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work incentives

VIEWS: 60 PAGES: 43

									   Work Incentives and
   Assistive Technology

         Using the SSDI, SSI, Medicare and
        Medicaid Work Incentives to Fund AT
            Or Leverage Funding for AT

                September 28, 2010

             Bridges to Better Advocacy
              2010 Annual Conference

                                              1




Today’s Presenters



James R. Sheldon, Jr., Esq.
National AT Advocacy Project
Neighborhood Legal Services, Inc.
jsheldon@nls.org

Edwin J. Lopez-Soto, Esq.
Employment and Disability Institute
Cornell University
ejl44@cornell.edu
                                              2
    Purpose of this Session
• Identify AT to support education, training
  or work

• How work incentives can fund AT
  – SSDI or SSI
  – Medicare or Medicaid

• How work incentives can leverage funding
  for AT
                                               3




   The Two Disability Programs




                                               4
                 Programs Known As
 Social Security Disability          Supplemental Security 
  Benefits                             Income

    RSDHI (Retirement,                  SSI (Supplemental 
     Survivor, Disability, Health         Security Income)
     Insurance)
                                         Title XVI
    SSDI (Social Security 
     Disability Insurance)
    Title II, DIB (Disability 
     Insurance Benefits)


                                                                5




                         Work History
 Social Security                     Supplemental Security 
  Disability Benefits                  Income

    Wage Earner must have               No work history is 
     accrued sufficient                   required
     “credits of coverage”




                                                                6
              Title II Disability Benefits
 Spouses: At least age 62, or if caring for either a child under 16 or a 
  disabled child of the worker
 Divorced Spouses: If the marriage lasted at least 10 years and the person 
  is age 62 years old or older and remains unmarried.
 Child: If under age 18 (or under 19 is a full‐time high school or 
  elementary student) and dependent unmarried child of an insured 
  eligible worker.
 Disabled Adult Child/Childhood Disability Benefit: Adult children (18 or 
  older) of a retired, disabled, or deceased worker, if the disability began 
  before the age of 22.



                                                                                7




        Benefits to Recipient’s Family
 Supplemental Security Income

            No family member of the SSI recipient will be 
             eligible for SSI benefits unless he or she 
             independently establishes eligibility for SSI




                                                                                8
     What Affects Benefit Amount?
 Social Security              Supplemental Security 
  Disability Benefits           Income

    Only Worker’s                 Any income (earned or 
     Compensation or other          unearned) affects 
     Federal or State               benefits.
     disability payments 
     may affect payment 
     level.




                                                             9




                Effect of Resources
 Social Security              Supplemental Security 
  Disability Benefits           Income

    No resource limits            Resources must be 
                                    below $2,000 for an 
                                    individual and $3,000 for 
                                    federally married eligible 
                                    couples.




                                                             10
                       Health Benefits
 Social Security                        Supplemental Security 
  Disability Benefits                     Income

     Eligible for Medicare 24                 In two‐thirds of states, 
      months after                              eligible for Medicaid if 
      establishing eligibility for              receiving even $1.00 of 
      SSDI                                      SSI




                                                                            11




               The Case or Mark, Age 48

Disability
• Multiple sclerosis, severe vision problem
• Power wheelchair for mobility


Computer use
• Difficulty typing
• Needs magnifier to see screen


AT Needs
• Adaptive keyboard/mouse AND/OR voice dictation software
• Enhanced computer screen AND/OR voice output software



                                                                            12
    Mark – Work Background, SSDI Receipt

Snow City Gazette
• Sports reporter, columnist
• Age 24 to 42


SSDI Approval, July 2004
• Currently $900 per month
• Medicare effective 2006
• $96.40 Part B premium in 2010




                                                        13




       Mark’s Need for Power Wheelchair


Current wheelchair 8 years old
• Constantly needing repairs
• Not equipped for changing disability


Needs “standing” power wheelchair
•   $24,000
•   Medicare Part B will not pay for standing feature
•   $12,500 without standing feature
•   Mark’s co-pay is $2,500



                                                        14
             Mark’s AT Funding Needs


• $96.40 for monthly Medicare Part B premium

• 20 percent Part B co-pay = $2,500

• Standing feature on wheelchair
   – Medicaid?
   – State VR agency?


