Benefits Training and Consulting


September 9, 2010

Coming Soon  - Training Sessions Online

Solving  Problems


For years, I have had the problem of not being able to be in three or more places at the same time.  Every day, I receive phone calls and emails asking when I'll be in Kansas, California, Michigan or someplace else to do training on Social Security benefits.  Obviously, I can only be in one place at a time.  So, I solved this problem.


Another problem I've faced - many attendees state the all-day training is too long and ask if it can be broken down. Well, most organizations can not afford to let staff off to attend multiple days of training and it financially not feasible for me to offer two half-day training events.  Also, recent studies have shown many people can no longer absorb information presented over a long period because the technology we use every day (computers, cell phones, text massaging , tweeter, etc..) has allowed us to multi-task and as a result people are losing the ability to stay focused on one task for a sustained period of time.  So, I solved this problem.


Another problem I encounter - people ask questions during a training, and others comment that the questions distract them. While I encourage audiences to ask questions to help them clarify the topic beginning presented, some questions can distract others.  And occasionally, I'll have as attendee who tries to dominate the session with questions that are not appropriate to the topic being presented at that time.  So, I solved this problem.


In a few weeks, I will be offering training sessions on the Internet on a 24/7 basis.  Right now, we are working on technical points in accessing the sessions.  Each training session will be about one hour in length and focus on a specific topic.  This will allow you to pick what you want to learn, when you what to learn it.  Each training session will have an accompanying handout for you to take notes and jot down questions.  You'll be able to email me the questions and receive a response.  From the privacy of your work space or home, others will not distract you from focusing on the content.  The fee for participating in these training will be nominal. 


While I have a list of topics available or being developed,  I would like to know what topics you want in a training session.  Please send me your recommendations:

Proposed Changes in Medical Criteria for Mental Disorders

The medical criteria Social Security uses to determine if a person is disabled is contained in the Listing of Impairments.  By law, Social Security is required to periodically update this criteria to reflect current medical findings and practice.  The medical criteria is divided into sections based on body functions or specific type of illness.  In the Listing of Impairments, there are 14 sections for adults and 15 sections for children. The updates are done by section.  For instance, Section 2.00 Special Senses and Speech (for adults) and Section 102.00 Special Senses and Speech (for children) were updated, effective August 2, 2010.


On August 19, 2010 Social Security announced they are beginning the process of updating Section 12.00 Mental Disorders (for adults) and Section 112.00 Mental Disorders (for children).  The last time they updated Section 12.00 was August 28, 1985 and Section 112.00 was December 12, 1990.


The announcement of August 19th, provides the proposed changes Social Security has for updating this medical criteria and they are asking the public to comment on these proposed changes and to offer additional points the update should consider.  Public comments must be submitted to Social Security by November 17, 2010.


The proposed changes include modifying the content and the structure of the mental disorders listings.  Social Security also proposes to broaden most of the listing categories to include more mental disorders, add listings, and revise the criteria that must be met.


      Current listing category                                               Proposed listing category
12.02 Organic Mental Disorders.........                      12.02 Dementia and Amnestic and
                                                                                                                              Other Cognitive Disorders.
12.03 Schizophrenic, Paranoid and Other                     12.03 Schizophrenia and Other
           Psychotic Disorders.                                                 Psychotic Disorders.
12.04 Affective Disorders...............                           12.04 Mood Disorders.
12.05 Mental Retardation...............                           12.05 Intellectual Disability/
                                                                                                  Mental Retardation (ID/MR).
12.06 Anxiety Related Disorders........                       12.06 Anxiety Disorders.
12.07 Somatoform Disorders.............                       12.07 Somatoform Disorders.
12.09 Substance Addiction Disorders....                    12.09 [Removed]
12.10 Autistic Disorder and Other                             12.10 Autism Spectrum Disorders
           Pervasive Developmental Disorders
                                                                                 12.11 Other Disorders Usually First
                                                                                                Diagnosed in Childhood or
                                                                                 12.13 Eating Disorders.   

