Understanding Supplemental Security Income
SSI Work Incentives2008 Edition

  WHAT  ARE  WORK  INCENTIVES?  

One of Social Security's highest priorities is to help people with disabilities achieve independence by helping them to take advantage of employment opportunities. Work incentives are rules intended to help disabled or blind SSI beneficiaries go to work by minimizing the risk of losing their SSI or Medicaid benefits.

Some incentives allow us to not count some of your income or resources.

Other incentives let you continue to receive Medicaid coverage even though you are not receiving SSI cash benefits.

You may be entitled to take advantage of more than one work incentive program. Depending on the types of income you receive, it will change the amount excluded and the SSI benefit amount.

For more information about work incentives, visit our website:  The Work Site.
(www.socialsecurity.gov/work)

  EARNED  INCOME  EXCLUSION  

We do not count the first $65 of earned income plus one–half of the amount over $65. Therefore, we reduce your SSI benefit only $1 for every $2 you earn over $65.

  STUDENT  EARNED  INCOME  EXCLUSION  

If you are a student under age 22, we may exclude up to $1,550 of gross earnings in a month (but not more than $6,240 in the 2008 calendar year) in figuring your countable income.

For more information, see the SSI Spotlight on Student Earned Income Exclusion.

  IMPAIRMENT–RELATED  WORK  EXPENSES  

If you are disabled, we may exclude from your earned income, out–of–pocket expenses you pay for certain items and services related to your disability that you need in order to work. For example, the costs of car modifications or attendant care may qualify.

If you have impairment–related work expenses, we may reduce the amount of countable earned income we use to figure your SSI benefit. This means your SSI benefit could go up.

We may also consider these items when we figure your earnings, in order to decide if you are doing substantial work. Substantial gainful activity (SGA) is an issue only when you are applying for SSI. If you are receiving SSI benefits and go to work, SGA is not an issue. However, we do have to figure your countable income, as explained in our chapter on SSI INCOME.

For more information, see the SSI Spotlight on Impairment–Related Work Expenses.

  WORK  EXPENSES  FOR  BLIND  PERSONS  

If you are blind, we will deduct any part of your earned income that you spend to be able to work (such as for transportation, taxes, or special equipment) from the amount of income we use to figure your SSI benefit. The expense does not have to be related to your disability.

For more information, see the SSI Spotlight on the Special SSI Rule for Blind People Who Work.

If you are disabled or blind, you may set up a plan to put aside income or resources to meet expenses for reaching an occupational goal. You may also exclude part of your ineligible spouse's income and resources.

If you are a child and living with your parent(s), you may also exclude part of your parents' income and resources.

Unlike impairment–related work expenses, you may use a PASS to exclude unearned income and resources as well as earned income.

We do not count income or resources set aside under a PASS when figuring the SSI benefit amount. Usually, you cannot use your SSI benefit to pay the expenses necessary to reach your occupational goal. This is because you need the SSI benefit to pay ordinary living expenses.

You can use a PASS to establish, maintain, or increase SSI benefits.

See the SSI Spotlight on Plans to Achieve Self-Support.

The Ticket to Work and Work Incentive Improvement Act of 1999 (Public Law 106–170) provides several important opportunities for people who receive Social Security disability or SSI benefits and who want to go to work or increase their work. To find out more about this law, see our web site, The Work Site — Ticket to Work.
(www.socialsecurity.gov/work/)

One of the opportunities provided by this law is the Ticket program. The Ticket program is available in all States.

Under this Ticket program, you may receive a ticket that you can take to an approved service provider of your choice. Our term for an approved service provider is an "employment network."

The employment network will work with you to come up with a plan designed to help you reach your work goals. We pay the employment networks for their services;there is no cost to you. When the employment network agrees to provide these services, it also decides on how it will be paid. The employment network can choose to be paid for the months in which you do not receive benefits due to your work (up to 60 months) or, it can choose payments based on assisting you to reach certain milestones connected with your work goals.

While you are using a Ticket, we will not conduct regularly scheduled continuing disability reviews to see if your disabling condition has improved.