                                                          15




     Mark Returns to Snow City Gazette

Part-time, high school & college sports
• $1,650 gross 2007 … $1,800 in 2010
• Drives old van
   – Hydraulic lift, passenger lock down for wheelchair
   – 114,000 miles, bad shape


AT funding needs
• New or newer used van
• Modified for travel as passenger



                                                          16
             Payment for Mark’s Driver

Driver duties
• Operate lift, wheelchair lock down
• Drive, “eyes at the game”


Driver payments
•   50 hours x $8 = $400 per month
•   2007-2008, payment by State VR agency
•   2009-2010, payment by Mark
•   2010, daughter does some “free services”



                                                               17




     Mark Reports “Statutory Blindness”


September 2010
• “I am now legally blind”
• SSA term is “statutorily blind”


Was Mark blind in 2007 or later?
• BPQY says “not statutorily blind”
• Ophthalmologist first certified blindness in November 2006




                                                               18
        SSDI and Medicare
         Work Incentives




                                                          19




Substantial Gainful Activity [SGA]

 Countable gross earned income over a set amount per
  month.


 Currently, in 2010, the set amount is $1000/month for
  all SSDI recipients who are not statutorily blind.


 Currently, in 2010, the set amount is $1,640/month for
  those who are statutorily blind .

                                                          20
          Application of the SGA Rule:
          Applicants for SSDI & SSI

   If an applicant’s countable earnings are over the SGA
    amount, the application will be denied.

   This is true for both SSI and SSDI applications.

   However, the SGA rules will never apply to SSI
    recipients.

   The SGA rules will apply to SSDI recipients after the
    9-month trial work period.
                                                                  21




              Trial Work Period (TWP)


• A 9-month period, within 60 months, in which a person on SSDI can
  work and earn any amount of money without earnings affecting
  SSDI eligibility

• Each month an SSDI beneficiary earns more than $720 in 2010
  counts as one TWP month.

• TWP amount usually goes up each year.

• These months need not take place one after another or reflect
  earnings from one job.


                                                                  22
               Mark’s Trial Work Period

• As SSDI beneficiary, first work was in 2007

• $640 was required for TWP month in 2007

• Mark earned $1,650 gross per month in 2007

• Mark used his 9 TWP months in 2007
    – January through June
    – September through November


                                                                          23




     Extended Period of Eligibility (EPE)


• A period of eligibility that starts with the month after the TWP ends
  and continues for the next 36 months.

• For any month during period that countable earned income is less
  than the SGA level, person continues to receive the SSDI check.

• When they earn more than the SGA level, SSA plans to stop
  benefits, but:
    – Will get benefits for that month, plus two more
    – This is “three-month grace period”




                                                                          24
       The EPE Continued -
  After the 3-Month Grace Period

• After the grace period, the SSDI stops if earnings ever go above the
  SGA level.


SSDI can be restored during 36-month EPE
• If earnings again fall below the SGA limit, the SSDI benefits can be
  restored.
• During remainder of EPE, can go “on and off” SSDI as countable
  wages go above or below SGA level.




                                                                         25




    Reducing Countable Earned Income
            Below SGA Level



                 Paid Time Off,
       Impairment Related Work Expenses &
                    Subsidies


                                                                         26
     Deductions for Paid Time Off

     Paid time off includes vacation, personal, holiday
      and sick pay.

     Amounts received as paid time off are deducted
      from gross pay to determine “countable wages.”




                                                                     27




   Case Scenario – Paid Time Off

Roger is in his EPE and earns $1,100 gross per month.

 In January he receives $50 in holiday pay for January 1st.

 He receives $100 for taking two vacation days in January.

 His countable wages for January are reduced by $150 to $950 –
  below the $1,000 SGA level for 2010.

 Since Roger is in his EPE, he will get an SSDI check in January.

                                                                     28
Impairment Related Work Expenses [IRWEs]


 Three-part test to determine if an IRWE exists:

      The individual with a disability pays for the item or service

      The item or service is related to an impairment of the
       person on benefits

      The person would not be able to work if he or she did not
       spend the money and receive the item or service



                                                                       29




              Sample IRWE Expenses
  Supported employment services
  Attendant care services
  Transportation costs
  SSA‐approved mileage allowances
  Medical devices
  Prosthesis
  Work‐related equipment & assistance
  Residential modifications
  Routine drugs/medical services
  Diagnostic Procedures
  Non‐medical appliances and devices
  Similar items and services
                                                                       30
      IRWEs – Application to Mark During EPE

• His EPE begin in December 2007 after his 9th TWP month.
• His EPE ends 36 months later in November 2010.