The proposed changes appear to be well thought out and reflect the input from many people, organizations, medical professions, and commissions.  The changes also reflect current practices in the professional fields serving people with mental disorders and make the qualifying criteria more relevant to the current practices.  But they are subject to modification based on the comments and recommendations Social Security receives prior to November 17th.  


While it will take some time to develop a final set of rule changes, the new rules will eventually impact the beneficiaries currently receiving benefits.  When a person qualifies for benefits, the favorable determination of disability is based on the medical criteria in effect at the time of qualification for benefits.  Everyone presently on benefits must be periodically medically reviewed to determined if they met the medical criteria in effect at the time the review is conducted.  Similarly, in almost all states, the same mental criteria is used to determine if a person with disability qualifies for Medicaid and continues to qualify for Medicaid.


If you want to review the proposed rules, (there are two waysto get to it)

1. Go the The Federal Register (Main Page)     Under the heading "2010 (Volume 75) Only" go to "Advanced Search" and click on it.   On the next page "Federal Register: Advanced Search" "Select a Volume(s)"  select "2010 FR, Vol. 75" then go to "Search by Issue Date": and enter "08/19/2010" on the "specific date" line, then in the "Search" box enter "Social Security" and press "submit."  On the "Search Results" screen select "fr19au10P Revised Medical Criteria for Evaluating Mental Disorders"    


Questions I Have Received


Note: Addressing real-life questions and issues is an excellent way to learn new points about the benefit programs.  And, you may find a solution to a problem you are dealing with.


Question 1

My daughter is 17 years old and we plan to apply for benefits when she turns 18.  Years ago I established a 529 plan for her.  How will this money effect her eligibility for about for SSI? 


A "529 plan" is a Qualified Tuition Programs (QTPs), also known as Section 529 Plans.  A QTP allows a parent (and others) to prepay or contribute to an account for their child's education expenses beyond high school at an eligible educational institution. QTPs are generally established by state and educational institutions.


There are two types of 529 plans: savings plans and pre-paid plans.

Savings plans

C                      They are accounts that provide investment options such as mutual funds or money market funds
                        (similar to a retirement account (e.g. 401K)).
C                      They are not guaranteed by the State and the value is subject to fluctuations in financial markets
                        (e.g. the stock market).
C                      They can be established for a beneficiary of any age.

Prepaid plans

C                      They allow the account owner to purchase units or credits at participating colleges and
                         universities for tuition.
C                      They allow the account owner to lock-in future tuition rates at current prices.
C                      States may guarantee investments in plans that they sponsor.
C                      Most plans must be established for a beneficiary of the account by a certain age or grade.


The funds in a 529 plan are a countable resource to the individual who owns the account (e.g. a parent or grandparent). Normally, the owner is the person who established the account. In most instances, the individual who establishes a QTP retains the ability to withdraw any or all of the funds in the account for his or her own benefit.  The designated beneficiary of the account is the individual (i.e. a student or future student) who is to receive the benefit of the funds in the account. The designated beneficiary can be changed to a member of the beneficiary's family.


While the son or daughter is a child (under 18), the 529 plan is a resource of the parent. A portion of the parent(s) resources are deemed to the child, thus the 529 plan can effect the child's eligibility for SSI.  If a grandparent owns the account, it is not a deemed resource for the child's eligibility for SSI.  The parents' resources no longer effect the son's or daughter's eligibility for SSI at 18 years of age.


Withdrawals or distributions to the account owner are not income but a conversion of a resource. The distribution is a countable resource to the account owner. Any distribution the designated beneficiary receives from a 529 plan is a gift. Distributions, which meet Social Security's definition of a gift and are used for educational expenses of the designated beneficiary, are excluded as income in the month of the SSI eligible student receives the money.  If the student holds on to the money, it remains an excluded resource for up to 9 months following the month it was received.


The gift can be used for educational expenses, which include: tuition and fees; books; laboratory fees; student activity fees; transportation; stationary supplies; technology fees; and impairment-related expenses necessary to attend school or perform schoolwork (e.g. special prosthetic devices necessary to operate school machines or equipment).  Any portion of the gift the student uses for food and/or shelter is unearned income.  Any part of the gift the student saves for future needs (i.e. emergency funds) becomes a resource.


