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Social Security Work Incentives

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Congress has approved several Social Security Work Incentives to encourage ... Notice of subsidy can be submitted to Social Security in letter-form. ... – PowerPoint PPT presentation

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Title: Social Security Work Incentives


1
Social Security Work Incentives
Presented on June 15th, 2006 by Scott Leonard
with KCDDD, and Joanne ONeill with the Arc of
King County Department of Community and Human
Services Developmental Disabilities Division
2
Before we start
  • This is part 3 of a three-part series.
  • There will be specific opportunities throughout
    the presentation to ask questions.
  • Commonly used acronyms and terms are marked in
    red.
  • Whats in your folder.

3
Work Incentives
  • Brief overview

4
What are Work Incentives?
  • Congress has approved several Social Security
    Work Incentives to encourage people with
    disabilities to engage in employment.
  • Work Incentives can help people maintain their
    benefits while working.
  • Work Incentives can help people afford the costs
    of items and supports necessary for becoming
    self-reliant and successful on their job.

5
Examples of Work Incentives
  • 1619b status
  • Individual Thresholds
  • Student Earned-Income Exclusion (SEIE)
  • Property Essential for Self Support (PESS)
  • Blind Work Expenses (BWE)
  • Subsidies and Special Conditions
  • IRWEs
  • PASS

6
Work Incentives and Benefits
  • Work Incentives impact Title II and Title XVI
    benefits differently!

7
Brief Review SSI and SSDI / SSDAC
  • SSI
  • SSI amounts can rise and fall due to fluctuations
    in income.
  • SSDI/DAC
  • All-or-nothing
  • Earnings over SGA (860 2006) can result in
    losing benefits.
  • To be eligible for both Title II and/or Title XVI
    benefits, you must be earning below SGA at the
    time of application.

8
Subsidies and Special Conditions
9
Subsidies SSDI / SSDAC
  • Social Security is required to consider the true
    value of someones work when determining if that
    person is earning above or below SGA.

10
Subsidies and Special Conditions
  • A subsidy exists when an employer pays an
    employee more in wages than the true value of
    actual services performed.
  • Evidence of subsidies include
  • Extra support and supervision on the job,
  • Additional time to complete job duties,
  • Lower productivity, and
  • Completion of fewer work tasks
  • when compared to unimpaired workers performing
    similar work.

11
Subsidy Example
  • Lai receives SSDAC. She is working at a Library,
    and due to a recent raise, she is now earning
    1,000 gross / month.
  • Based on this wage information alone, Lai would
    appear to be over SGA and at jeopardy of losing
    her SSDAC benefits.

12
Subsidy Example
  • However! Lais work is subsidized
  • She requires the ongoing support of a job coach
  • She is unable to accurately re-shelve books as
    such, this task has been taken away from her
    position
  • Due to her disability, she requires longer breaks
    than her coworkers.

13
Subsidy Example
  • The employer and the job coach decide that the
    actual value of Lais work, compared to other
    coworkers without disabilities, is about 70.
    (The employer is subsidizing Lais wages by 30.)
  • Lai lets Social Security know!
  • SSA now only looks at 70 of her wages to
    determine if she is earning above or below SGA.
  • 70 x 1,000 700
  • The true value of Lais work is 700. As 700 is
    less than SGA - 860 - she is NOT performing
    SGA.
  • Lai will keep her benefits.

14
Where Did That 70 Figure Come From?
  • Lais job coach and her employer filled out a
    form that helps determine a numerical value for
    Lais overall work productivity.
  • This form is in your packet
  • This form is not an official SSA form.
  • Subsidies are open to subjective interpretation.
  • Social Security makes the final determination.

15
Letting Social Security Know About Subsidies
  • Notice of subsidy can be submitted to Social
    Security in letter-form. Consider
    hand-delivering it and getting a receipt.
  • Social Security may ask an individual for subsidy
    information when conducting a CDR.
  • Social Security may contact the employer to
    confirm the subsidy is still in place.
  • The employer may receive an SSA Work Activity
    Questionnaire.
  • SSA is not required to inform you whether or not
    a subsidy has been approved.

16
Subsidies, SSDI/DAC Additional Information
  • With Title II benefits, subsidies can only be
    looked at when the TWP has ended.
  • Subsidies can be back-dated, up to an allowable
    period of time.

17
Subsidies and SSI
  • Subsidies only impact SSI during the time of
    initial application.
  • If a person applying for SSI is working and
    earning over SGA, indication of a subsidy may
    lower countable earnings below SGA and allow for
    SSI eligibility.

