1. ADEN SSA Work incentive training series
Case study in SSDI
Welcome to the American Dream Employment Networks core competencies training series. This training will focus on Impairment Related Work Expenses, a Work Incentive for SSA disability beneficiaries. ADEN is a division of National Disability Institute.
Kevin Nickerson, ADEN Co-Director
American Dream Employment Network (ADEN)
American Dream Employment Network, a division of National Disability Institute, is an authorized Social Security Ticket to Work service provider.

2. agenda Review of Case Study Materials Questions specific to Case Study
General Q&A
Notes:
Recommended to take notes help track of case details
Cornell University has approved this training for 2 hours of CEUs for Cornell Benefits and Work Incentives Practitioner certification

3. Initial assessment Personal Info: Disability and benefits info:
ADEN Member hosted a Beneficiary Outreach event and Steve requested to meet with the ADEN Member afterwards.
initial assessment and review of intake information:
Personal Info:
Steve is 42, married and has two children ages 12 and 15
Disability and benefits info:
On SSDI benefits since December, 2011
A back injury, and is concerned about losing his health care insurance as a result of his return to work since he is regularly seeing his doctor still
Concerned lifting requirements of any potential job, which is why he wishes to target management positions within retail, which his doctor supports

4. Case study info Past work history: Educational background:
Currently unemployed, worked 5 months in 2016
Jobs in retail in the past, and held two positions in management
Had a gap in employment
Educational background:
H.S. diploma, and has some business management college courses; no college degree
Employment goal:
Willing to work full-time for the right position
Work in retail management, starting with part-time work and then preferably no more than 40 hours/week

5. Needed services Needed services / impression Other info:
States he could use some assistance brushing up on his computer skills
Need staff supports to assist with things such as his resume, cover letters, and how to make sure he is connected to all potential job leads
Personable, but stated he hasn’t been on an interview for a management position in many years and is concerned he won’t be able to land a management job without a degree
Other info:
Has his own vehicle
Steve indicated he would like to invest in a home; currently renting a home
No services from VR or another EN

6. Initial impression
What kind of services might Steve be eligible for to assist him in the return to work?
ADEN
State Vocational Rehabilitation agency
American Job Center (AJC)
Benefits Planning and Work Incentive Guidance (from an EN or from Work Incentive Planning and Assistance)
Financial counseling services for home buying
What are your next steps with Steve?
Follow the ADEN Ticket Assessment Guide

7. Decision point 1 Does Steve have a Ticket that is assignable? YES
Is Steve appropriate for Ticket program?
Very well could be, further assess needs
Can ADEN Member provide services Steve needs, what should you consider?
If Steve wants to work immediately, then assign the Ticket.
If Steve wants more education, then decide whether to refer to VR or assign Ticket. It could be possible he would get financial aid (Pell/TAP) and use work incentives for other expenses (books, gas)
Can VR serve him immediately?
What can VR offer than ADEN does not?
Decided: Need more information from Steve

8. Progress Update: More information about Steve
He had a bout with cancer, which is now in remission. He worked for a Home Improvement company for about 15 years, his longest employer, where he worked his way up the ladder to management. Steve had to leave that job due to his deteriorating condition, and ongoing treatments. This was his last job. He worked for five months at a retail business; laid off due to lack of work. He was earning $900/month at this job. After some initial career counseling with Steve, he decides that now would be a good opportunity for him to return to school to complete his Business Management degree. Because his wife is not working, he is sure he will be eligible for federal aid and state tuition assistance (if applicable). You also discover that Steve has more than a few college credits; he had one full year of credits toward his AS in Business Management.