Mark’s earnings subject to SGA level for blind
•   December 07: Gross earnings $1,650 and SGA level $1,500
•   Calendar year 08: Gross earnings $1,700 and SGA level $1,570
•   Calendar year 09: Gross earnings $1,750 and SGA level $1,640
•   Calendar year 10: Gross earnings $1,800 and SGA level $1,640



                                                                              31




                   Mark’s IRWE Analysis

Payments to Driver/Onsite Assistant
• VR agency payments, 2007-08, not an IRWE as Mark did not pay.

• Mark’s $400 (later $300) payments, 2009-10, met 3-part test:
    – He paid; disability related; could not work without driver’s services


• Countable earnings below SGA each year
    – 2009: $1,750 – 400 = $1,350 (less than $1,640 SGA level)
    – 2010: $1,800 – 300 = $1,500 (less than $1,640 SGA level)


• Mark entitled to SSDI payments in 2009 and 2010
                                                                              32
            IRWE Calculation ‐ 2009
• STEP ONE    $1750       Gross Monthly Earnings
•            ‐ 400        Minus IRWE
•             $1350       Equals Adjusted Gross    
                          Earnings (Non‐SGA)

• STEP TW0 $1750          Gross Earnings
•         + 900           Plus SSDI
•          $2650          Equals Monthly Income
•         ‐ 400           Minus IRWE
•          $2250          Equals Total Usable Income


                                                                            33




                 Additional IRWEs for Mark

December 2007:  Repairs to Lockdown Mechanism in Van
• $218 expense meets 3‐part test for an IRWE
• Countable wages reduced to $1,432 ($1,650 – 218)
• Less than SGA of $1,500

January 2008:  Ramp Construction
•   $3,000 expense meets 3‐part test for IRWE
•   Mark will opt to spread cost out over 12 months ($250 per month IRWE)
•   Countable wages reduced to $1,450 ($1,700 – 250)
•   Less than SGA of $1,570

SSDI Payments Continue in December 07, all of 2008

                                                                            34
                    Subsidies

A Subsidy Exists When the Employer:

• Willingly pays more in wages than the value of the
  services performed; or

• Receives full value only because some agency provides
  extra services to the employee.



                                                             35




    Subsidies – Special Conditions

    Human services agencies may provide support and
     services to beneficiaries, potentially subsidizing an
     individual’s ability to work at an SGA level.

    By regulation subsidy should be computed using the
     employee’s hourly wage.

    Typically, this occurs in a supported employment
     setting – i.e., extra service of job coach can amount to
     subsidy.


                                                             36
                    Subsidy for Mark
   VR Agency Payment for Driver
    Paid $400 per month during 10 work months of 2007-08.

    Driver assistance (driving, operating van lift, eyes at game)
     analogous to job coach and should count as subsidy.

    Countable wages reduced to $1,250 in 2007 ($1,650 – 400), less
     than SGA level of $1,500

    Countable wages reduced to $1,300 in 2008 ($1,700 – 400), less
     than SGA level of $1,570

   Mark is Eligible for SSDI for 12/07 and all of 2008

                                                                     37




 Expedited Reinstatement (EXR) of SSDI


Persons Who do SGA-level Work, after EPE, can Return to
Benefits Status

Key Eligibility Criteria:
 Was receiving SSDI
 SSDI terminated due to SGA-level work after EPE
 No longer performing SGA because work stopped or earnings drop
  below SGA level
 Requests EXR within 60 months of last month or the EPE or last
  month of SSDI eligibility (whichever is later)
 Meets medical standard of disability (using medical improvement
  review standard)
                                                                     38
            How EXR Might Apply to Mark


Mark Thrives at Job, SSDI Terminated
 Countable wages now more than SGA level for blind, even with paid
  time off, IRWEs, subsidies

Mark Stops SGA-level Work within 60 Months
 Cannot handle physical demands and reduces work hours; or
 Employer cuts back on sports coverage, hours and pay reduced; or
 Pay remains constant, but
      SGA level for the blind goes up

