Introducing the Social Security Administration's Social Security Disability Insurance Work Incentives: Helping American Indians and Alaska Natives With Disabilities Go to Work
American Indian Disability
Technical
Assistance Center
Practice Guideline
January 2005
American Indians and Alaska Natives with disabilities would often like to work, but those who receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) cash benefits, and Medicare or Medicaid health insurance coverage may be concerned about losing these benefits if they seek employment. The good news is the Social Security Administration (SSA) has work incentives that make it possible for these individuals to continue receiving these benefits until they can work on a regular basis.
What are Social Security Administration Work Incentives?
The Social Security Administration developed work incentives to help American Indians and Alaska Natives with disabilities, and others with disabilities, to achieve work goals and continue, for a time, to receive SSDI or SSI cash payments, and Medicare or Medicaid coverage. These work incentives were also developed to help increase employment and self sufficiency of SSDI and SSI recipients; thus, reducing their dependency upon disability benefits. Work incentives differ between the SSDI and SSI programs; therefore this practice guideline provides a brief overview of the major work incentives available under the SSDI program. For information about major work incentives available under the SSI program please request a copy of AIDTAC's practice guideline Introducing the Social Security Administration's Supplemental Security Income Work Incentives: Helping American Indians and Alaska Natives With Disabilities Go to Work (November 2004). Call toll free: (866) 424-3822 or visit the AIDTAC website at http://aidtac.ruralinstitute.umt.edu.
What is Social Security Disability Insurance (SSDI)?
SSDI benefits are cash payments to individuals who are disabled or blind and are "insured" through the Social Security trust fund.1 Insured status is earned by working and paying Social Security (FICA) taxes. In doing so, workers are credited with "quarters" of coverage. To be established as insured to receive disability benefits, individuals over age 31 generally need 20 quarters of coverage in the 10 years prior to the onset of disability. To be eligible for payments an individual must be determined to be medically disabled; earn under the Substantial Gainful Activity (SGA) level ($830 monthly in 2005 or $1,380 monthly, if blind); and have insured status either as a former worker, or a disabled widow/widower of a spouse who is a former worker.
What major Social Security Administration Work Incentives are available to SSDI recipients?
Substantial Gainful Activity (SGA):
This program allows the SSDI recipient to earn up to the SGA level and still receive cash benefits. In 2005, earnings over $830 (or $1,380 if blind) are considered SGA.
Trial Work Period (TWP):
This program allows the SSDI recipient to test his or her ability to work for at least nine months. During a trial work period, an individual will continue to receive full Social Security benefits regardless of how much money is earned. The trial work period continues until an individual has worked nine months within a "rolling" 60 consecutive month period.
Impairment Related Work Expenses (IRWE):
Under this program SSA, in determining SGA, will deduct from an individual's earnings the cost of certain impairment-related items and services that he or she needs to work. To qualify, the item or service must be necessary for the individual to work; the item or service must be related to the individual's disabling impairment; the item or service must be paid by the individual and not reimbursable by another source; the cost must be reasonable; and the cost of the item or service must be paid by the individual in a month during which he or she worked.
Unsuccessful Work Attempt:
This program is for the SSDI recipient who makes an effort to do substantial work, in employment or self-employment, but that work stopped or was reduced to below the SGA level after a short time (6 months or less) because of the individual's impairment, or removal of special conditions related to impairment and essential to further work performance. When SSA makes a SGA decision for initial eligibility for SSDI benefits, it does not count earnings during an unsuccessful work attempt that occurred prior to the SSDI award. When making a SGA decision to determine whether an individual's disability continues or ceases because of work, SSA does not count earnings during an unsuccessful work attempt. During the trial work period, or after the month (if any) in which the individual's disability status ceased, SSA does not consider unsuccessful work attempts because they only have effect upon a SGA decision.
Extended Period of Eligibility (EPE):
This program provides the SSDI recipient, upon completion of the trial work period, a 36 month period during which he or she can work and still receive benefits for any month in which earnings are not "substantial." During this period, SSDI benefits can begin again for any month in which an individual continues to have a disabling impairment, and his or her earnings are below the SGA level. No new application or disability decision is needed to receive SSDI benefits during this period.
Continued Medicare Coverage:
This program is available when the SSDI recipient's disability benefits stop because of substantial earnings, but the individual is still disabled. For at least 93 months, beginning the month after the last month of this individual's Trial Work Period, free Medicare Part A coverage will continue. After the premium-free Medicare coverage ends due to work, some individuals may purchase continued Medicare coverage. To qualify an individual must be under age 65, continue to have a disabling impairment, and Medicare stopped due to work.
