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CHANGES
IN THE LAW MAKE IT MORE FEASIBLE
FOR PEOPLE WITH SCI TO RETURN TO WORK
Many changes in the law during the last few years have made it easier
for persons with a disability such as SCI to return to work,"
states Rick Baisden, Vocational Counselor at the Ann Arbor Center
for Independent Living. Baisden said that sweeping civil rights
legislation such as The Rehabilitation Act of 1973 and the Americans
with Disability Act (ADA) of 1990 have received most of the publicity,
but many other, lesser known laws and regulations can also be important
for those wishing to return to work. "It's often difficult
for people to understand these laws and how they can benefit from
them." Baisden cited the Plan for Achieving Self-Support (PASS)
and Trial Work Period (TWP) as examples of programs that have been
around for a long time but are underutilized by persons with a disability
who want to enter the workforce. Recently, the Ticket to Work and
Work Incentives Improvement Act of 1999 (TW/WIIA) was enacted by
the Federal Government. It can also help people with disabilities
enter the workforce.
This Special Issue of SCI ACCESS provides basic information about
the numerous laws that can help people with SCI to successfully
return to work.
Social
Security Disability Benefit Basicis: SSDI and SSI
Social Security Disability Insurance (SSDI) and Supplemental Security
Income (SSI) are two programs of the U.S. Government's Social Security
Administration that provide cash benefits to people with disabilities.
Social
Security Disability Insurance (SSDI)
People with disabilities such SCI may qualify for SSDI six months
after their injuries, depending upon their work history. While the
formula used to determine eligibility for SSDI is complex, basically
it depends on how long you have worked at jobs for which Social
Security taxes (also called FICA) were withheld and how much you
earned before the time of your injury. SSDI payments are based on
a worker's FICA taxed earnings
over the ten-year period, before they became disabled. Payments
are increased every year based on inflation. For information about
SSDI call: 1-800-772-1213.
If you have access to the internet, check out the website: http://www.ssa.gov/.
(In the column entitled, "Benefits," click on "disability".)
Another good site is: http://www.ssa.gov/pubs/10029.html#part1c.
Medicare is the federal program that provides health care
benefits to people who qualify for SSDI. You will be enrolled in
Medicare automatically after you have been receiving SSDI benefits
for two ears, as long as you are age 21 or older. For more information
about Medicare, call 1-800-633-4227 or check out the website: http://www.medicare.gov/.
Will
I lose my SSDI benefits immediately if I start working?
No, Social Security has a created a Trial Work Period (TWP). This
allows people to work for up to nine months during a five-year period
without losing their SSDI benefits. There is no limit to what your
earnings can be during these trial months. After that, for every
month when you earn above the SGA you will lose your cash SSDI benefits.
However, after your TWP, for every month within your three-year
Extended Period of Eligibility (EPE) that you earn less than SGA,
you will still be eligible for SSDI cash benefits.
Will
my disability status be reviewed?
Some
beneficiaries have asked, "If I return to work, won't they
immediately review my status and assume I am no longer disabled?"
The Social Security Administration periodically reviews a person's
disability status. However, the new law states that SSA will not
conduct a review to see if a person's medical condition has improved
while they are using a Ticket To Work. (Scroll down for more information
on Ticket to Work.)
What
about the $800 Substantial Gainful Activity?
If you earn less than $800.00 or are self-employed and work less
than 80 hours in a month, you can work and receive your SSDI benefits
indefinitely. After your trial work period, you will lose your cash
benefits for any month you earn over $800.00 or work more than 80
self-employed hours.
Supplemental Security Income
(SSI)
SSI
gives cash assistance to people with disabilities who have limited
financial resources. Eligibility for SSI depends on income and financial
resources. Income includes money from wages, Social Security benefits,
pensions, stocks, bonds and non-cash items you receive such as food,
clothing or shelter. If you're married, your spouse's income is
also included. Your financial resources are limited to $2,000 if
single and $3,000 if married. This does not include the value of
your car or home. To learn more about SSI, call 800-772-1213 or
go to http://www.ssa.gov/pubs/11000.html#PART%202
Are
the rules for SSI the same as those for SSDI?
