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| How Employment Supports Can Help You | Name of Employment Support |
|---|---|
| Do you want assistance to help you return to work? | Ticket to Work (Ticket or TTW) |
| How can you test your ability to work without losing your SSDI benefits? | Trial Work Period (TWP) |
| How long can you receive SSDI benefits after you return to work? | Extended Period of Eligibility (EPE) |
| What happens to your SSDI benefits if you try to return to work but have to stop working or reduce your hours because of your disability? | Unsuccessful Work Attempt (UWA) |
| Are you paying for items or services related to your disability that you need in order to work? | Impairment-Related Work Expenses (IRWE) |
| Do you work, receive SSI based on blindness, and have work related expenses? | Blind Work Expenses (BWE) |
| Do you receive SSDI and work but have extra support on-the-job or have fewer or simpler tasks than other workers? | Subsidy and Special Conditions |
| Do you receive SSDI, and are self-employed? | Unincurred Business Expenses |
| How do we figure your monthly SSI payment amount if you work? | Earned Income Exclusion |
| Are you under age 22, receiving SSI, attending school and working? | Student Earned Income Exclusion (SEIE) |
| Do you receive SSI (or are you eligible for SSI) and want to set aside money to pursue an employment goal? | Plan to Achieve Self-Support (PASS) |
| Do you receive SSI and own property or resources that are essential to your means of self-support? | Property Essential to Self-Support (PESS) |
| What happens to your SSI cash benefits when your earned income is substantial but you are still disabled? | Special SSI Payments for Individuals Who Work - Section 1619(a) |
| How can you restart your SSI cash payments if you stop working? | Reinstating Eligibility Without a New Application |
| What happens to your SSI payment if you are working, but you have to enter a medical facility? | Special Benefits for Individuals Eligible Under Section 1619 Who Enter a Medical Treatment Facility |
| Has your medical condition improved and are you participating in a vocational rehabilitation or similar program? | Continued Payment Under a Vocational Rehabilitation or Similar Program (Section 301) |
| If your entitlement to benefits ended because you successfully returned to work, can you get benefits again if you stop working? | Expedited Reinstatement (EXR) |
| What happens to your Medicare after you return to work? | Continuation of Medicare Coverage |
| What happens to your Medicaid after you return to work? | Medicaid While Working – Section 1619(b) |
| What happens if you are no longer eligible for free Medicare Part A because of your work? | Medicare for Individuals with Disabilities Who Work |
| What is a Ticket? | The Ticket to Work Program is an innovative program for individuals with disabilities who want to work. It increases your available choices when obtaining employment services, vocational rehabilitation services, and other support services you may need to get or keep a job. It is a free and voluntary service. You can use the Ticket if you choose, but there is no penalty for not using it. While you are using the Ticket, SSA will not conduct a continuing disability medical review of your case. |
| Where can I use a Ticket? | This program is available in all 50 States and 10 United States Territories. Many SSDI and SSI disability beneficiaries will receive a “Ticket” they can use to obtain services from a state vocational rehabilitation (VR) agency or another approved provider of their choice. We call these approved providers “Employment Networks.” Employment Networks are private organizations or government agencies that have agreed to work with Social Security to provide employment services to beneficiaries with disabilities. |
| Where can I use a Ticket? | For more information on Ticket to Work, including a list of approved Employment Networks, contact the SSA Ticket Program Operations Support Manager, MAXIMUS, at their toll free numbers; 1-866-YOURTICKET (1-866-968-7842) or for TTY/TDD call 1-866-833-2967 between 8 a.m. to 10 p.m. Eastern time (Monday through Friday). Current information about the Ticket to Work Program can be found online at www.ssa.gov/work/Ticket/ticket_info.html or www.yourtickettowork.com. |
| How does the TWP help individuals? | The TWP allows you to test your ability to work for at least 9 months. During your TWP, you will receive full SSDI benefits regardless of how high your earnings might be so long as your work activity has been reported and you have a disabling impairment. |
| When does the TWP start? | Your TWP starts the first month you are eligible for SSDI benefits or the month in which you file for benefits, whichever is later. |
| When does the TWP start? | The TWP continues until you accumulate 9 months (not necessarily consecutive) in which you perform what we call “services” within a rolling 60-consecutive-month period. We use this "services" rule only to count TWP months. In 2008, we consider your work to be “services” if your gross earnings are more than $670 a month, or if you work more than 80 self-employed hours in a month. |