9. Decision point 2 Option 1: refer to VR
If referral to VR, inform Steve to come back to ADEN after VR services. If Steve goes to VR first, Phase payments are not available to ADEN later. CDR protections apply.
Option 2: Assign Ticket to ADEN
If Steve can get financial aid and he can pay for transportation and books, he could assign to ADEN. ADEN would be able collect all payments. Assuming Steve made the decision to work with ADEN vs. VR, the assignment of the Ticket would not need to wait; he will need the services ADEN can offer prior to college graduation, as well as the medical CDR protections Ticket offers.
Action: Explain both options - Steve chooses ADEN

10. Benefits and work incentive advisement (bwia) services
What is the first step?
If ADEN Member is not certified?
refer to WIPA
If ADEN Member is certified?
Obtain BPQY
More Information about Steve: Steve attends community college to complete his AS in Business Management. You are now ready to take next steps in helping him achieve his goal of working as a manager in retail. You access the BPQY and review any earnings David has had since he started receiving SSDI. This provides a baseline for work incentives guidance and help determining if his SSA record is current.

11. BPQY Data Key BPQY Data: Type of Benefit: SSDI Current Status: In Pay
Date of Disability Onset: 6/3/2011
Date of Entitlement: 12/2011
Full Amount: $1,127
Others Paid On This Record: Yes
Total Family Cash Benefit: $1,788
Overpayment Balance: $0
Medical Review: 6/17
Medical Re-exam cycle: 3 years
Trial Work Period Months Used: 0

12. Next steps: focus on benefits
What other questions should you ask Steve about benefits?
How old are David’s dependent(s)? In this case, he has two children, now ages 13 and 16.
Is the family receiving any other public benefits? SNAP? QMB? HEAP? Health Insurance?
How does Steve’s work impact Dependents benefits?
Steve’s youngest dependent will continue to receive benefits until age 18 or until graduation from HS, therefore this should be taken into account when looking at replacement value of the total benefits Steve and his family receive. Remember if Steve’s benefits cease, so do Dependents benefits.
Based on the BPQY, how much in Dependents benefits do his children receive?
Total Family Cash Benefits ($1,788) – Steve’s SSDI ($1,127) = $661 (Dependents benefits total)

13. More focus on benefits details
What Work Incentives has Steve used, if any?
Steve has used 5 of his TWP months when he worked the retail job in 2016; the TWL amount in 2016 was $810/month and his earnings were $900/month, therefore, he used TWP months during that time.
Why does the BPQY not show the use of Trial Work Period months?
It is possible Steve was not reporting wages to SSA. Alternatively, he may have reported wages, but SSA did not record these wages in his record. This should be corrected with SSA by providing wage data for that period of work.
What SSA work incentive, if any, might be appropriate in supporting Steve while he is attending college?
 Plan to Achieve Self-Support (PASS), potentially

14. PASS?
Is Steve a good candidate for PASS? What questions would you need to ask to sort this out?
You need information about Steve’s assets, as he would need to meet all SSI criteria.
You need to run numbers to evaluate how much he’d need to set aside to potentially be eligible for SSI. Remember the PASS deduction comes after the 2 for 1 rule, making this a powerful incentive, but not right for every situation.
You need to look at the total amount of the PASS expenses, to see if developing this incentive would make sense.

15. PASS? Doing the math Basic Math: SSDI = $1,127 General exclusion = $20
Remainder = $1,107
PASS = $500 (Example)
Remainder = $607
SSI FBR = $735 (federal only – why this rate?)
Subtract countable wages = $607
Total SSI amount = $114
Conclusion: In Steve’s situation, PASS may not be the greatest solution to pay for books and transportation costs unless these expenses were fairly large over the year he attended school. Additionally, he would need to set aside a large amount of his SSDI check to cover PASS, therefore, it probably would not be the most effective use of PASS in this situation.

16. Other areas to Focus on benefits
What other service may help Steve pay for transportation expenses while he was attending college?
Supportive service funding through the AJC. This would need to be coordinated with the WIOA case manager for approval, and availability of funding will vary from state to state.
Can he car pool with another student?
Any local program that provides small amounts of funds for such expenses? Does the college have any information to explore?

