1. Social Security Disability Benefits 101 Mary Glanden, WIP

2. This Presentation is Brought to You By:
LandAjob is a national Employment Network of Social Security Administration’s Ticket to Work program.
At LandAjob, our mission is to provide individuals with disabilities with supported employment. Through work expense reimbursement and guidance on work incentives, we help consumers maximize their financial outcome.

3. Social Security Disability Insurance (SSDI)
9 Months Trial Work Period (TWP)
36 Months of Extended Period of Eligibility (EPE)
Impairment Related Work Expense (IRWE)
Extended Period of Medicare Eligibility (EPMC)
Expedited Reinstatement (EXR)

4. Social Security Disability Insurance (SSDI)
Social Security Disability Insurance (SSDI) is also known as Title 2. It provides payments to disabled workers, i.e. individuals who have worked and paid Social Security tax on their earnings.
You have to worked long enough and recent enough to qualify. The SSDI amount you receive each month is based on your average lifetime earnings.
If you have not worked long enough or recently enough, you will not qualify. No matter how severely disabled you are.
SSDI is not a means tested program. It doesn’t matter how much unearned income or resources/assets you have.

5. 9 Months Trial Work Period (TWP)
9 service months in any 60 months (5 years) period = 1 service month used when earnings are above Trial Work Level (TWL) $840 in 2017
$810 is TWL for 2016
Benefits no matter how much earned (as long as you remain medical disabled)
No other work incentives apply during this period
Only 1 Trial Work Period per period of disability
Your income is based on when it is earned (Pay Period), not when it is paid (Pay Date or Check Date)
The Bipartisan Budget Act of 2015 simplifies post entitlement SGA determinations by allowing us to presume earnings were earned in the month they were paid. However, prior to applying this paid versus earned assumption, you will evaluate any readily available earnings verification sources and determine when earnings were earned. If you have no other readily available evidence to determine when earnings were earned, you will use other sources of earnings verification even if the earnings source only documents when earnings are paid. This new policy will apply to all post entitlement determinations made after September 23, 2016, including trial work period and reopening determination.

6. EXAMPLE: How to calculate TWP?
Anna gross earnings went over TWL in the following months, what month of her TWP is she in as of Jan 2017?
Dec 2009
Jan 2010
Feb 2010
Mar 2010
Apr 2010
May 2010
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
EXAMPLE: How to calculate TWP?

7. TWP Tracking Sheet: Dec 2009 Jan 2010 Feb 2010 Mar 2010 Apr 2010
Year
Jan
Feb
Mar
Apr
May
Jun
July
Aug
Sept
Oct
Nov
Dec
2009 1
2010 2 3 4 5 6 7 8 9 10 11 12 13
2011 14 15 16
17  18
19  20
21  22
23  24 25
2012 26
27  28
29  30
31  32 33
34  35 36
37 
2013 38
39  40 41
42  43
44  45
46  47
48 
49 
2014 50
51 
52  53 54
55  56 57 58
59  60
2015
2016
2017
Dec 2009
Jan 2010
Feb 2010
Mar 2010
Apr 2010
May 2010
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017  Anna used 6 of her 9 months Trial Work Period
TIP: It is best to map it out to make sure there are no 9 service months used within a 60 month period. Within 60 months (5 years), Anna’s Dec 2009 earnings are dropped after Nov Her 2010 earnings are dropped after Apr 2015.

8. 36 Months of Extended Period of Eligibility (EPE)
36 months start after the last month of the Trial Work Period
Does not matter if earnings are below SGA
Get SSDI in months where countable earnings are under Substantial Gainful Activity (SGA) $1170 or $1950 for blind (as long as you remain medically disabled)
Get no SSDI in months where countable earnings are above SGA
SSA can reinstate SSDI benefits without new application or a new disability determination
SGA level for 2016: $1130 and $1820 for blind

9. EXAMPLE: How to calculate EPE?
Anna’s 9th month Trial Work Period is Dec When does her EPE run?
Answer: Jan 2017 – Dec 2019 (36 months)
Example: In Nov 2018, Anna becomes stressed and cannot work full-time. Her earnings drop below SGA. What happens?
Answer: Anna is within her EPE and her SSDI benefits are reinstated right away without her filing for a new application.
EPE Tracking Sheet:
Year
Jan
Feb
Mar
Apr
May
Jun
July
Aug
Sept
Oct
Nov
Dec
2016 1 2 3 4 5 6 7 8 9
TWP ends
2017 6  8 
10 
11  12
2018
13  14 15
16  17
 18
19  20
21  22
23  24
2019
 25
26  27
28  29
30  31
32  33
34  35
36 EPE ends
EXAMPLE: How to calculate EPE?

10. Impairment related work expense (IRWE)
After your TWP, SSA is looking at your countable income, not your gross income. Countable income does not include sick time and vacation time. Also, you can reduce your countable income by using your Impairment Related Work Expense (IRWE) work incentive.
An IRWE is an item or service that you pay for because of your impairment and because you need it for work.
Social Security deducts the cost of certain impairment related items and services that you need to work from your gross earnings when deciding if your work is substantial gainful activity.