| What happens when you complete your TWP? | After you complete your TWP, you begin your extended period of eligibility (EPE), unless we conduct a medical review of your disability and find your impairment has medically improved. After the TWP ends, we take into account your work and earnings to decide if you can work at the SGA level (see our chapter, OVERVIEW OF OUR DISABILITY PROGRAMS). When your TWP is complete, you become eligible for other employment supports and we consider whether any of them apply to your situation. |
| What else do you need to know about the TWP? |
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| Does the TWP apply to SSI | No. A TWP does not apply to the SSI program. |
| What is the EPE? | During the 36 consecutive months following the TWP, if you qualify, we may restart your SSDI benefits without a new application, disability determination, or waiting period. |
| When does the EPE begin? | The EPE begins the month after the TWP ends, whether you are working or not. |
| How does the EPE help you? | The first 36 months of the EPE is the reentitlement period. During the reentitlement period benefits are paid for months your earnings or work activities are below the substantial gainful activity limits as long as you continue to have a disabling impairment. Benefits are suspended for months your earnings or work activities are over the substantial gainful activity limit. A new application and/or disability determination are NOT required to start your benefits again. (This is a different rule than expedited reinstatement that is described in the section below.) |
| What happens the first time you work above SGA? | If we find you have worked above SGA in the EPE for the first time, we will pay for the first month your benefits cease due to SGA and the following 2 months. This is referred to as the grace period. |
| Can you continue to receive benefits after the reentitlement period ends? | If you are eligible for a benefit payment for the 37th month, you will continue to be eligible for benefits until you:
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| What happens if I work after the reentitlement period ends? |
Your benefits will end if you work above SGA limits after the 36-month reentitlement period. However you may be able to start your benefits again if you stop work within the next 5 years. See the information on expedited reinstatement, in the section below. |
| Do you get an EPE under SSI? | No. The EPE applies only to individuals who receive SSDI cash benefits |
| What is an UWA? | A UWA is an effort to do substantial work, in employment or self-employment, that you stopped or reduced to below the SGA level after a short time (6 months or less) because of:
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| What is the benefit of an UWA if I receive SSDI? | When we make a SGA decision to determine if your disability continues or ceases because of your work, we do not count your earnings during a UWA. |
| Can a UWA occur during the extended period of eligibility? | Yes. During the Extended Period of Eligibility (see our previous section), we consider UWA(s) as part of our SGA decision(s) for months up to and including the month (if any) in which we cease your disability. |
| Can a UWA occur during the trial work period? | No. We do not consider UWA during the trial work period (see our previous section), or after the month (if any) in which we cease your disability. |
| Does a UWA affect my monthly SSI payment? | For SSI we only consider a UWA at the time you file an initial claim. After that time, a UWA is not considered in figuring your SSI payment. |
| How do IRWE help you? | We deduct the cost of certain impairment-related items and services that you need to work from your gross earnings when we decide if your “countable earnings” demonstrate performance of SGA. It does not matter if you also use these items and services for non-work activities. |
| When will we deduct your IRWE? | We deduct IRWE for SGA purposes when:
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| How do we use IRWE to figure your SSI monthly payments? | If you are receiving SSI benefits, we will also exclude IRWE from your earned income when we figure your monthly payment amount when you meet requirements 1 through 4 above, and you paid the expense in a month that you receive earned income or performed work while you used the impairment related item or services. |
| Can IRWE be deducted during a non-work month? | In certain situations, we can deduct IRWE amounts for expenses paid before you start or after you stop work. |
| Where can you get more detailed information on these deductible expenses? | The following table outlines the types of expenses that are deductible as IRWE. |
| TYPE OF EXPENSE | IRWE DEDUCTIBLE | NOT DEDUCTIBLE |
|---|---|---|
| Transportation Costs | The cost of structural or operational modifications to your vehicle that you need in order to travel to work, even if you also use the vehicle for non-work purposes. The cost of driver assistance or taxicabs that is required because of your disability rather than the lack of public transportation. Mileage expenses at a rate determined by us for an approved vehicle and limited to travel to and from employment. |