18
Questions?
19
IRWEs
  • What is an IRWE?
  • IRWEs and SSI
  • IRWEs and SSDI/DAC

20
IRWE
  • IRWE is an acronym for Impairment-Related Work
    Expense.
  • If a disabled person pays out-of-pocket for items
    and services that are
  • related to his/her disability, and
  • necessary for employment,
  • those expenses may qualify as
    Impairment-Related Work Expenses.

21
IRWE Examples
  • Examples of IRWEs include
  • Supported Employment Services
  • Attendant Care Services if performed at work, or
    in the process of helping someone prepare for
    work or return from work
  • Certain transportation costs, including mileage
    for approved vehicles
  • Routine drugs and medical services
  • Work-related equipment.

22
IRWE Criteria
  • For an IRWE deduction to be allowable, the
    following criteria must be met
  • Expenses must be directly related to the persons
    impairment and enabling the individual to work
  • Costs must be paid by the individual and not be
    reimbursable from other sources
  • Expenses must be paid in a month in which the
    individual is, or was, working
  • Expenses must be reasonable.

23
IRWE and SSDI / SSDAC
  • The cost of certain impairment-related items and
    services required by individuals in order to work
    may be deducted from gross earnings in
    calculating SGA.

24
IRWE and SSDI / SSDAC Example
  • Kirk is working, earning 950 gross / month. He
    is also eligible for 650 SSDI, and his TWP ends
    next month.
  • Based on wages alone, Kirk would lose SSDI due to
    earning over SGA.

25
IRWE and SSDI / SSDAC Example
  • Kirk pays out-of-pocket for job coaching
    services, a monthly ACCESS pass, and a medication
    each month for a total of 200 / month.
  • Kirk lets Social Security know by providing
    receipts and a brief explanation.
  • The IRWEs are approved by SSA.

26
IRWE and SSDI / SSDAC Example
  • SSA subtracts the IRWEs from Kirks wages to
    determine the true value of his work
  • 950 gross wages
  • - 200 IRWEs
  • 750 adjusted earnings
  • 750 is less than SGA (860 2006) therefore,
    Kirk remains eligible for SSDI benefits.

27
IRWE Example 2
  • Colonel has an SSDI benefit of 700. He is now
    earning 1200 / month gross. He is paying 400 /
    month for job-coaching.
  • George has an SSDI benefit of 700. He is now
    earning 1400 / month gross. Generals job
    coaching is being paid for by another source.
  • Which person will have a higher monthly income
    (wages plus benefits)?

28
IRWE Example 2
  • Colonel will have higher monthly income.
  • Colonel George
  • 1200 Gross General is earning
  • - 400 IRWE over SGA and will
  • 800 lose his SSDI
  • 700 SSDI benefits.
  • 1500 Total 1400 Total

29
Questions?
30
IRWE and SSI
  • If you are a recipient of SSI, and you have an
    approved IRWE, you can be reimbursed up to 50 of
    the IRWE amount on your SSI check.

31
IRWE and SSIExample 1
  • Olaf is working, receiving 885 gross / month.
    He also receives SSI in the amount of 203.
  • Olaf needs a job coach to remain successful at
    his job.
  • The job coach is negotiated to cost 200 / month.
    Olaf will pay for this service himself.
  • Olaf lets SSA know about the IRWE, and it is
    approved.

32
IRWE and SSIExample 1
  • SSA calculates his new SSI
  • 885 gross wages
  • - 85 exclusion
  • 800
  • 800
  • - 200 IRWE
  • 600
  • 600 / 2 300 Countable Income
  • 603
  • - 300
  • 303 SSI

33
IRWE and SSIExample 1
  • Without an IRWE, Olaf receives
  • 885 wages 203 SSI 1088 total income / mo
  • With an IRWE, Olaf receives
  • 885 wages - 200 job coaching 303 SSI 988
  • Olaf is paying 200 out-of-pocket for his IRWE,
    but his total income is only reduced by 100.

34
IRWE and SSIExample 2
  • June is receiving 485 gross / month in wages.
    She is 19 yrs old and a full-time student.
    Because of the Student Earned-Income Exclusion,
    her SSI is not being reduced.
  • June is paying 150 / month for therapies not
    covered by Medicaid. They are related to her
    disability, and they are necessary for work.
  • Can June submit an IRWE and receive up to half of
    the 150 back on her SSI?