MAXIMUS, Inc. is helping us to manage the Ticket program. You can find a list of employment networks in your area and other information on this program on their website, Your Ticket to Work  [Disclaimer].
(www.yourtickettowork.com)

  MEDICAID  BUY–IN  

Another provision of the Ticket to Work and Work Incentive Improvement Act of 1999 (see above) expands the States' options under Medicaid buy–in for working individuals with disabilities.

	States can cover working individuals with disabilities who are at least age 16, but less than age 65, using income and resource limits set by the State; and
	States can provide Medicaid to employed individuals covered under the group described above, who lose that coverage due to medical improvement, but who still have a medically determinable severe impairment.

Social Security and the Centers for Medicaid and Medicaid Services are encouraging States to participate in this new program.

  HOW  TO  APPLY                

To apply for assistance under this rule, you should contact the State Medicaid office in your area to find out if your State participates or plans to participate.

  BENEFIT  CONTINUATION  FOR  PEOPLE  WHO  WORK  
  SECTION 1619(a)  OF  THE  SOCIAL  SECURITY  ACT  

Section 1619(a) provides that, even if you are working at or above the substantial gainful activity level, you can continue to receive cash and Medicaid benefits. We will not stop your benefits just because of work. However, your disabling condition must continue to exist.

  MEDICAID  ELIGIBILITY  FOR  PEOPLE  WHO  WORK  
  SECTION 1619(b)  OF  THE  SOCIAL  SECURITY  ACT  

Section 1619(b) provides that, in most cases, even if your earned income (after the applicable exclusions) is too high to permit a SSI cash benefit, you may still be eligible for Medicaid as long as you need Medicaid in order to work and your earnings are under a “threshold” amount.

For more information, see the SSI Spotlight on Continued Medicaid Eligibility for People Who Work.

  REINSTATEMENT  WITHOUT  REAPPLYING  

If you are eligible for Medicaid under Section 1619(b), you remain eligible for SSI and may begin receiving cash benefits again without a new SSI application if your earnings drop.

  SSI  AND  MEDICARE  

If you are eligible for SSI and Medicare or you become eligible, you are automatically eligible for prescription drug coverage and extra help. You will not be required to file a separate application. You will be able to select a prescription drug plan. If you do not select a plan on your own, Medicare will enroll you in a plan with no premium to make sure you get help paying for your prescription drugs. You can join, switch, or drop a Medicare Drug Plan at anytime.

  SPECIAL  BENEFITS  FOR  SOME  INSTITUTIONALIZED  
  BENEFICIARIES  

If you are eligible under Section 1619 of the Social Security Act and you enter a medical institution, you are eligible for a full SSI benefit for up to two months.

  EXPEDITED  REINSTATEMENT  OF  BENEFITS  

If your eligibility for disability benefits ended because of work activity, you can request that we reinstate your benefits. We may make payments to you while we decide whether you meet the reinstatement requirements.

To get payments while we make our decision and to meet the reinstatement requirements, you must be unable to work because of your original medical condition or a related medical condition. Also, you must file a request for reinstatement within 60 months from the month your eligibility ended because of work activity.

Please also see our section on EXPEDITED REINSTATEMENT.

  EFFECT  OF  WORK  ON  MEDICAL  REVIEW  

Effective January 1, 2002, we will not conduct a continuing disability review of a disabled beneficiary based on work activity alone. This provision applies to beneficiaries who have received Social Security disability benefits for at least 24 months.

We base Social Security disability benefits on the beneficiary's own work or a family member's prior work. This provision does not apply to beneficiaries who receive only SSI benefits.

We will still conduct regularly scheduled medical reviews, unless you are using your Ticket to Work. As long as you are using your Ticket to Work and participating in the program, we will not conduct a medical review

For more information, please see our section on the TICKET TO WORK program.

  CONTINUATION  OF  BENEFITS  AFTER  MEDICAL  
  CESSATION  (SECTION  301  BENEFITS)  

You can continue getting SSI benefits even after we determine that your disability or blindness ceased if you are participating in:

	a program under the Ticket to Work and Self–Sufficiency Program; or
	an approved Plan to Achieve Self-Support; or
	an approved program of vocational rehabilitation services, employment services, or other support services; or
	an approved educational or training program.
And
	we determine that your completion or continuation in the program, for a specified period of time, will increase the likelihood that you will be permanently removed from the disability or blindness benefit rolls.