Source: POMS SI 01140.150 Qualified Tuition Programs (QTPs)


Question 2


My client lost her Medicaid, when her SSI stopped.   She still receives SSDI and has Medicare. I took her to the state economic support office (they administer Medicaid) to see if she could qualify for any other type of Medicaid.  The worker said she might qualify for Medicaid under the Pickle category.  I don't know what this means.  Can you help me.


Unfortunately, through a subsequent phone call, I learned the person's SSI was suspended when she left employment and cash-out her company-sponsored retirement.  The following month she was over the resource limit for SSI and Medicaid. So the Pickle amendment does not apply to her.  If she can bring her resources below $2,000 within twelve months, the suspension of her SSI can be removed, thus her Medicaid eligibility will be reinstated.


So what is the "Pickle Amendment"?


There are over 70 categories of Medicaid eligibility.  The "Pickle Amendment" is one of those categories. [It is named after the Congressman who introduced the amendment.]  It applies to a person who was a concurrent beneficiary until a cost-of-living increase (COLA) to the title II benefit wipes out eligibility for SSI.   For instance, the person was receiving $693 of title II and was eligible for $1 of SSI, then the next COLA adjusts the title II payment above the SSI Federal Benefit Rate (FBR) plus $20 (this year $694).  So the person's unearned income (title II) exceeds the limit for SSI eligibility and the SSI-related Medicaid eligibility ends.   Under the Pickle category, the state Medicaid office would disregard all COLA adjustments to the title II benefit after SSI eligibility is stopped and compares this adjusted amount to the current FBR.  If the adjusted amount is below the current FBR, the person remains eligible for Medicaid (provided resources are below $2,000).


In other instances, when the FBR rate is adjusted and this new amount exceeds the title II benefit amount when SSI was originally lost, the person may be eligible for Medicaid under the Pickle category.  This application is important in states with Social Security administered state supplements.  Until recently, many concurrent beneficiaries were receiving only a portion of the SSI state supplemental payment and a title II benefit.  The SSI state supplemental payment provided access to Medicaid.  Due to state budget problems, the state supplemental payment was reduced, and some people no longer qualified for SSI.   Future adjustments to the FBR may bring the title II benefit amount (at the time SSI ended) below a new FBR, at which time the person may re-qualify for Medicaid under the Pickle category.


The Pickle category does not apply to a concurrent beneficiary who works and through additional contributions to the Social Security trust fund, the title II benefit is increased beyond the FBR plus $20, so SSI ends because the unearned income is too high. 


What  Does  It  Take  To  Schedule  A  Workshop?

   People have called asking for more details on hosting workshop on Social Security and medical benefits.  To some people, the offer sounds too simple and there must be a catch.   


   By serving as the host organization for a workshop, the organization has ten free seats at the workshop.   This certainly reduces staff training costs, particularly when your program is on a tight budget.


   We ask the host organization to provide meeting space, for approximately 40 people in a classroom setting.  The host organization is responsible for providing light refreshments (coffee, soda, snack foods).  We also ask the host organization to distribute an advertisement of the workshop to local contacts, as they have a better mailing list of contacts in the local area.


  The host organization's distribution of the advertisement is an important role in suburban and rural areas. This usually assures a minimum registration of people to conduct the workshop.  We supply the master copy of the ad by e-mail in Word format.


   Benefits Training and Consulting provides the training materials and audio-visual equipment.  In addition, we take care of registration matters and the confirmation of registrations.


   Host organizations have used a variety of free meeting space when their own facility was inadequate to accommodate the workshop.  The meeting site must be accessible to individuals with disability.


   We maintain a list of interested organizations and contact them approximately 3 months prior to the week I will be in their area. Contact me if you would like to host a workshop during 2004.  You can reach me by phone: (610) 696-1551, fax (610) 932-0428, or by e-mail:


We are now planning for Winter and Spring of 2011

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