35
IRWE and SSIExample 2
  • No. SSA is unable to reimburse June any of the
    IRWE costs because she is already receiving the
    maximum SSI amount available.

36
Letting Social Security Know About IRWEs
  • Notice of an IRWE can be submitted to Social
    Security in letter-form. Include any receipts
    for payment.
  • Consider hand-delivering it and getting a
    receipt.
  • Keep copies of everything!
  • SSA is not required to inform you whether or not
    a subsidy has been approved.

37
More Info on IRWEs
  • There are no time limits on how long individuals
    can use an IRWE.
  • It is not necessary that an IRWE be a monthly
    recurring expense.
  • In cases of one-time large expenses, an
    individual may choose to have the IRWE prorated
    over (up to) a 12 month period.

38
More Info on IRWEs
  • IRWEs can be backdated as long as there is proof
    of payment.
  • IRWEs can be used in conjunction with a subsidy.
  • IRWEs can be used to make a person eligible for
    SSDI or SSI (by earning below SGA).

39
King County DDD Assistance
  • A KC DDD Employment Resource Coordinator can help
    you
  • Identify an IRWE or Subsidy
  • Write a letter of explanation to be submitted to
    SSA
  • If you are paying for job coaching, act as fiscal
    intermediary for IRWEs and produce all necessary
    receipts.

40
Questions?Break?
41
PASS
  • Who can use PASS?
  • What is a PASS?
  • How does it work?
  • Whats in it for SSA?
  • FAQs

42
Who can use a PASS?
  • Anyone who is receiving SSI or could be eligible
    to receive SSI AND who has resources or income
    other than SSI may utilize a PASS.
  • PASS works for many people, but it doesnt work
    for everyone.

43
What is a PASS?
  • PASS stands for Plan for Achieving Self Support.
  • PASS is a Social Security Work Incentive Program.
  • PASS is a great tool for people who are serious
    about employment and need support to be
    successful.
  • PASS plans are as unique as the individuals who
    choose to utilize them.

44
What is a PASS?
  • PASS is a tool that helps people afford to pay
    for items and services they need to reach a
    specific work goal.
  • In short, when a person is utilizing a PASS, he /
    she sets aside money to pay for the outlined
    items and services, and SSA responds by
    reimbursing the person some or all of the money
    via an SSI check.

45
What is a PASS?
  • PASS is a sheltering mechanism. It shelters
    money in two ways
  • When income is set aside for a PASS, that money
    is sheltered when Social Security computes the
    persons SSI amount.
  • Money in a PASS account is sheltered from the
    2,000 SSI / Medicaid resource limit.

46
How does it work?
  • A PASS template is filled out and submitted to
    SSA.
  • In this plan, the person identifies a work goal,
    the steps it is going to take to reach that goal,
    and all the costs involved with that process.
  • Once approved, PASS allows individuals to set
    aside and shelter money. This money is used to
    pay for all the items and services listed in the
    PASS.

47
Accounts Marked for PASS
  • A separate bank account under the individuals
    name must be used for all PASS funds.
  • Only funds associated with the PASS can be placed
    in this account.

48
What money can be sheltered and used in a PASS?
  • Any money other than SSI can be set aside in a
    PASS.
  • Resources (savings) can be set aside in a PASS.
    This money is sheltered from the 2,000 resource
    limit of SSI and Medicaid.
  • Income, both earned (wages) and unearned (Social
    Security check, child support, etc.), can be
    sheltered in a PASS.
  • PASS may allow a person not receiving SSI and
    Medicaid to become eligible for those benefits.

49
The Quick Version of How It Works
  • A person with an approved PASS plan sets a
    portion of his/her own income aside monthly in a
    separate bank account to pay for the items
    listed.
  • Social Security responds by reimbursing the
    person that set-aside amount on his/her SSI
    check.

50
Example 1 - SSI
  • Nigel receives 685 gross / month wages and 303
    SSI for a total of 988 / month.
  • Based on his wages, Nigels SSI is being reduced
    by 300.
  • Nigel wants to change jobs and earn more money.
    He writes a PASS to pay for the things he needs
    to reach this work goal. The PASS is approved.

51
Example 1 SSI The Sheltering Mechanism
  • Nigel will take 300 of his
    hard-earned money and
  • set it in a special account dedicated to
    the PASS.
  • In return, SSA will reimburse Nigel the 300 on
  • his SSI check.
  • w/o the PASS 685 wages 303 SSI 988
  • w/ the PASS 685 wages - 300 PASS 603 SSI
  • 988 ( 300 PASS)

52
SSA and
  • If Social Security is just reimbursing me for the
    things that Im paying for, wouldnt it be easier
    for SSA to just pay for everything Ive written
    in the PASS?
  • Sure. But then you really wouldnt have any
    ownership in the plan.