11. How Do IRWEs Work? EXAMPLE:
Anna’s gross earnings for Jan 2017 is $ She has an approved IRWEs of $100.
$ $100 = $1100  this is less than SGA $1170, which means Anna gets to keep her SSDI because her countable earnings is $1100 and that is below SGA!
IRWEs lower your countable earnings allowing you to earn more income and maximize your financial outcome. You can utilize IRWEs as long as you need the impairment related item or service. IRWEs allow you the time you need to become self-sufficient.
You need the item or service because of physical or mental impairment
An item or service enables you to work
You pay for the item or service and are not reimbursed by another source
The cost is reasonable (fair market value)

12. EXTENDED PERIOD OF MEDICARE COVERAGE (EPMC)
Medicare is the SSDI health insurance
Medicare coverage will continue as long as you receive your SSDI
You will continue to receive your Medicare Coverage for at least 93 months (7 years and 9 months) after your TWP.
Most beneficiaries keep it far longer than that!

13. Expedited Reinstatement
If your benefits are terminated because of your earnings, you have 60 months (5 years) to use your Expedited Reinstatement (EXR) work incentive!
EXR allows you to request to have your benefits reinstated without having to complete a new application. While SSA determines your case, you are eligible to receive temporary benefits for up to 6 months (benefits include cash and Medicare).
You must have the same disability
If denied, you do not have to pay back the 6 months of benefits!
The EXR must be filed within 60 months of the date of termination of entitlement. For SSDI, the EXR start date is the first SGA month after the 36 months of the EPE.
Expedited Reinstatement
EXR Tracking Sheet:
Year
Jan
Feb
Mar
Apr
May
Jun
July
Aug
Sept
Oct
Nov
Dec
2016 1 2 3 4 5 6 7 8
9 TWP ends
2017 6  8  9
10 
11  12
2018
13  14 15
16  17
 18
19  20
21  22
23  24
2019 25
26  27
28  29
30  31
32  33
34  35
36 EPE ends
2020
2021
2022 36
2023 37 38 39 40 41 42 43 44 45 46 47 48
2024 49 50 51 52 53 54 55 56 57 58 59
60 EXR ends

14. Concluding Thoughts:
One of the biggest fears about working is losing your disability benefits and health care coverage. However, there are many safety nets called work incentives.
With 9 Months Trial Work Period, 36 Months (3 years) Extended Period of Eligibility, 60 Months (5 years) Expedited Reinstatement, that is 8 years and 9 months of protection!
This presentation only reviewed some of SSDI’s work incentives, there are additional SSDI work incentives that may apply to you.
Last but not least, this is a general guide to SSDI’s work incentives. Where you fall in relations to the work incentives is dependent upon your previous work history, what Social Security has on record for your work history and earnings, a lot of factors goes into mapping out your benefits and work incentives. DO NOT rely on this guide to make conclusive determinations about your specific and unique case.

15. Supplemental Security Income (SSI)
Income and Assets
Impairment Related Work Expense (IRWE)
Medicaid and 1619(b)
Expedited Reinstatement (EXR)

16. Supplemental Security Income (SSI)
Supplemental Security Income (SSI) is also known as Title 16. It provides payments to individuals who are disabled and have limited income and resources/assets.
If your income and/or resources/assets are too high, you will be turned down for SSI no matter how severe your medical disorders. You will be turned down even if you have not paid enough in Social Security tax to qualify for SSDI.
The Federal Benefit Rate (FBR) for 2017 is $735 per month for individuals ($1103 for couples). Your income cannot exceed $735 per month.
Most states supplements Federal SSI benefits with additional payments. For Massachusetts, the State Supplement Program (SSP) for 2017 is $
Individuals on SSI receives $ in MA
Assets cannot exceed $2000 per month for individuals ($3000 for couples)
Supplemental Security Income (SSI)

17. INCOME Types of Income: Earned = from work
Unearned = from another source (SSDI, unemployment, annuities, pensions, alimony, dividends, interests, inheritance, etc.)
Deeming = from someone else’s income (parent or spouse)
In-kind = shelter or food received free or at reduced cost (capped at 1/3 FBR)
In 2017, this translates to a reduction of $245 from $735 = $490.
What is not income?
Tax refunds
Loans (spent in month received)
Bills paid by 3rd parties directly to the vendor for other than food and shelter
Student loans
EITC and child tax credit payments
For more information on SSA’s definition of income, please visit:

18. How is Income Calculated?
General Income Exclusion: $20 is excluded from unearned income (SSDI, unemployment, annuities, interest, inheritance, settlements, etc.)
Earned Income Exclusions: $65 is excluded from earned income (from work)
Income = Gross pay – (minus) exclusions ÷ (divided) by ½
If you have no unearned income, your total exclusion is $85
Example #1: How to calculate unearned income?
Anna receives $520 per month in SSDI, how much will she receive in SSI?
$520 - $20 (general income exclusion) = $500 countable SSDI
$735 (SSI FBR) - $500 = $235  SSI payment + state supplement
TOTAL INCOME: $520 (SSDI) + $235 (SSI) = $755
Example #2: How to calculate work income?
Anna receives $735 (SSI FBR), has no unearned income, and decides to take a job paying $885 in gross wages per month, how does work affect her SSI?
$885 - $85 (general + earned income exclusion) = $800 ÷ by 2 = $400  countable gross monthly income
$735 - $400 = $335  SSI payment + state supplement
TOTAL INCOME: $885 (Anna’s gross wages) + $335 (SSI) = $1220