      Has additional IRWEs for new or replacement AT

                                                                  39




   Mark’s SSDI Reinstated through EXR

• Gets 6 months of “provisional benefits” while waiting for
  decision

• Benefits can be retroactive up to 12 months

• His dependents can be reinstated, if they still meet criteria




                                                                  40
            The Importance of Medicare
• Eligible for Medicare after 24 months eligibility for SSDI

• Part A – hospital insurance is automatic and cost free

• Part B – optional and subject to premium ($96.40 in 2010 for
  existing enrollees & $110.50 for new enrollees)
    – Covers durable medical equipment, subject to 20 percent copayments

• Part C – optional managed care coverage

• Part D – prescription drug coverage




                                                                           41




           Extended Medicare Eligibility
• SSDI beneficiary entitled to Medicare coverage during 9-month trial
  work period and at least 93 months following TWP
• During extended period
   – Medicare Part A is still automatic and cost-free
   – Medicare Part B is still optional and subject to premiums,
     deductibles and copayments


SSDI beneficiary who goes to work can keep Medicare
for at least 102 months (nearly 9 years)!

                                                                           42
                  SSI Work Incentives




                                                                               43




         Special Connection Between SSI
                  and Medicaid


SSI Recipients in Most State Get Automatic Medicaid
•   Exception, 209(b) states: Connecticut, Hawaii, Illinois, Indiana, Minnesota,
    Missouri, New Hampshire, North Dakota, Ohio, Oklahoma, Virginia.
•   209(b) states use their own Medicaid criteria.


When Medicaid Automatic, a Primary AT Funder is Leveraged
•   AT usually funded as durable medical equipment (DME)
•   Could pay for expensive wheelchairs, patient lifts, speech generating
    devices, and many more things




                                                                               44
       SSI Federal Benefit Rate 2010

   In 2010, the Federal Benefit Rate (FBR) is:
      $674 per month

   States Supplement the FBR at their Option
      In New York, for example the FBR is supplemented by $87 to
       $761 for individuals who live alone in the community

      In Texas, FBR not supplemented and base SSI rate is $674



                                                                    45




          SSI’s Key Work Incentives
         Reducing Countable Earnings


• $65 plus 50 percent exclusion

• $1,640 student earned income exclusion (up to $6,600 per year)

• Impairment related work expenses (IRWEs)

• Blind work expenses (BWEs)

• Plan for Achieving Self Support (PASS)


                                                                    46
          When SSI Recipient Works
           Simple Formula Applies
 First $20 earned disregarded if no unearned income

 The next $65 earned is disregarded as a work exclusion

 IRWEs then subtracted

 One half of the remaining earned income is disregarded

 BWEs then subtracted

 Approved PASS expenses subtracted

 What is left is the net countable earned income

 Countable earned income is subtracted from state SSI base rate

                                                                   47




SSI Budget – Unearned Income Only
      Ted has a disability
      Ted receives $385/month SSDI benefits.
      The SSI program will disregard or not count the first
       $20 each month of Ted’s SSDI benefits.


                       $ 385      Social Security Disability
                       - 20       Disregarded
                       $ 365      Countable income

                       $   674 SSI base rate
                       -   365 Countable income
                       $   309
                                                                   48
  SSI Budget – Earnings, No IRWES or BWES
        Ted earns $385/month.
        SSI  will disregard the first $85 each month (20 general, 
         65 earned income disregards)
        Then, an additional 50% will also be disregarded

                          $     385    Gross wages
                                ‐ 20   General Disregard
                          $     365
                          ‐       65   Earned Income Disregard
                          $     300
                          ‐ 150        Additional 50% disregarded
                          $ 150        Countable wages

                          $    674     SSI base rate
                          ‐    150     Countable income
                          $    524     Monthly SSI check
                                                                           49




              Impairment Related Work
                 Expenses and SSI

Same 3‐Part Test as with SSDI
• SSI recipient must pay for item/service
• Must be related to disability
• Could not work if did not get item/service


An IRWE reduces earned income in SSI calculation
• Subtracted after $65 exclusion, before additional 50 percent exclusion
• Result is reduction of $1 of earned income for every $2 in IRWEs