53
Example 2 SSDI/DAC
  • Rebecca receives 680 SSDI. Rebecca writes and
    submits a PASS, and it is approved!
  • Rebecca is not receiving SSI because she has too
    much SSDI.
  • With a PASS, Rebecca shelters her SSDI into an
    account marked for the PASS. Now that the SSDI
    is sheltered, it looks as if she has no unearned
    income, and she becomes eligible for SSI!

54
Example 2 SSDI/DAC The Sheltering Mechanism
  • Rebecca must put her entire SSDI minus a 20
    exclusion into the PASS account 680 - 20
    660 into the PASS.
  • In return, she gets reimbursed 603 SSI.
  • w/o a PASS 680 / month
  • w/ a PASS 603 SSI 20 excl. / month
    (660 PASS)

55
SSA is kicking in their own money. What do they
get out of it?
  • SSA wants people to be successfully employed, pay
    taxes, and rely less on their system.
  • One goal of the PASS must therefore be for the
    participant to have a reduction in benefits by
    the end of the PASS (unless the PASS is for only
    for a vocational assessment)

56
SSA is kicking in their own money. What do they
get out of it?
  • If you receive SSI, you must, by the end of the
    plan, demonstrate that you are receiving less
    SSI.
  • If you are a beneficiary of SSDI / SSDAC, you
    must demonstrate that you will stop receiving
    these benefits by the end of the plan. (Remember
    SSDI and SSDAC are all-or-nothing benefit
    checks.)
  • If your goal is to earn over SGA, then PASS makes
    sense if you are unable to earn over SGA and
    lose SSDI/SSDAC, you cannot write a PASS.

57
Frequently Asked Questions
  • I have SSI and no other income and resources.
    Can I write a PASS?
  • No. However, as soon as you begin working, you
    may have enough wages to set aside in a PASS.

58
Frequently Asked Questions
  • I am not eligible for SSI because I have 5,000
    that my grandmother left me in her will. Could
    I use this money in a PASS?
  • Yes. If you put that 5,000 into the PASS, it
    will be sheltered from the 2,000 resource limit,
    and you will become eligible for SSI. It will be
    expected that you use that money for items listed
    in your PASS.

59
Frequently Asked Questions
  • I would like to work, but I dont have any idea
    what my work goal might be. Can I still write a
    PASS?
  • Yes. You can write a PASS to pay for items and
    services necessary to explore and decide upon an
    attainable work goal. (This is called a VR
    Evaluation on the PASS template.) You do not
    need to rely less on the system by the end of
    this plan. It is not necessary that you follow
    up with a new PASS, though that is often a
    logical next step.

60
Frequently Asked Questions
  • I am working right now, and Im pretty stable on
    my job. Can I write a PASS?
  • Yes, but remember, you would need to demonstrate
    that by the end of the plan, you will rely less
    on the system than you are currently. You can
    write a PASS if your goal is to earn more money
    at your current job or to obtain new employment
    with higher wages.

61
Frequently Asked Questions
  • I dont want to change jobs or earn more money.
    I just need to pay for a job coach to come in now
    and then to help me out.
  • Then a PASS would not be the appropriate SSA Work
    Incentive for you to use. It might make better
    sense to establish an IRWE while paying for this
    job coach support.

62
Frequently Asked Questions
  • I am a under 22 years of age, and I am a
    full-time student. I understand that there is a
    Student Earned-Income Exclusion where my SSI may
    not initially decrease with wages. Can I still
    use a PASS?
  • No. With a PASS, you are reimbursed through SSI.
    If your SSI is not going down, then there is no
    room by which you can be reimbursed.

63
Frequently Asked Questions
  • How long can my PASS last?
  • As long as necessary for you to reach your work
    goal. Plans do not run indefinitely. You
    identify your work goal, and the PASS continues
    until you have reached that goal.

64
Frequently Asked Questions
  • How many plans can I have in my lifetime?
  • As many as you want or need. Of course, SSA will
    have the final decision on whether or not to
    approve each plan.

65
Frequently Asked Questions
  • Do I establish a PASS with my local field office?
  • No. You submit a PASS with the PASS Cadre,
    located in downtown Seattle. The PASS Cadre will
    conduct all audits and monitor the PASS.
  • You must still report wages on a monthly basis to
    your local SSA office!