17. Financially viable
Based on the facts provided to you, roughly how much would Steve need to earn each month to make losing SSDI benefits financially viable for his family?
David’s benefits = $1,127
Dependents benefits = $661
SGA = $1,170/month
Total benefits + SGA = $2,958
NOTE: This calculation only applies while his children are receiving dependents benefits.
What would it take for benefits replacement, using this logic, if no dependents benefits?
Why does this logic make sense?

18. Progress update: You have learned about Steve
Based on the meetings you have had with Steve, you now understand the following:
 After Work Incentive advisement, Steve is now ready to try working full-time. His initial decision to work part-time had more to do with his lack of understanding of benefits, and his concern of not being able to replace the amount of benefits he receives through work activity. Now he understands that he has a period of time to evaluate his ability to work full-time. Based on his schooling schedule, Steve has discovered he is capable of a schedule that would mimic full-time work
Steve is anxious to get back to work and earning as much as possible. He should also command more money now that he has his AS degree.

19. Progress update: information Steve has learned
Either you have already made a referral to WIPA or you have provided advisement to Steve directly regarding his SSA disability benefits and Work Incentives.
Steve now knows:
He can receive 9 Trial Work Period (TWP) months in order to try returning to work with NO penalties to any of his Social Security Administration (SSA) benefits.
He has used 5 of his 9 TWP months, leaving 4 available for use.
After he uses up all of his TWP months, he is then provided a 36 month Extended Period of Eligibility (EPE), during which, insurance is maintained, and benefits are maintained if his earnings are below a certain threshold SSA calls the Substantial Gainful Activity (SGA) limit of $1,170 gross / month in earnings.
He is more interested in getting back to work gainfully, than he is in maintaining his SSDI benefits.

20. Progress update: Steve starts work
With the assistance of ADEN, Steve is offered employment, and begins working June 1, 2018.
He is offered a management position which will start out at 20 hours/week, at $16.50/hour. He is told he will eventually move to full-time hours after about 6 months.
During his first month of employment, Steve is told there is some heavy lifting that managers often assist with, such as unloading trucks. Steve confides in his supervisor that he has a back injury, and his supervisor removes Steve from unloading duties. His supervisor also allows him to call upon other store associates as needed if there are tasks that require him to lift beyond his capacity.

21. Benefits analysis questions: Impact of new job
Estimate Steve’s gross wages for this position.
Gross Wages = 20 x x 4.33 = $1,428.90
How does this impact his use of work incentives, specifically, TWP months?
Steve will be using TWP months as a result of this position. Since he has 4 TWP months left, his last TWP would be September,
When will Steve’s EPE begin and end, assuming work continues?
Steve’s EPE would begin in October, 2018, and therefore would end September, 2021.

22. Benefits analysis questions to consider
Will this part-time position be worth forgoing benefits for Steve and his family? If not, what should you do next to support him?
No, part-time wages of $1, wouldn’t replace his total family benefits of $1,788.
What work incentive might help Steve maintain benefits while he is working part-time, and why?
Subsidy. Based on the description of Steve’s work, it is apparent that he is being given certain considerations based on his back injury, such as extra help, and fewer or easier duties.

23. Subsidy development: what we know
Since Steve is receiving supports (accommodations) on the job, this is a flag for you to consider the use of a work incentive such as subsidy. This will help reduce countable wages potentially below SGA. Steve indicated two areas of assistance that SSA will look at under Subsidy. Below is a list from form SSA-3033, Work Activity Questionnaire, which is how SSA will evaluate whether wages are subsidized.

