 2. has been determined by SSA to have a disability or, 3. are deceased
• Obtain Medicare after 24 months of payments
What is SSI?• Needs based program to provide cash assistance to people with disabilities and seniors who have limited
income and
resources
• Examples of resources:1. cash, 2. assistance from family/spouse, 3. some trusts, 4. certain valuable possessions
• Excluded :1. one house in which you live, 2. one vehicle.
• Marriage can affect SSI, as can living arrangements
• Comes with Medicaid health Insurance
Common SSI Work Incentives
• General Income Exclusion (GIE)• Earned Income Exclusion (EIE)
General Income Exclusion (GIE)
• SSI work incentive • 1st $20 of earnings excluded
Earned Income Exclusion (EIE)
• SSI work incentive• $65 of earned income are excluded, plus $1.00 for
every $2.00 earned after that
Impairment Related Work Expenses (IRWEs)
• Out-of-pocket expenses paid for by the person with a disability,
• necessary in order to work,
• paid for in a month when working,
• reasonable,
• must be approved by Social Security prior to use
Other SSI Work Incentives
• Student Earned Income Exclusion (SEIE)-limited• Plan to Achieve Self-Support (PASS)• Ticket to Work
Break Even Point
◦ Individual amount ◦Based on earned and unearned income (SSDI, private disability)
◦Point at which cash benefits are reduced to $0
1619(b) Medicaid• Continuation of SSI related Medicaid (MA) when working above
BEP. • In 2015, can earn up to $33,622 higher amount, based on need• Must need MA in order to work• SSI asset limit still applies• It must be earnings that reduce SSI payment to $0, not unearned
income or being above asset limit
SSDI Work Incentives
Trial Work Period (TWP)
• 9 months total used within 5 year period.
• Months do not have to be back to back.
• If not complete, months can “expire”
• Once all 9 mo are used in a 5 year period, TWP is complete.
• 2015 TWP amount is $780/month
• Amount generally increases each year.
Extended Period of Eligibility (EPE)
• 3 year period, begins the month after TWP is complete. • Months are used regardless of work. • During EPE, when earnings above SGA, no cash benefit • Earnings below SGA for that month, receive cash benefit.
Substantial Gainful Activity (SGA)
• Earnings level established by Social Security at which people with disabilities are considered able to work substantially enough to no longer need benefits/meet Social Security’s definition of having a disability.
• Work incentives may be available to use to lower amount of earnings Social Security considers when determining SGA
Impairment Related Work Expenses (IRWEs)
• Out-of-pocket expenses • paid for by the consumer, • necessary in order to work, • paid for in a month when working, reasonable, • must be approved by Social Security prior to use
Other SSDI Work Incentives
• Subsidy• Special Conditions• Unsuccessful Work Attempt (UWA)• Averaging
Cessation vs Termination
Expedited Reinstatement vs
Reapplication
Health Insurance: Medicare vs Medicaid• Medicare is not comprehensive health insurance. • Available to SSDI beneficiaries who have been receiving
payments for 24 months. • 4 parts, 80% outpatient costs, drug coverage, low income
plans• Medicaid is comprehensive health insurance for
consumers. Many programs, different rules
Medicaid Purchase Plan (MAPP)• Way to buy into State’s Medicaid program through work• Higher asset limit (asset limits for other programs still apply to
those)• Way to build up savings, • Can set aside 50% annual earnings in special independence
account• Paid work vs in-kind and HEC
Other programs impacted by earnings
• FoodShare • Subsidized Housing• Medicare Savings Programs
Always report all earnings/income to Social Security
and other programs, like county benefits or subsidized housing programs
Successful employment is possible, with planning
Questions?
Thank you!Contact information: Jessica Reed [email protected] 608-246-3444 x245
http://www.wibsa.org/