66
Questions?
67
PASS
  • For what things can a PASS be used to pay?
  • Amendments
  • King County PASS Management
  • FAQs

68
What Kind of Things Can I Pay For With My PASS?
  • Vocational Assessment
  • Job coaching
  • Transportation Costs
  • Clothing
  • Equipment (computers, modification at the work
    place, etc.)
  • Home-support directly before and after work
  • Education
  • Cost of someones support with writing the PASS.
  • Physical therapy / Counseling
  • Etc., Etc. Etc.

69
What Kind of Things Can I Pay For With My PASS?
(cont.)
  • Essentially, if its necessary for you to reach
    your work goal, chances are pretty good that you
    can get it approved as part of your PASS.
  • Here are some exceptions
  • If youve already paid for it, you cant ask to
    be reimbursed
  • If it can be paid for through another resource
    (i.e. grants, DVR funding), then it may not be
    covered by the PASS.
  • There are cheaper alternatives.

70
Example
  • Lizettes dream is to become a clown.

71
Example, cont.
  • Lizette has requested the following items in her
    PASS
  • Cost of tuition at Clown Community College (1
    year program)
  • Job coaching
  • 8 rubber chickens
  • 1 pair bulbous red shoes, size 20
  • Show-Pony
  • 2005 Mercedes-Benz SL Roadster

72
Example What Will Be Approved?
  • Cost of tuition at Clown Community College
  • This could be approved however, Lizette would
    need to demonstrate that she has researched
    possible grants and none exist (or she doesnt
    qualify for any).
  • Job coaching
  • This could be approved. Lizette would need to
    explain in detail how much job coaching she would
    need and why she needs this support.

73
Example What Will Be Approved?
  • 8 rubber chickens
  • No problem, as long as SSA knows its a necessary
    item for a clown.
  • Bulbous shoes
  • Again, no problem, as long as SSA understands
    that it is part of a work uniform.
  • Show-Pony
  • This one would be pretty tough to get through.
    Why does she need one? Can she afford to take
    care of it? SSA will want to know.

74
Example What Will Be Approved?
  • Mercedes-Benz
  • Not a chance.
  • Actually, cars can be approved in a PASS.
    However, the burden falls on the user to prove
    that it is absolutely necessary. If you can take
    the bus to and from work, and that trip takes a
    reasonable amount of time, SSA is not going to
    help pay for a car.

75
Amendments
  • Rarely do plans move along precisely as
    originally predicted in the PASS. When
    deviations from the plan occur, you must notify
    the PASS Cadre.
  • The PASS Cadre will review and either approve or
    not approve the amendment. They will send a
    letter explaining their decision.

76
Suspension
  • If major changes happen to the plan, i.e. you
    lose your job, you can request to suspend PASS.
  • Suspensions can last for up to one-year. During
    this time, the PASS is simply frozen.

77
The PASS Ends
  • The PASS ends once the individual reaches her
    work goal and all debts have been paid.

78
King County PASS Management
  • King County can help people write and manage
    their PASS plans.
  • Assist with writing the PASS
  • Use virtual accounts for PASS funds
  • KC DDD will help monitor the flow of funds
  • KC DDD will produce all documents for audits
  • KC DDD can assist with writing amendments.

79
Frequently Asked Questions
  • Im leaving the country, and I havent yet met my
    work goal. Will I owe all that money Ive spent
    back to SSA?
  • Assuming that you were following the PASS
    honestly and according to plan, you probably will
    not owe SSA any money that you have spent for the
    PASS.
  • Any money left in the account will go back SSA
    unless that money came from resources, not
    income.
  • Technically, the money will go to you, and then
    SSA will request all or some of the money as an
    overpayment)

80
Frequently Asked Questions
  • If my PASS falls apart and is terminated, can I
    write a second PASS down the road when Im more
    ready?
  • Yes. The PASS Cadre will make the decision on
    whether or not to approve it. If your PASS
    failed in the past, then they will want to know
    why, and how are things different this time
    around.

81
Frequently Asked Questions
  • Why would I want King County to help manage my
    PASS?
  • Its free, our help could make the process a
    whole lot easier for you, and each employee for
    KC DDD is a pure joy to work with.

82
Questions?
83
Thank You!Please fill out the evaluation before
you leave.
  • Department of Community and Human Services
  • Developmental Disabilities Division
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