In addition, if you are a student aged 18 through 21, you can continue getting SSI benefits after we determine that your disability or blindness ceased if you are participating in an Individual Education Plan (IEP) with an approved educational institution.

  MEDICAID  BUY–IN  PROGRAM  FOR  
  WORKING  PEOPLE  WITH  DISABILITIES  

What is Medicaid Buy–in?

Medicaid Buy–in is designed to provide Medicaid to working people with disabilities who, because of relatively high earnings, cannot qualify for Medicaid under one of the other provisions.

Who is eligible?

States are allowed to provide Medicaid to these individuals by creating a new optional eligibility group.

Although some States may have more liberal income limits, in most States individuals may become eligible if:

	they are in a family whose net income is less than 250 percent of the national poverty level for a family of the size involved (i.e., the 2008 Federal Poverty Level for a family of three is $17,600, so the limit for this program would be $44,000); and
	except for their earnings, they would be considered eligible for SSI benefits––this includes the definition of disability; and
	they meet all other SSI income and resource limits.

Each State determines its own definition of a “family.” All SSI exclusions apply to the determination of "family" income, including the earned income exclusions.

Individuals are not required to have been receiving SSI benefits to be eligible for this Medicaid Buy–in provision. However, the State must make a disability determination if an individual was not an SSI beneficiary. Substantial gainful activity (wages or self–employment) is not a consideration when States make this determination.

EXAMPLE:

The 2008 Federal Poverty Level for an individual is $10,400. The net income limit for Medicaid Buy–in for an individual is income of less than 250 percent of $10,400, or, less than $26,000.

For example, if Joe Green's annual income is earnings of $42,765, he meets the net income limit (after the SSI earned income exclusions) and is eligible for Medicaid Buy–in if his State participates (as long as he meets all other eligibility factors for SSI benefits).

$42,765.00  earnings divided by 12 months =
$  3,563.75

$  3,563.75  monthly earnings
       -85.00  general and earned income exclusion
$  3,478.75
   -1,739.37  exclusion of half remaining earned income
$  1,739.37  monthly countable income, or
$20,872.44  a year.

In this example, Mr. Green's net income of $20,872 is below 250 percent of the poverty line for an individual; that is, $26,000.

Are there premiums?

States are allowed (but not required) to charge eligible individuals premiums or other cost–sharing charges. These charges may be set on a sliding scale based on income. Each State makes the decision about the premiums or other cost–sharing charges.

How do I get more information?

To find out more about Medicaid in your State, call your State Medicaid agency. A list of toll–free numbers can be found on the Centers for Medicare and Medicaid Services (CMS) website, State and Federal Medicaid Contacts Database.
(www.cms.hhs.gov/medicaid/apps/contacts/)

To find out if your State has a Medicaid Buy–in plan, contact your State Medicaid agency.

  HOW  TO  FIND  OUT  MORE  

Each local Social Security office has a Work Incentive Liaison who works with outside organizations that serve disabled and blind people. Please contact your local office for the name and telephone number of this Work Incentive Liaison.

For more information on work incentives, see the SSI Spotlights on:

	Impairment–Related Work Expenses;
	Special SSI Rule for Blind People Who Work;
	Individual Development Accounts;
	Plans to Achieve Self–Support;
	Property You Need for Self–Support;
	Student Earned Income Exclusion; and
	Continued Medicaid Eligibility for People Who Work (Section 1619(b)).

The Red Book — A Guide to Work Incentives, is available online at: www.socialsecurity.gov/redbook/.

The Red Book is also available on audiocassette and contains additional information on both SSI and Social Security disability work incentives. In addition, the above site, along with The Work Site, (www.socialsecurity.gov/work/)provides information on our efforts to help people with disabilities enter the workforce in employment or self–employment. There are sections about Vocational Rehabilitation Programs, Employment Support, Legislation, Employment Programs, Health Care for People with Disabilities, and much more.