The cost of your vehicle whether modified or not. The costs of modifications to your vehicle that are not directly related to your impairment or critical to the operation of your vehicle, for example, paint or pin striping. Your travel expenses related to obtaining medical items or services. |
| Attendant Care Services | Services performed in the work setting. Services performed to help you prepare for work, the trip to and from work, and after work; for example, bathing, dressing, cooking, and eating. Services that incidentally also benefit your family, for example, meals shared by you and your family. Services performed by your family member for a cash fee where he/she suffers an economic loss by reducing or ending his/her work in order to help you. This includes your spouse reducing work hours to help you get ready for work. |
Services performed on non-workdays or help with shopping or general housekeeping, for example, cleaning and laundry. Services performed for someone else in your family, for example, babysitting. Services performed by your family member for payment "in-kind", for example, room and board (even if the family member suffers economic loss. Services performed by your family member for a cash fee where he/she suffers no economic loss. This includes services provided by your non-working spouse. |
| Medical Devices | Deductible devices include wheelchairs, dialysis equipment, pacemakers, respirators, traction equipment, and braces. | Any device you do not use for a medical purpose. |
| Prosthesis | Artificial hip, artificial replacement of an arm, leg, or other parts of the body. | Any prosthetic device that is primarily for cosmetic purpose. |
| Residential Modifications | If you are employed outside of home, modifications to the exterior of your house that permit access to the street or to transportation; for example:
|
If you are employed outside of home, modifications to your house to help you in your home; for example:
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| Routine Drugs & Routine Medical Services | Regularly prescribed medical treatment or therapy that is necessary to control your disabling condition, even if control is not achieved. This includes:
|
Drugs and/or medical services used for your minor physical or mental health problems, for example:
|
| Diagnostic Procedures | Procedures related to the control, treatment, or evaluation of your disabling condition; for example, brain scans, electroencephalograms. | Procedures not related to your disabling condition, for example, allergy testing. |
| Non-Medical Appliances & Devices | In unusual circumstances, devices or appliances that are essential for the control of your disabling condition either at home or at work; for example, an electric air cleaner if you have severe respiratory disease. Your physician must verify this need. | Devices you use at home or at the office that are not ordinarily for medical purposes and for which your doctor has not verified a medical work-related need. These include:
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| Other Items & Services | Expendable medical supplies; for example, incontinence pads, elastic stockings, and catheters. The cost of a service animal including food, licenses, and veterinary services. |
An exercise bicycle or other device you use for physical fitness, unless verified as necessary by your physician. Health insurance premiums. |
| When do we consider? | We consider the existence of subsidy and special conditions when we make a SGA decision. We use only earnings that represent the real value of the work you perform to decide if your work is at the SGA level. |
| What is a subsidy? | “Subsidy" is support provided by your employer that may result in you receiving more pay than the actual value of the services you perform. |
| What are special conditions? | “Special conditions" refers to support provided by someone other than your employer, for example, a vocational rehabilitation agency. As a result of this support, you may be receiving more pay than the actual value of the services you perform. |
| How can I tell if they apply to me? | A subsidy or special conditions may exist if:
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| Do they affect my SSI payments? | No, we do not take into account subsidy or special conditions when we figure your SSI payment amount. |
| What are they? | "Unincurred business expenses" are contributions made by others to your self-employment business effort. For example, if the state VR agency gives you a computer for your business, or a friend works for your business as unpaid help, these are “unincurred business expenses.” SSA generally follows the Internal Revenue Service (IRS) rules to figure your net earnings from self-employment. The IRS only allows you to deduct expenses for which you actually paid or incurred debt. When we make a SGA decision, we also deduct unincurred business expenses from your net earnings because we want an accurate measure of the value of your work. |