Ticket to Work:
This SSA program provides individuals with disabilities more choices in obtaining employment services, vocational rehabilitation services, and other support services. SSDI recipients receive a Ticket to obtain services from a state vocational rehabilitation (VR) agency or another approved provider (Employment Network). The program is voluntary and services are provided free of charge to SSDI recipients.2
Plan For Achieving Self-Support (PASS):
This program allows an individual with a disability, or is blind, to set aside countable income and/or resources for a specific time to achieve a work goal. This program is available to SSDI recipients who can qualify for Supplemental Security Income (SSI) benefits. SSA will not count the income set aside under a PASS when calculating initial and continuing eligibility for SSI payments. A PASS can help an individual establish and maintain SSI eligibility, and increase SSI payment amounts. For more information about PASS please rsee AIDTAC's fact sheet Plan for Achieving Self-Support (PASS) (August 2004).3
Continued Payment Under a Vocational Rehabilitation Program (Section 301):
This program allows the SSDI recipient who is determined to no longer be disabled due to medical improvement to continue receiving disability benefits. Section 301 requires an individual to be participating in an approved program of vocational rehabilitation, employment services, or other support services at the time disability ended under SSA rules. Additionally, SSA must review the situation and decide that continued participation in the program will increase the likelihood of permanent removal from the disability benefit rolls. Under this program, disability benefits may continue until an individual completes the vocational rehabilitation program, participation in the program stops, or SSA decides that continued participation in the program will not increase the likelihood of permanent removal from disability benefit rolls. 4
Important Phone Numbers
Social Security Disability Insurance, Supplemental Security Income, and Work Incentives
Social Security Administration, Office of Public Inquiries, Windsor Park Building, 6401 Security Blvd., Baltimore, MD 21235. Call Toll Free (800) 772-1213 or Toll Free (800) 325-0778 (TTY), (7:00 a.m. to 7:00 p.m., Monday-Friday). Recorded information and services are available 24 hours a day including weekends and holidays by touch-tone telephone. Have your Social Security number available when calling. On the Internet go to http://www.socialsecurity.gov
Medicare or Medicaid Health Insurance Programs
Centers for Medicare & Medicaid Services (Formerly the Health Care Financing Administration), 7500 Security Boulevard, Baltimore, MD 21244-1850. Call Toll Free (877) 267-2323 or Toll Free (866) 226-1819 (TTY). On the Internet go to http://www.cms.hhs.gov
Endnotes:
1 Adults with disabilities who have not achieved "insured" status through payment of FICA (Social Security Taxes) may receive Title II benefits based upon their parent's insured status. To be eligible for Social Security for the Disabled Adult Child (SSDAC) benefits, an individual must be eligible as the child of someone who is receiving Social Security retirement or disability benefits, or of someone who has died, and that child must have a disability that began prior to age 22. More information is available by contacting the local Social Security Administration office. To find the telephone number for your local office, look under Social Security in your local telephone book.
2 For more information about Ticket-To-Work please contact MAXIMUS, Inc. Call Toll Free (866) 968-7842, or (866) 833-2967(TTY); or visit the SSA website at http://www.ssa.gov/pubs/10061.html
3 For more information about PASS visit the SSA website at http://www.ssa.gov/pubs/11017.html.
4 For information about other SSDI work incentives please contact your local SSA office. Call Toll Free (800) 772-1213, or Toll Free (800) 325-0778 (TTY); or visit the SSA website at http://www.socialsecurity.gov.
References:
Shelly, R., Katz, M., & Hammis, D. (2003). It Doesn't Take A Rocket Scientist To Understand & Use Social Security Work Incentives. (Available from The University of Montana Rural Institute, Adult Community and Supports/Training Department, 52 Corbin Hall, Missoula, MT 59812).
Social Security Administration. (n.d.). Welcome to the Social Security Administration's American Indians and Alaska Natives (AIAN) website. Retrieved January 10, 2005 from http://www.ssa.gov/aian/index.htm
Social Security Administration (2004, February). Red Book (SSA Publication No. 64-030). Retrieved January 10, 2005 from http://www.ssa.gov/work/ResourcesToolkit/redbook.html
Social Security Administration. (2001, April). The Ticket To Work And Self-Sufficiency Program . (SSA Publication No. 05-10061). Retrieved January 10, 2005 from http://www.ssa.gov/pubs/10061.html
Social Security Administration. (2004, February). Working While Disabled: A Guide To Plans For Achieving Self-Support. (SSA Publication No. 05-11017). January 10, 2005 from http://www.ssa.gov/pubs/11017.html
Social Security Administration. (2005, January). Working While Disabled How We Can Help. (SSA Publication No. 05-10095). Retrieved January 10, 2005 from http://www.ssa.gov/pubs/10095.html
Note: This practice guideline presents a brief overview of Social Security Administration Work Incentives. Always consult SSA guidelines when beginning the application process for work incentives.
This practice guideline is supported by a cooperative agreement (#H235K00002) with the U.S. Department of Education's Rehabilitation Services Administration.
This practice guideline was developed by Alan P. Fugleberg