                                                                           50
             IRWE Example - Leonard

Has Post‐Polio Condition, Works from Home
• Income:  $420 SSDI, $885 in wages
• $810 in countable income, too much for SSI
     – $400 countable unearned ($420 – 20)
     – $410 countable earned ($885 – 65 = $820 ÷ 2 = $410)
• Eligible for Medicare, not presently getting Medicaid


Obtains Loan to Convert Spare Bedroom to Office
•   Widened doorway, accessible entrance, work station for wheelchair user
•   $400 per month payments for three years
•   Will telecommute as an employee
•   Meets 3‐part IRWE test (he pays, disability related, needed to work)

                                                                             51




         Leonard’s SSI Budget with IRWE

Step 1: $420      SSDI                   Step 3: $400 Counted unearned
        - 20      General exclusion              +210 Counted earned
        $400      Counted Unearned               $610 Total counted

Step 2: $885      Earned income        Step 4: $674 SSI federal benefit rate
        - 400     IRWE deduction              - 610 Counted income
          485                                  $ 64 SSI payment
        - 65      Earned income exclusion
        $420
        - 210     Additional 50 % exclusion
        $210      Counted earned income


Leonard will qualify for automatic Medicaid in his state.


                                                                             52
           Blind Work Expenses

 Must be “statutorily blind”

 Exclusion from earned income for any “expense
  reasonably attributable to the earning of income.”

 A BWE is not counted in determining SSI eligibility and
  monthly cash payments.




                                                            53




       BWEs – Allowable Expenses

 Need not relate directly to individual’s blindness.


 Need only be work-related expenses incurred by the
  individual, be reasonable, and may not exceed total
  countable income.


 A BWE taken under SSI may also be simultaneously
  counted as an IRWE under SSDI.


                                                            54
         BWEs - Deductible Expenses

 Guide dogs
 Fees
 Transportation to and from work
 Vehicle modifications
 Training to use impairment-related items
 Tax withholding (income tax and FICA)
 Prosthesis
 Meals consumed during work hours



                                                 55




   BWEs – Deductible Expenses (Cont.)

 Physical therapy
 Other work-related equipment/services
 Non-medical equipment/ services
 Drugs and medical services essential to work
 Expendable medical supplies
 Mandatory pension contributions
 Attendant care



                                                 56
                   Use of BWEs by Mark

Mark Was an SSI Recipient when he Started Working
for Snow City Gazette
• Has multiple sclerosis and is statutorily blind
• Earns $2,585 per month gross

Mark has $865 in Monthly BWEs:
   $ 95            State and federal income taxes
    160            Social Security, Medicare taxes (FICA)
     15            Union dues
    300            Driver/onsite assistant
     45            Guide dog
    250            Ramp construction payments


                                                            57




            Mark’s SSI Budget with BWEs

          $2585           Earned income
          - 85            $20 + $65 exclusions
            2500
          - 1250          Additional 50 % exclusion
          $1250
          - 865           Blind work expense
          $ 385           Counted earned income

          $ 674           SSI base rate
          - 385           Counted income
          $ 289           SSI payment


Leonard will qualify for automatic Medicaid in his state.

                                                            58
  The Medicaid Work Incentives

                        1619(b)

            The Medicaid Buy-In for
               Working People


                                                        59




      Under 1619(b), Former SSI Recipients
        Can Still Get Automatic Medicaid


• Person must lose SSI due to budgeting of wages

• Person who receives 2010 federal benefit rate, $674 per
  month, loses SSI if monthly wages are $1,433 or higher

• The person’s disability must continue




                                                        60
 Section 1619(b)’s Financial Criteria

 Person must be otherwise eligible for SSI


   Unearned income must be within
    SSI’s limits

   Resources must be within SSI’s limits




                                                                     61




      Section 1619(b)’s Earned Income
            Eligibility Threshold

This will vary from state to state
 For calendar year 2010, New York’s threshold is $43,956 per year

 Threshold for Texas is $28,730

 Threshold for Alaska is $50,054

 Threshold of Oklahoma is $26,422


                                                                     62
            Mark’s Eligibility for 1619(b)

Mark was getting a reduced SSI check and working for
the Snow City Gazette
• He gets a promotion to make $3,500 per month/$42,000 per year.
• He loses his SSI check.
• His disability continues and his resources are within SSI limits.


He will be eligible for continued Medicaid as his annual
earnings are less than $43,956
• Medicaid will continue to be a source of payment for expensive AT
  like his power wheelchair.