| What qualifies as an unincurred business expense? | For an item or service to qualify as an unincurred business expense:
|
| Do they affect my SSI payments? | No. We do not deduct unincurred business expenses from earnings when we figure your SSI payment amount. |
| We do not count the first $65 of your earnings in a month plus one-half of the remainder. This means that we count less than one-half of your earnings when we figure your SSI payment amount. We apply this exclusion in addition to the $20 general income exclusion (an exclusion that is first applied to any unearned income that you may receive). This table shows an example of the earned income exclusion. |
Example of the Earned Income Exclusion | |
|---|---|---|
 Situation 1Ed receives $361 SSDI each month, $10 unearned income from another source and no wages. $361 SSDI + 10 Other unearned income$371 - 20 General income exclusion$351 Countable income $637 2008 Federal BenefitRate-351 Countable income $286 SSI payment Available income: $361 SSDI + 10 Other unearned income+286 SSI $657 Total Monthly Income |
Situation 2 Ed receives wages of $361 per month, no SSDI and $10 unearned income from another source. $ 0 SSDI $ 10 Other unearned income- 20 General income exclusion$ 0 Countable unearned income$361 Earned income - 10 Remaining general income exclusion$351 - 65 $65 Earned income exclusion$286 -143 ½ remaining earnings $143 Countable earned income$637 2008 Federal Benefit Rate-143 Countable income $494 SSI payment Available income: $361 Earned income + 10 Other unearned income+494 SSI $865 Total Monthly Income | |
| How does the student earned income exclusion help you? | If you are under age 22 and regularly attending school, we do not count up to $1,550 of earned income per month when we figure your SSI payment amount. The maximum yearly exclusion is $6,240. These amounts are for the year 2008; they are adjusted each year based on the cost-of-living. |
| What is the definition of “regularly attending school?” | “Regularly attending school” means that you take one or more courses of study and attend classes:
|
| Does home schooling qualify? | If you are home taught, you may be considered “regularly attending school” if:
|
| How is the income exclusion applied? | We apply the student earned income exclusion before the general income exclusion or the earned income exclusion. |
| How does it help you? | A PASS allows you to set aside income and/or resources for a specified period of time so you can pursue a work goal. For example, you could set aside money to pay expenses for education, vocational training, or starting a business as long as the expenses are related to achieving your work goal. We do not count the income that you set aside under your PASS when we figure your SSI payment amount. We do not count the resources that you set aside under your PASS when we determine your initial and continuing eligibility for SSI. A PASS can help you establish or maintain SSI eligibility and can increase your SSI payment amount. For example, if you receive $800 in SSDI, you have too much income for SSI. But if you otherwise qualify for SSI and have a work goal, you could use some of your SSDI to pay for PASS expenses. That could reduce your income enough to be eligible for SSI. The result will be a higher monthly cash benefit with eligibility for both SSDI and SSI. |
| Who can have a PASS? | If you receive SSI or could qualify for SSI, you can have a PASS. You may not need a plan now, but you may need one next month or next year to remain eligible or to increase your SSI payment amount. |
| What are the requirements for a PASS? | Your PASS must:
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| Who can help you set up a PASS? | Anyone may help you with your PASS; for example, vocational counselors, social workers, benefit specialists or employers. SSA evaluates the plan and decides if it is acceptable. We also help individuals put their plans in writing. |
| How does a PASS affect your SSI eligibility and/or payment? | We do not count resources set aside under a PASS towards the resource limit. When we figure your SSI payment amount, we do not count income set aside under a PASS. We apply this exclusion to your countable income after we apply all other applicable exclusions |
| Where can you get more information about a PASS? | You can get a PASS Expert’s telephone number by calling our toll-free number 1-800-772-1213 between 7 a.m. and 7 p.m. Monday through Friday or visit our web site at: www.socialsecurity.gov/disabilityresearch/wi/passcadre.htm. We also have a pamphlet entitled Working While Disabled – A Plan for Achieving Self-Support (SSA Publication No. 05-11017) that is available online at: www.ssa.gov/pubs/11017.html. You can also get a copy from your local office or by calling our toll-free number 1-800-772-1213 between 7 a.m. and 7 p.m. Monday through Friday. |
| How does PESS help you? | We do not count some resources that are essential to your means of self-support when we decide your continuing eligibility for SSI. |