No. If you receive SSI you can only earn up to $85.00 before your
benefits will be lowered. Above that, your SSI payments will be
reduced by $1.00 for every $2.00 you earn. You may still be eligible
to receive Medicaid, the health insurance program for people with
limited financial resources, even if you no longer receive money
from SSI. Starting January 1, 2004, you can earn up to $22,450 per
year and still be eligible for Medicaid without paying premiums.
If you earn over that amount, you can pay for your premiums on a
sliding scale beginning at $50 a month. (Scroll down for information
about the Medicaid buy-in.)
Does
it cost too much to work?
When people with spinal cord injuries return to work, their expenses
for attendant care, transportation, and other impairment-related
work expenses may increase. Social Security will allow you to deduct
the cost you pay for a large number of goods and services that make
it easier for you to work. These include certain attendant care
costs, vehicle and home modifications, and medical supplies. This
amount is subtracted from your
gross earnings to determine if you have exceeded the SGA threshold
of $800 per month (See article in this newsletter, "How does
working affect SSI and SSDI").
For example, John pays $400 per month for attendant care services
to help prepare for work. He spends another $400 per month for several
months to pay for the cost of modifications to his car. John can
earn up to $1580.00 per month ($800 + $400 + $400) before his SSDI
benefits are affected.
How does Working Affect SSDI and SSI?
You can earn up to $800 a month and continue to receive SSDI benefits.
Earnings of $800 or more are called Substantial Gainful Activity
(SGA). This $800 amount is increased annually for inflation.
If you receive SSI you can earn up to $85 a month without your SSI
payment being affected. After that, your SSI income is reduced by
an amount that depends on how much you earn.
What
Happens to Your Medicare if You Work?
Recent changes in Medicare regulations created by the Ticket to
Work and Work Incentives Improvement Act allow you to keep your
Medicare coverage for at least 8 ½ years after returning
to work as long as you continue to be disabled.
Note: Working people with disabilities who received Social Security
Disability Insurance (SSDI) or Medicare in the last three years
can get these benefits restarted if they are no longer able to work
because of their medical condition without filing a new application
with the Social Security Administration.
The following timeline shows what might happen:
Some useful terms to know…..
Trial Work Period (TWP) A period of nine months (not necessarily
consecutive) during which your Social Security benefits will not
be affected by employment earnings. (The nine months of work must
occur within five years. If 9 months are not used in a 5-year period,
your TWP renews.)
Substantial Gainful Activity (SGA) SGA is defined as work "that
involves doing significant physical or mental activities and is
the kind of work usually done for pay or profit. "Significant
activities" are useful in the operation of a business and have
a specific economic value.
Extended Period of Eligibility For at least three years after a
successful trial work period, a Social Security beneficiary who
is disabled may receive a disability benefit for any month that
his/her earnings are below the substantial gainful activity level
of $800 per month
Don't
"PASS" Up this Opportunity
Plan for Achieving Self-Support (PASS) is a work incentive for people
who receive SSI and SSDI. PASS is designed to help people with disabilities
enter the work force. It is provided through the Social Security
Administration.
PASS lets people with disabilities set aside money and/or things
they own to pay for things they need to achieve self-sufficiency
through specific work or self-employment goals. Funds can be used
to achieve these goals without their counting against SSI income
and asset limits. Qualified expenses include things such as education,
training, and assistive technology.
(If you do not already receive SSI, you will need to apply for SSI
when you apply for your PASS.)
In order to take part in the PASS program, you must develop a plan
for how the funds set aside will be spent. PASS plans must be submitted
and approved by the Social Security Administration before they start.
Plans normally last 3 to 5 years. For more information, go to
http://www.ssa.gov/work/ResourcesToolkit/generalinfo.html
or call the SSA at
1-800-772-1213
An
Individual Who Made Use of PASS
Carole is a 45 year-old woman who sustained a spinal cord injury
five years ago. She was formerly a secretary but now does not work.
Carole recently used PASS to help her achieve a dream of becoming
a computer programmer. Here's how PASS is working for her:
Carole submitted a PASS to SSA to assist her in obtaining programmer
training. The PASS included a timeline and detailed budget, all
of which were approved by Social Security. Carole
now has $4000 in savings, money that would normally exclude her
from receiving monthly SSI benefits. Carole plans to use this $4000
to help pay for tuition and books and some personal attendant expenses.
