Benefits Training   and Consulting

The Guide - Table of Contents


  The Guide: To Social Security Programs and Work Incentives

Table of Contents

Chapter

 1       INTRODUCTION

                        Introduction

                        What Are Work Incentives?

                        Which Benefit Does the Person Receive?

 

 2       THE BASICS

                        The Definition of Disability

                        Substantial Gainful Activity (SGA)

                        Initiating the Disability Claims Process (Applying for Benefits)

                        Determining the Existence of a Disability Involves Answering Five Basic Questions

 

TITLE II

(Social Security Disability Insurance, Childhood Disability Benefits, and

Disabled Widow(er)s Benefits)

           

 3        SOCIAL SECURITY DISABILITY INSURANCE

                        The Evolution of Title II Programs

                        Who May Qualify For A Title II Benefits?

                        To Be Entitled To  Social Security Disability Insurance (SSDI)

                        How SSDI Payment Amounts Are Determined

                        Entitlement To Childhood Disability Benefits (CDB)

                        How CDB Payment Amounts Are Determined

                        Conversion To CDB Benefits

                        What Is Income?

                        What Are Wages For SSDI Purposes?

                        What Income Is Not Wage For SSDI Purposes?

                        Resources

 

 4        SSDI PROCESS

                        Receiving A SSDI Benefit

                        Five-Month Waiting Period

                        Initiation Of Benefit Payment

                        Continuing Disability Reviews

                        The Process Of Continuing Disability Reviews (CDR)

                         When Can A CDR Occur?

                         Vocational Re-examination Diary Review

                         If Medical Improvement Was Expected And The Individual Returns To Work

                        SECTION 301: Continued Payment Under A Vocational Rehabilitation Program

                        Other Factors In Determining The Continuance Of A Disability

                        Four Conditions Must Be Met to Terminate From SSDI Because of Work

                        The Impact Of Work On The "Routine" Of Receiving SSDI Benefits

                        SSDI Process (diagram)

 

 5        TRIAL WORK PERIOD

                        The Time Frame Of A Trial Work Period

                        Performance of Services

                        Entitlement to a Trial Work Period

                        The "Rolling 60-Month" Period

                        Example 1  The "Rolling 60-Month" Period

                        The Trial Work Period Amount Changes

                        When The Trial Work Period Ends

                        EXAMPLE 2

                        EXAMPLE 3

                        EXAMPLE 4

                        EXAMPLE 5

                        EXAMPLE 6

                        How To Monitor TWP Months

                       The Impact of Work On The "Routine" of Receiving  SSDI Benefit Payments

 

 6        EXTENDED PERIOD OF ELIGIBILITY

                        Beginning Of The Extended Period Of Eligibility (EPE)

                        Example  7

                        Example  8

                        Re-entitlement Period

                        Example  9

                        Example 10

                        Example 11

                        The Key Issue During the EPE

 

 7       SGA CESSATION MONTH AND BENEFIT TERMINATION MONTH

                        Introduction

                        How the SGA Cessation Month is Determined

                        Example 12

                        Example 13

                        Example 14

                        When An Unsuccessful Work Attempt Is Not A Measure Of SGA

                        When Will The EPE End?

                        When does the Benefit Termination Month (BTM) occur?

                        Example 15

                        Example 16

                        Example 17

                        CAUTION !  Benefits can be linked together

                        Expedited Reinstatement of Benefits

                        Extended Medicare

                        Summary of the SSDI Process

 

 8        SUBSIDY and SPECIAL WORK CONDITIONS

                        Introduction

                        When Can A Subsidy Be Used?

                        Types Of Subsidy

                        Agency Services Provided To Supported Employees

                        Use Of Subsidy By Self-Employed Individuals

                        Responsibility Of The SSA Representative

                        Responsibility Of The Agency Supporting A Person

                        Special Points About The Use Of Subsidy

                        How To Submit A Subsidy and/or Special Work Condition Claim

                        Example 18

                        Example 19

                        Example 20

                        Example 21

                        Employer-provided Job Subsidy Report (Form)

                        Agency-provided Subsidy Report (Form)

 

9         IMPAIRMENT-RELATED WORK EXPENSE (IRWE)

                        Introduction

                        What Conditions Must be Met to Claim an IRWE?

                        When Can an IRWE Be Used?

                        What Expenses Can Be Claimed As An IRWE?