| What is not counted? | We do not count your property if you use it in a trade or business (for example, inventory) or use it for work as an employee (for example, tools or equipment), regardless of the value or rate of return. Other use of the items does not matter. We do not count up to $6,000 of equity value of non-business property that you use to produce goods or services essential to daily activities, regardless of the rate of return. An example is land used to produce vegetables or livestock solely for consumption by your household. We do not count up to $6,000 of equity value of non-business income-producing property if the property yields an annual rate of return of at least 6 percent. An example is a rental property. |
| What type of resources do not qualify as PESS? | We do not consider liquid resources; for example, stocks, bonds, or notes as PESS, unless you use them as part of a trade or business. |
| What is Section 1619(a)? | You can receive SSI cash payments even when your earned income (gross wages and/or net earnings from self-employment) is at the SGA level. This provision eliminates the need for the trial work period or Extended Period of Eligibility under SSI. |
| How do you qualify? | To qualify, you must:
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| How does it work? | Your eligibility for SSI will continue for as long as you meet the basic eligibility requirements and the income and resource tests. We will continue to figure your SSI payment amount in the same way as before. If your state provides Medicaid to individuals on SSI, you will continue to be eligible for Medicaid. |
| Do you need to apply? | You do not need to file a special application. Just keep us up to date on your work activity. |
| How does it help you? | If you have been ineligible for a SSI payment due to your work, you may be able to restart your SSI cash payment again at any time without a new application. If you have been ineligible for SSI and/or Medicaid for any reason other than medical recovery or work, you may be able to restart your SSI cash payment and/or Medicaid coverage within 12 months without a new application. When your situation changes, contact us and ask about how you can restart your SSI benefits and/or Medicaid. If your cash payment and Medicaid benefits ended because of your work and earnings, and you stop work within 5 years of when your benefits ceased, we may be able to start your benefits again. See the section, Expedited Reinstatement, in this chapter. |
| How does it help you? | If you are eligible under section 1619, you can receive an SSI cash benefit for up to 2 months while in a Medicaid facility or a public medical or psychiatric facility. |
| What happens if you enter a Medicaid facility? | Usually, if you enter a Medicaid facility where Medicaid pays more than 50 percent of the cost of care, your SSI payment is limited to $30 per month, plus any state supplement, minus any countable income. However, if you enter a Medicaid facility while you are eligible under section 1619, your benefit will be figured using the full Federal Benefit Rate (see our chapter, WHAT'S NEW IN 2008?) for up to 2 months. |
| What happens if you enter a public medical or psychiatric facility? | Usually, if you are in a public medical or psychiatric facility, you are not eligible to receive an SSI payment. However, if you enter a public medical or psychiatric facility while you are eligible under section 1619, your SSI cash benefits can continue for up to 2 months. For this provision to apply, the facility must enter an agreement with us that will allow you to keep all of the SSI payment. |
| How do I qualify for continued payment? | If we find that you no longer have a disabling impairment due to medical improvement, your benefit payments usually stop. However, if you are participating in an appropriate program of vocational rehabilitation services or similar services, your benefits may continue until your participation in the program ends. |
| What is an appropriate program of vocational rehabilitation or similar services? | An appropriate program must be approved by us and includes:
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| How long may my benefits continue? | Under Section 301, your benefits may continue until you either:
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| How do I qualify for Section 301? | To qualify for Section 301:
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| What is EXR? | EXR is a safety net for those individuals who successfully return to work, and later lose their entitlement to SSDI or SSI benefits and payments. If your cash payments ended because of your work and earnings, and you stop work within 5 years of when your benefits ended, we may be able to start your benefits again. |
| How does EXR help you? | If you have stopped receiving benefits due to your work, you may be able to restart them again without a new application. The EXR provision allows an individual to receive up to 6 months of temporary cash benefits while SSA conducts a medical review to determine whether the individual can be reinstated to benefits. The individual may also be eligible for Medicare and/or Medicaid during the provisional benefit period. |