Because this money is used to help Carole achieve the work goals
detailed in her PASS, it will not be used in calculating Carole's
SSI benefit amount. Because of her PASS, Carole's monthly SSI benefit
will actually increase while she is attending classes.
IMPORTANT
LAWS AFFECTING EMPLOYMENT
The Rehabilitation Act
of 1973
The Rehabilitation Act was the first piece of Federal legislation
focused on protecting the rights of individuals with disabilities.
It includes a variety of provisions focused on rights and advocacy.
The
Americans with Disability Act (ADA)
The ADA, enacted in 1990, is the major Federal civil rights law
that applies to individuals with disabilities. The ADA protects
you from discrimination in employment practices. You have a right
to request a reasonable accommodation in both the hiring process
and on the job.
Specifically, you cannot
be discriminated against because of your disability if you can perform
the essential functions of the job with reasonable accommodation.
A reasonable accommodation
is any change or adjustment to a job, the work environment or the
way things are usually done that would allow you to apply for a
job, perform job functions, or enjoy equal access to benefits available
to other people in the workplace. Many things that can help people
with a SCI successfully work are protected under the ADA. Some
of the most common accommodations include physical changes such
as installing a ramp, providing equipment, such as voice recognition
software or modifying a workspace or an adjusted work schedule or
time off for someone who needs treatment for a disability. For more
information, call 800-514-0301 (voice) 800-514-0383 (TTY) or go
to the Web site: http://www.usdoj.gov/crt/ada/adahom1.htm.
Ticket
to Work and Work Incentives Improvement Act of 1999 (TW/WIIA)
The Ticket to Work and Work Incentives Improvement Act of 1999 is
an important law that makes it easier for people with SCI to become
employed in a number of ways. For example, recent changes in Medicare
created by the TWWIIA allow you to keep your Medicare coverage for
at least 8 ½ years after you return to work. Other parts
of TW/WIIA focus on support.
Starting in 2001, people receiving SSDI and SSI in some states were
issued a "ticket". With these "tickets", people
could obtain free vocational rehabilitation services from private
or state vocational rehabilitation agencies, as well as other organizations
approved by the Social Security Administration. The organizations
that provide services through the Ticket to Work program are called
Employment Networks (ENs). Michigan joined the Ticket Program in
October 2002.
MAXIMUS is a private organization that helps the SSA manage the
Ticket Program, overseeing the approval of ENs and providing information to beneficiaries
about the Ticket to Work Program.
For information about
the program details and Employment Networks, call MAXIMUS at
1-800-866-968-7842 (1-866-YOURTICKET) or TTY (1-866-833-2967) (1-866-TDD
2 WORK).
On the web, go to:
http://www.ssa.gov/work/Ticket/ticket_info.html
and
http://www.yourtickettowork.com/program_info?s
elect=what-program.
Important: Participation
in the Ticket to Work program is voluntary. If you choose not to
participate, your decision will have no effect on your Social Security
benefits.
If I get a job through
the Ticket Program, will my disability status be reviewed?
Periodically, the Social Security Administration reviews everyone's
disability status to see if they are still disabled. However, the
new law states that work activity will not trigger a medical review
to see if a person's condition has improved while they are using
a Ticket To Work.
Michigan To Implement Medicaid Buy-in January
1, 2004
We are happy to report
that Michigan will join 27 other states which have reduced the financial
burdens of returning to work by allowing persons with disabilities
to work and still keep their Medicaid benefits.
Under the new law, which goes into effect on January 1, 2004,
People with disabilities
who earn up to $22,450 a year can continue to receive Medicaid
without paying premiums.
People who earn over $22,450 will pay a premium for Medicaid on
a sliding scale, beginning at $50 a month. Anyone earning more
than $75,000 a year will pay the full Medicaid premium, estimated
to be $6,000 to $10,000 annually.
The asset limit will increase from $2,000 to $75,000. People also
will be allowed to set up individual retirement accounts.
To see the entire bill,
go to www.michiganlegislature.org
and enter Senate Bill 22 or House Bill 4270. You may also link to
an analysis of the bill on this page.
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