19. SSI WORK INCENTIVE – IMPAIRMENT RELATED WORK EXPENSE!
An Impairment Related Work Expense is an item or service that you pay for, that you need because of your impairment and because you need it for work.
Social Security deducts the cost of certain impairment related items and services that you need to work from your earned income when determining your SSI monthly payment amount.
Example #3: How to calculate work income including IRWEs?
Anna receives $735 (SSI FBR), has no unearned income, and decides to take a job paying $885 in gross wages per month. Anna has an approved IRWEs of $100, how does work affect her SSI?
$885 - $85 (general + earned income exclusion) = $800 - $100 (IRWEs) = $700 divided by 2 = $350  countable earned income (vs. Example #2, $400 in countable earned income)
$735 - $350 = $385  SSI payment + state supplement (vs. $335 in SSI payment without IRWEs)
TOTAL INCOME: $885 (Anna’s original gross income) + $385 (SSI) = $1270 (vs. $1220 in total income without IRWEs)
Similar to SSDI, IRWEs lower your countable earnings so that you can maximize your financial outcome. You can utilize IRWEs as long as you need the impairment related item or service. IRWEs allow you the time you need to become self-sufficient. And:
You need the item or service because of physical or mental impairment
An item or service enables you to work
You pay for the item or service and are not reimbursed by another source
The cost is reasonable (fair market value)
KEY TAKEAWAY: While your SSI may reduce or even stop, your TOTAL INCOME will always be higher than $735! Your financial outcome will always be better!
In 2017, for your SSI payment to reduce to $0 with no work incentives, you need to earn $1555.
SSI WORK INCENTIVE – IMPAIRMENT RELATED WORK EXPENSE!

20. ASSETS
Assets limit:
To qualify for SSI, your assets cannot exceed a certain limit. An “asset” is cash or resource that can be converted to cash and used for your support. An asset can be either liquid or nonliquid. Liquid = cash and resource that can be converted to cash within 20 working days. Nonliquid = resources that cannot be converted to cash within 20 days.
$2000 for a single person
$3000 for a married couple (even if only one member is eligible for SSI)
SSA does not count the following as assets:
Your home
Household goods and personal effects (your wedding ring and engagement ring)
One automobile, regards of value, if used to provide necessary transportation
Burial plots and burial funds up to $1500
Life insurance policies with a combined face value of $1500 or less
Retroactive SSI benefits (back payments) for up to 9 months after you receive them
For more information on SSA’s definition of assets, please visit:

21. Medicaid is the SSI health insurance (in MA this is Masshealth)
Medicaid coverage will continue as long as you receive a monthly SSI payment (even as little as $1)
In 2017, for your SSI payment to reduce to $0 with no work incentives, you need to earn $ (b) is an SSI work incentive that allows you to keep your Medicaid even if your SSI is reduced to $0. It must meet 2 requirements:
Your SSI is reduced to $0 because of earned income only! If your SSI is reduced to $0 because of unearned income or asset, then 1619(b) does not apply.
Your earned income is below state threshold. For MA: $40,333.
As long as you are in 1619(b) status, your SSI is considered suspended not terminated. This means, if your income decreases or you stop working, your SSI benefit can be reinstated right away.
Medicaid and 1619(b)

22. Expedited Reinstatement
If your benefits are terminated because of your earnings, you have 60 months (5 years) to use your Expedited Reinstatement (EXR) work incentive!
EXR allows you to request to have your benefits reinstated without having to complete a new application. While SSA determines your case, you are eligible to receive temporary benefits for up to 6 months (benefits include cash and Medicare).
You must have the same disability
If denied, you do not have to pay back the 6 months of benefits!
The EXR must be filed within 60 months of the date of termination of entitlement. As noted, while under 1619(b), even though you are not receiving an SSI payment, your SSI is suspended, not terminated. To find out if your benefits are terminated, when they were terminated, you need to consult SSA.
Expedited Reinstatement

23. Concluding Thoughts:
One of the biggest fears about working is losing your disability benefits and health care coverage. However, there are many safety nets called work incentives.
While your SSI payment may reduce or even stop, your TOTAL INCOME will always be higher than $735! Your financial outcome will always be better!
While your SSI payment may reduce to $0, you can still retain Medicaid coverage through your 1619(b) work incentive!
Last but not least, this guide covers the basics of SSI and work incentives. There are additional SSI work incentives that were not covered in this guide. Where you fall in relations to the work incentives is dependent upon your previous work history, what Social Security has on record for your work history and earnings, a lot of factors goes into mapping out your benefits and work incentives. DO NOT rely on this guide to make conclusive determinations about your specific and unique case.