| Who can be reinstated? | If you meet all the following requirements you are eligible to request EXR:
|
| What is Continuation of Medicare Coverage? | Most individuals with disabilities who work will continue to receive at least 93 consecutive months of Hospital (Part A) and Supplemental Medical Insurance (Part B) under Medicare, after the nine month trial work period. You do not pay a premium for Part A. Although cash benefits may cease due to work, you have the assurance of continued health insurance. |
| When does this start? | The 93 months start the month after the last month of your TWP. |
| How do you qualify? | You must already have Medicare and be working at SGA, but not be medically improved. |
| How does it help you? | After you return to work, your Medicaid coverage can continue, even if your earnings (alone or in combination with your other income) become too high for an SSI cash payment. |
| How do you qualify? | To qualify, you must meet all of the following qualifications:
|
| What is the “threshold amount”? | The “threshold amount” is the measure that we use to decide whether your earnings are high enough to replace your SSI and Medicaid benefits. Your threshold amount is based on:
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| STATE | THRESHOLD | STATE | THRESHOLD | |
|---|---|---|---|---|
| Alabama | $23,363 | Montana | $28,212 | |
| Alaska | $53,821 | Nebraska | $33,015 | |
| Arizona | $28,171 | Nevada | $29,850 | |
| Arkansas | $26,388 | New Hampshire | $38,727 | |
| California | $34,346 | New Jersey | $33,022 | |
| Colorado | $29,409 | New Mexico | $32,574 | |
| Connecticut | $53,631 | New York | $43,636 | |
| Delaware | $33,317 | North Carolina | $31,474 | |
| District of Columbia | $39,311 | North Dakota | $37,917 | |
| Florida | $27,655 | Ohio | $32,983 | |
| Georgia | $27,646 | Oklahoma | $24,360 | |
| Hawaii | $30,540 | Oregon | $29,638 | |
| Idaho | $36,562 | Pennsylvania | $28,554 | |
| Illinois | $31,200 | Rhode Island | $36,148 | |
| Indiana | $32,148 | South Carolina | $27,108 | |
| Iowa | $30,688 | South Dakota | $31,835 | |
| Kansas | $31,870 | Tennessee | $27,811 | |
| Kentucky | $25,386 | Texas | $28,358 | |
| Louisiana | $27,166 | Utah | $28,235 | |
| Maine | $41,139 | Vermont | $36,207 | |
| Maryland | $35,962 | Virginia | $29,348 | |
| Massachusetts | $36,056 | Washington | $27,143 | |
| Michigan | $26,318 | West Virginia | $27,154 | |
| Minnesota | $44,799 | Wisconsin | $32,991 | |
| Mississippi | $24,963 | Wyoming | $27,233 | |
| Missouri | $30,454 | N. Mariana Islands | $16,308 |
| STATE | THRESHOLD |
|---|---|
| California | $35,906 |
| Iowa | $31,216 |
| Massachusetts | $36,905 |
| Nevada | $32,473 |
| Oregon | $30,238 |
| Do all States use the same Medicaid eligibility rules? | These States use their own eligibility rules for Medicaid that are different from our SSI eligibility rules:
If you live in one of these States, you will continue to be eligible for Medicaid under section 1619(a) or (b) if you were eligible for Medicaid in the month before you became eligible for section 1619. |
| Can you buy Medicare coverage? | Yes. After premium-free Medicare coverage ends due to work, some individuals who have returned to work may buy continued Medicare coverage, as long as they remain medically disabled. Some individuals with low incomes and limited resources may be eligible for State assistance with this cost. |
| Who is eligible to buy Medicare coverage? | You are eligible to buy Medicare coverage if:
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| What kind of Medicare coverage can you buy? | Premium Hospital Insurance (Part A) is available at the same monthly cost that uninsured eligible retired beneficiaries pay. If you have less than 30 quarters of coverage, the premium is $423 in 2008. However, you may qualify for a reduction in this premium. Premium Supplemental Medical Insurance (Part B) is available at $96.40 per month; this is the same monthly cost that uninsured eligible retired beneficiaries pay in 2008. You can buy Hospital Insurance separately without Supplemental Medical Insurance. You can buy Supplemental Medical Insurance only if you also buy Hospital Insurance. |
| Do you qualify for a reduction in your monthly Part A premium? | You may qualify for a 45% reduction in the monthly amount of your premium for Hospital Insurance (Part A). You qualify for the reduced premium of $233 in 2008 if you:
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| When can you enroll? | You may enroll:
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| How does it work with an employer’s group health plan? | If you purchase Premium Hospital Insurance (Part A) and maintain your employer group health plan, Medicare will be your primary payer if you are working. Your group health plan would become a secondary payer. |
| When does the State pay premiums for Medicare? | States are required to pay Hospital Insurance (Part A) premiums for some working individuals with disabilities. You qualify if you:
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