                        The Advantage Of Using An IRWE

                         Deductible Services Or Items

                        Use Of Special Transportation Services As An IRWE

                        Special Points About The Use of IRWE

                        How To Submit An IRWE And Monitor Benefits

                        Example 22

                        Example 23

                        Example 24

                        Example 25

 

Title XVI

Supplemental Security Income (SSI)

 

10       SUPPLEMENTAL SECURITY INCOME

                        Introduction

                        To Be Eligible for SSI

                        To Remain Eligible for SSI

                        The SSI Payment

                        Income

                        Additional Points Regarding SSI

                        What Constitutes Earned Income for the SSI Program?

                        What Constitutes Unearned Income for the SSI Program?

                        What Is Not Counted As Income in the SSI Program?

                        Disability Programs Comparison Chart

 

11      SSI PROCESS

                        The Process Of Receiving A SSI Payment

                        Initiation Of The SSI Payment and Medicaid

                        SSI Review (Redetermination) Process

                        Continuing Disability Reviews

                        Current Process of Continuing Disability Reviews

                        When Else Can a CDR Occur?

                        The Impact Of Work On The "Routine" Of Receiving SSI Payments

 

12      HOW SSI PAYMENT AMOUNTS ARE DETERMINED

                        Introduction

                        The Federal Benefit Rate

                        Income Exclusions

                        Calculating Monthly Income And SSI Payment Due

                        How Much Can a SSI Recipient Earn?

                        Example 26

                        Example 27

                        Section 1619(a):  Special SSI Payments For People Who Work

                        Break Even Point

                        Example 28

                        Section 1619(b): Continued Medicaid Coverage

                        Medicaid Needs Test

                        Example 29

                        How Does Wage Affect a Concurrent Beneficiary?

                        Example 30

                        Example 31

                        Example 32

                        Example 33

  

13      STUDENT EARNED INCOME EXCLUSION

                        Introduction

                        Eligibility For The Student Earned Income Exclusion

                        How The Exclusion Is Applied

                        Example 34

                        Other Points About Using The SEIE

                        Comparison Of Benefit Calculations

                        Example 35

                        Example 36

                        Example 37

                        Example 38

 

14      IMPAIRMENT-RELATED WORK EXPENSES (IRWE)

                        Introduction

                        What Expenses Can Be Claimed As An IRWE?

                        What Conditions Must Be Met To Claim An IRWE?

                        The Advantage Of Using An IRWE

                        Deductible Services Or Items

                        Example 39

                        Example 40

                        Example 41

                        Example 42

                        Example 43

 

15      PLAN TO ACHIEVE SELF-SUPPORT (PASS)

                        Introduction

                        What Income Can Be Used For A PASS?

                        Basic Provisions Of A PASS

                        Who Is Not A Candidate For A PASS?

                        What A PASS Must Contain

                        The Approval Process

                        Revision Of A PASS

                        Important Points When Using A PASS

                        Potential Users Of A PASS

                        The Advantage Of Using A PASS

                        Examples Of Permissible PASS Expenditures (list)

                        Example 44

                        Example 45

                        Example 46

                        Example 47

                        Example 48

                        Example 49

                        Example 50

 

16       COMPARISON OF PASS AND IRWE

                        Introduction

                        Example 51

                        Example 52

                        Example 53

 

17       USE OF THE PASS TO ESTABLISH ELIGIBILITY FOR SSI

                        Introduction

                        Example 54

                        Points To Consider When A SSDI Beneficiary Uses A PASS

                        Example 55

                        Example 56

                        Example 57

 

18       BLIND WORK EXPENSES (BWE)

                        Introduction

                        Deductible Services Or Items

                        The Advantage Of Using A BWE

                        What Conditions Must Be Met To Claim An BWE?

                        Example 58

                        Comparison of Income Exclusions

 

OTHER  INFORMATION

 

19        CONCLUDING  RECOMMENDATIONS

 

20        THE TICKET TO WORK AND SELF SUFFICIENCY PROGRAM

                        Introduction

                        Ticket to Work Program Goals

                        Beneficiaries Eligible to Receive a Ticket

                        What Beneficiaries Must Know

                        “Timely” Progress Reviews

                        A Word of Caution

 APPENDIX

 

            #1  GLOSSARY      

 

            #2  SSA MATERIALS

                           List of Threshold Amounts for Calendar Year 2016

                           Listing of Impairments

 

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