24. Subsidy development: Can it apply?
Based on the information you have been provided, will Subsidy work in this case?
Yes, Steve indicated he is provided “Fewer or easier duties”, and he also receives “Extra help”.
Explain how this will play out, assuming there are subsidized wages in this situation?
While it is up to the employer to ultimately decide the percent of subsidized wages, it is your job to help guide the process. Since there are ten categories that SSA examines when determining subsidized wages, and two of these categories seem to apply to Steve, you could say that he has a 20% subsidy. The next slide shows the next question the employer must fill out in this form that will establish the percent of subsidized wages:

25. Subsidy development (cont.)
Assuming you and the employer complete the form based on “80% of other employees’ productivity” (a 20% subsidy), this is how the math would work:
Remember that Gross Wages – Work Incentives = Countable Wages
(Gross wage) $1, – (20% of total) $ = $1,143.12
Countable wages are what SSA looks at in making SGA determinations. Based on the use of this work incentive, Steve’s countable wages are now below the SGA level, therefore, he would continue to receive SSDI benefits while working at this level of income.

26. Subsidy and EN payments
How does Subsidy development impact EN payments?
Since Steve has no VR history, and has never worked with another EN, and since his previous work wouldn’t impact Phase 1 Milestone payments, ADEN in this example would be eligible for Phase 1 Milestones based on this work activity. If work continued at part-time, ADEN would also be eligible for Phase 2 Milestone payments since earnings are over SGA, but he continues to be in receipt of Federal cash benefits.

27. Progress update: news from job
Steve continues to work part-time, and in October 2018 he is offered full- time employment. He will now be working 40 hours/week at $17.50/hour, or $3,031/month in gross wages. He also has the option of employer sponsored health care at a reasonable cost. Steve is excited about the prospects of now working full-time again, but needs further guidance regarding his benefits.
September, 2018 – Last TWP month used
September, 2021 – End of EPE

28. New Benefits questions
Steve is eligible for a Grace Period, when would SSA determine this would occur?
SSA would look at October, 2018 as Steve’s cessation month. The first cessation month, and the two months following would constitute Steve’s Grace period, therefore it would occur October – December, 2018.
What will happen to Steve’s Medicare benefits, will he still be eligible?
He will continue to receive Medicare for at least 93 months after the TWP has been completed.
How are Medicare Premiums handled if there is no disability cash benefit being paid to Steve?
SSA will bill him quarterly for Part-B premiums which he would need to pay directly.

29. Final benefits questions
When would Steve’s benefits terminate, assuming he keeps working?
Benefits would terminate the first month outside of the EPE, which would occur October, 2021.
What if Steve has to stop working, what work incentive could be used to help him get benefits back? Until what date could this incentive be used?
Expedited Reinstatement of Benefits (EXR). This would be available until September, EXR can be applied for up to 60 months after benefits termination. Based on recent changes, SSA now allows a former beneficiary to apply in the same month they stop working at SGA level.

30. Progress update: Steve’s life now and prior to ticket assignment
Steve came to you over a year ago with family income of $21,456/year including Dependents benefits.
After increasing his skills, and returning to work full-time, Steve’s family income has increased to $36,372/year. He will have room to grow in the company he works for, and will be provided cost of living adjustments that far outpace any annual SSDI benefits adjustments.
He is now saving for retirement again, with an employer matched 401(k), and his taxes from earnings will improve his eventual SSA retirement benefit amount.
If Steve’s health becomes an issue in the future, there are options to return to the benefits roles if needed through Expedited Reinstatement of Benefits (EXR).

31. The big picture
While it is typical that individuals may utilize VR services first in situations like this, it is also possible in some cases to find the necessary funding through other means, as Steve did.
Work incentives can help become a bridge in some cases, to preserve benefits until such time as it is financially viable to leave them behind.
Understanding SSA work incentives, and providing a road map to Participants about how work impacts benefits allows for informed choice, and removes fear – A wise investment of staff time that leads to improved employment outcomes

32. American Dream Employment Network (ADEN)
ADEN Co-Directors of
American Dream Employment Network (ADEN)
Mary Lynn ReVoir Kevin Nickerson
As always, if you have any questions, or would like additional information and support regarding any of our training topics, or have specific technical assistance needs, please feel free to contact myself, or Mary Lynn. Thank you for viewing this training, and for your support of ADEN Participants.