                                                                         63




             Additional 1619(b) Criteria

Prior month criteria
• To be initially eligible, must have received an SSI check within the
  previous 12 months
• A person loses 1619(b) only if he/she went through a period of 12
  consecutive months with no eligibility for an SSI check or 1619(b)


Medicaid use test: Met if the person
• Used Medicaid within past 12 months, or
• Expects to use Medicaid in next 12 months, or
• Would need Medicaid to pay unexpected medical bills in next 12
  months.



                                                                         64
               Individualized Eligibility
                Threshold for 1619(b)
This is determined by adding
•     Base amount from threshold chart
•     Medicaid amount from chart, or actual Medicaid expenses for a
      year if higher
•     IRWEs
•     BWEs
•     Income excluded under a PASS
•     Publicly funded attendant care that would be lost based on
      earnings


If annual wages below new total, Medicaid continues.


                                                                      65




    Mark’s Individualized 1619(b) Threshold

Mark earns $42,000 in state with $28,000 threshold

Mark’s individualized threshold is $49,577 based on
• A base amount of $17,197 from chart
• Actual Medicaid expenses of $22,000
• Blind work expenses of $10,380 ($865 x 12)


Since his annual gross wages are less than $49,577, he
will be eligible for continued Medicaid.



                                                                      66
            The Problems with 1619(b)


• Not available if never on SSI

• Not available if “prior month requirement” not met
   – If no SSI or 1619(b) eligibility for 12 consecutive months


• Resources subject to $2,000 SSI limits




                                                                  67




      The Medicaid Buy-In for
         Working People




                                                                  68
               Key Federal Requirements
                  for Medicaid Buy-In
•   Paid work, with countable income, using SSI exclusions, less than 250
    percent of federal poverty level (can be up to 450 percent of FPL)

•   Not required to have been on SSI in past

•   Meets SSI definition of disability

•   Disability determined by state if no disability determination by SSA

•   No SGA rule – Can earn more than $1,000/$1,640 per month in 2010

•   States can charge premiums or cost-sharing charges


                                                                            69




           43 States Have Medicaid Buy-In

Some States at Today’s Training (Income Limits)
     –   Alaska – 250% of federal poverty level (FPL)
     –   Arizona – 250% of FPL
     –   Iowa – 250% of FPL
     –   Illinois – 350% of FPL
     –   New Jersey – 250% of FPL
     –   New York – 250 % of FPL
     –   Oklahoma (section 1115a HIFA waiver)
     –   Texas – 250% of FPL
     –   Utah – 250% of FPL


Links to websites: http://www.nchsd.org/links/index.asp?c=39


                                                                            70
New York’s Medicaid Buy-In for Working
       People with Disabilities

Key Eligibility Criteria:
   –   Meets SSI definition of disability
   –   Age 16 to 64
   –   Paid work (part-time or full-time)
   –   Countable income up to $2,257 per month (250% of FPL)
   –   Up to $55,188 if only income from work
   –   Resources up to $13,800
   –   No SGA test
   –   $25 monthly premium, if income more than $1,354 (150% of FPL)




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              Key Medicaid Buy-In
            Monthly Income Exclusions

These are the same as SSI’s and apply in every state.

   –   $20 general income exclusion
   –   $1,640 student earned income exclusion (up to $6,600 per year)
   –   $65 earned income exclusion
   –   IRWEs
   –   Additional 50% earned income exclusion
   –   BWEs
   –   Income set aside in Plan for Achieving Self Support (PASS)



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         Mark’s Eligibility in New York
Mark receives $900 in SSDI
   – $880 counted ($900 – 20)


Mark earns $1,800 gross per month, with $865 in BWEs
   – $2.50 in counted earned income
   – $1,800 – 65 = 1,735/2 = 867.50 – 865 BWEs = $2.50


Countable income, $882.50, is less than $2,257.

Mark will be eligible for Medicaid Buy-In in New York
(and all other states with a Buy-In).

                                                         73




        SSI’s Plan for Achieving
         Self Support (PASS)



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                  What is a PASS?
A special SSI rule for not counting income or
resources that support a work goal.

