The best kept secret among disability benefit recipients, advocates, the Social Security Administration and complimenting agencies (Medical Assistance, Hud) is the availability of work incentives which are provided for recipients by permanent Public Law. Section 1619 was originally effective January 1, 1981 as a 3 year demonstration and extended by Congress in 1984 for an additional 3 1/2 years ending June 30, 1987. The Employment Opportunities for Disabled Americans Act (Public Law 99-643) made section 1619 a permanent part of the Social Security Act effective July 1, 1987.
Under section 1619b, once a person is approved for Supplemental Security Income, SSI, the amount of earnings made by the recipient, will never effect the Social Security Administration’s determination of whether that person continues to be disabled. This has far reaching financial implications. Medical insurance will still be available to these persons while they are working. They will lose their cash benefits as their earnings increase, but their permanent disability will not be redetermined because of their income, and they will be able to use Medicaid. If you have sizable medical expenses or need attendant care services, it is essential that you retain medical insurance. It is very unlikely that a employment position with a benefit package that was adequate could be found in the private sector in a year, or in four years, or ever. The high cost of these services and the fear of losing that support is what keeps many recipients from working.
The “Plan for Achieving Self-Support” or PASS for short, (Social Security Manual 00870.001) allows a disabled person to set aside income and resources for a work goal that will increase that person’s financial independence. Some examples of suitable expenses are: education, vocational training, or starting a business. Individuals may even set aside funds to purchase work related equipment like a computer, furniture for a computer, adapted equipment, attendant care, a vehicle in which to get to work and so on. The suggested list is open-ended.
A candidate for a Plan to Achieve Self-Support must be: under age 65, over age 15, not terminally ill, able to pursue a feasible occupational goal, is blind or disabled claimant or recipient who currently does not have the capability for self-support.
It is necessary to distinguish between Social Security Disability Income – SSD for short, and Supplemental Security Income – SSI, Medicare and Medicaid, and to determine which of these programs apply to you.
Social Security Disability Income, SSD, is an insurance program. To qualify, one must meet an earning or “insured status” test, i.e., theapplicant has worked and contributed to the social security system. As an SSD recipient your amount of income must be considered by the Social Security Administration to determine your disability status. This is a major disincentive to employment. It puts a recipient with a permanent disability at risk of losing all government support while making a relatively small amount of money. The Substantial Gainful Activity (SGA) limit range is now $390 – $500 and is relevant only to SSD recipients. Generally speaking, after a 9 month trial work period you will lose your cash and medical benefits if you are earning at the SGA limit. There are other work incentives under SSD but different criteria must be met and overall the opportunity for real advancement is not available in the SSD program.
Supplemental Security Income, SSI, is a welfare program and based on need. SSI can be one’s only income, or it can supplement another income source, such as SSD. The maximum SSI payment in MN at this time is $407 per month. Ironically, the legislators have given much greater work incentives for persons who have not work experience.
Medicare is a medical insurance program and is linked to the receipt of social security benefits. An SSD recipient who has been eligible for benefits for 24 months qualifies for Part A of Medicare automatically, and for Part B Medicare by paying a monthly premium.
Medicaid, like SSI is a welfare program, is need based and provides for medical expenses and attendant care. In most states, Minnesota being one of them, eligibility for SSI provides for Medicaid benefits.
If you are receiving SSD you can use The Plan to Achieve Self-support to become eligible for SSI. This is an essential step if you are serious about going to work and if you will always have substantial medical/attendant care expenses. Write a “Plan to Achieve Self Support”. Or, find someone else to write it. Your Claims Rep. will need at some point to be available to help/write your PASS. If you know exactly what you want to do, gather all supporting information, and have many months to wait, Social Security will write your PLAN. It often takes several months for an advocate written proposal to wind its way through the system waiting for corrections and approval. They can be made retroactive to the date of the first inquiry to your claims Representative. It is wise to ask them to make a written note of your inquiry and you should also save a note about that call.
Time can be important to persons who are preparing to go to work while on SSD. If You will always need substantial medical and attendant care services you should delay work until you can write a PASS and establish prior month eligibility for SSI. You may lose the chance to access the much greater work incentive benefits if you begin work and make more than the income allowed for new SSI applicants.
Persons who are working and hope to increase their earning power cannot use PASS…”It is not the purpose of a plan for achieving self-support to assist a self-supporting individual to achieve his or her optimum level of earnings.” Similarly, persons who are receiving SSI and have no earned income or other sources of income are not PASS candidates since PASS is a method for sheltering otherwise countable income.
It is a creative step-beyond to envision and assert one’s self into a new productive role. Deciding what you want to attempt is the hard part, writing the PASS is less difficult.
A PASS must have some basic information:
It must be in writing. (No specific form, and you can get help from any capable person)
It must have a designated and feasible occupational goal
1. Identifies the proposed occupation
2. Can be attained given the person’s impairment
3. Will produce additional earned income sufficient to eliminate or reduce SSI payments within a reasonable period of time.
Identify all income resources that will be excluded. The exclusions must compliment the expenditures.
List of planned expenditures, note relationship to the goal and a cost estimate which explains how the cost was calculated.
Identify a specific time frame for achieving the goal. Optimal length is 18 months and 18 months to equal 36 months and if you are going to be in school, add another 12 months.
A specified way to account for PASS funds must be noted. All records must be kept and may be reviewed at intervals by the Social Security Administration.
A PASS can be written for any length of time, setting aside various amounts. The optimal situation is to have a firm goal in mind that will require the use of all SSD income, earned income and other resources for the full 36 months, or 48 months.
The Social Security Administration in St. Paul and Mpls. have knowledgeable and cooperative Supervisors. The author has found other individuals in Social Security to be very willing to be of help, sometimes well informed, rarely confidant about the process.
There may be other hurdles to roll around when it comes to Medical Assistance and the Department of Housing and Urban Development, HUD. These agencies are required to acquiesce to Social Security’s decision on PASS. Very little information is provided for Medical Assistance’s financial workers, or for the personnel at HUD. The regulations allowing PASS should supersede any other agency regulations that might appear contradictory.
Once on SSI you can work and receive full Medicaid benefits until you make over 24K. This level of income is Minnesota’s general income limit at which point, Medical Assistance can calculate your ability to pay part or all of your medical insurance costs. The individual formula they use is called a “reasonable equivalent of earnings threshold”. Each case can be determined individually with regard to their real medical expenses and their Impairment Related Work Expenses. Impairment Related Work Expenses can be put in place with the PASS. These deductions provide for the on-going expenses that will need to be paid which are related to your disability. These deductions can be in place for as long as you work. Next month IRWE deductions will be discussed in detail.
“Where have we been so long???” Why are these available work incentives not known to us? It has been suggested that in the early eighties the Social Security Administration was overwhelmed with continuing disability investigations and the confusion of litigations to deal with the problems that resulted. No advocate can guarantee that the laws protecting your right to work and keep your benefits will never be changed. There is always a certain risk factor.
Attitudes are changing and the disabled community is becoming increasingly visible. This newly recognized work incentive will if fully used make it possible for many very capable adults to become partially or wholly independent of government support.
The savings to our system over one successful person’s life time is considerable, and would support many other attempts. It is demoralizing to have to live in such a way as to limit your fullest potential. Those persons who want to work will be able to increase their standard of living and more fully contribute in an area of their own choosing.
Toni Zachariae Watt is President of Propose Ability Inc., a company specifically formed to assist individauls in writing plans achieve self-support and impairment related exemption proposals.