If approved the PASS can result in:

• Retained SSI eligibility

• A larger SSI check

• SSI eligibility when none existed before

• Establishing Medicaid eligibility or retaining Medicaid eligibility



                                                                        75




                SSI Payments Based on
                  2010 State SSI Rate

• $674 – federal benefit rate

• State supplement is optional

• If individual has income, other than SSI, part of income
  subtracted from base rate to determine monthly SSI
  payment.




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                      The Case of Joan

Joan, age 33, receives SSDI of $580 per month based
on a cerebral palsy.

• SSI disregards $20 and remaining $560 is subtracted from the $674
  SSI base rate, giving Joan a $114 monthly SSI check.

• Her total monthly income is $694 ($580 SSDI, $114 SSI).

• Since Joan gets SSI, she also qualifies for automatic Medicaid in
  most states.



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              Joan’s Need for a PASS
SSI Rule: If income or resources are used in a PASS to support a work
goal, the income/resources will not count when determining SSI eligibility.

Example. Joan plans to attend a two-year community college program to
become a social work assistant.

•   State VR agency will pay for tuition, transportation to college, books, and
    hand controls for car she hopes to buy.

•   Will still need: $700 for laptop; $10,800 for a used car to travel to work; and
    $650 for six months of car insurance.

•   Joan proposes to set aside $450 of her SSDI check each month, for 27
    months, to save for these items to meet her work goal.




                                                                                  78
                 Joan’s Approved PASS
With approval, SSI no longer counts $450 of SSDI
• Countable income reduced to $110. SSI check increased to $564.
• PASS savings = $12,150 (27 months x $450)
• Savings will pay for computer, car, and insurance.

PASS starts July 2010, continues through August 2012
• Can purchase car and insure it in August 2011.
• Will borrow mother’s car, in interim, to travel to job interviews.
• Will graduate in May 2012.

Joan still has $694 for living expenses ($564 SSI, $110 SSDI).




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    PASS Must Increase Prospect for Self Support

PASS policy requires:

•    If SSI received before PASS approval, work goal must significantly reduce
     the SSI payment amount.

•    If only SSDI received before PASS approved, goal must be expected to
     eliminate SSDI (through work at SGA level - $1,000 per month in 2010).

Joan’s goal: make $22,000 ($1,833 per month) upon graduation.

•    She meets the first criteria as this would eliminate her SSI eligibility.

•    If SSDI were her only income before PASS approval, she would meet the
     criteria, as she will earn more than $1,000 per month.




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         What Money Goes Into a PASS?

Earned income
• Wages from a job
• Income from a business

Unearned income
• Such as a Social Security check or VA pension

Resources
•   Savings
•   Personal injury award
•   Inheritance
•   Lump sum Social Security or SSI award


                                                              81




             Allowable PASS Expenses

All reasonable and necessary expenses, such as:
•   College or training costs
•   Transportation, including vehicle lease or purchase
•   Vehicle insurance, maintenance, repairs, warranty costs
•   Computer, software and Internet costs
•   Work clothes, professional clothing
•   Business start-up costs
•   Dues, fees, licenses
• Child care


Anything reasonably tied to the work goal


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                    PASS Time Limits

General Rule: A PASS can be approved for whatever
period of time is needed to achieve the goal.

Application to Joan’s PASS:

• Her PASS should go for 27 months, through August 2012, to allow
  her to save for the computer, car, and car insurance, find a job, and
  start working.




                                                                      83




                 Mark’s Use of a PASS

Goal: Retain newspaper work and make more money.
• Current income: $900 SSDI, $1,800 gross wages
• Needs new van for travel as passenger
• Would allow Mark to retain and expand his sports writing


Mark to save $880 from SSDI and $2.50 from wages
• Savings will increase by $250 when ramp loan paid and BWEs
  decrease.
• Will save $10,590 during first 12 months ($882.50 x 12)
• Will save additional $13,590 during next 12 months ($1132.50 x 12)
• Total saved toward van = $24,180


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               Mark’s PASS Approved

He meets key PASS criteria
• Van needed to meeting sports writing goal
• Cannot save for purchase without PASS
• Goal: earn $42,000 per year ($3,500/month) when PASS completed
   – Even with IRWEs, more than SGA for blind
   – Meets self support criteria


Will purchase van in 24 months
• $24,180 savings enough to purchase new van
• State VR agency will pay for new lift, lockdown
• PASS has leveraged VR agency funding for AT!



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                    Joining Us

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