2019 Red Book

Red Book Home

Introducing The 2019 Red Book

What's New In 2019?

Contacting Us

How Do We Define Disability?

Overview Of Our Disability Programs

Returning To Work

How Do Employment Supports Help?

Resources To Assist You Return To Work

Resources To Assist Youth With the Transition To A Successful Adulthood

SSDI and SSI Employment Supports

SSDI Only Employment Supports

SSI Only Employment Supports

Special Rules For Persons Who Are Blind

Additional Help With Health Care For Persons With Disabilities

Example of Concurrent Benefits With Employment Supports

Demonstration Projects Update


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SSDI only employment Supports

Trial Work Period (TWP) (SSDI eligible)

How does the TWP help you?

The TWP allows you to test your ability to work for at least nine months. During your TWP, you will receive full Social Security Disability Insurance (SSDI) benefits regardless of how high your earnings might be as long as you report your work activity and you have a disabling impairment.

When does the TWP start?

Your TWP starts when you begin working and performing “services”. In 2019, we consider your work to be services for the TWP if your gross earnings are more than $880 a month, or if you work more than 80 hours in self-employment in a month. Your TWP cannot begin until the first month you are entitled to SSDI benefits, or the month you file for benefits, whichever is later.

How long does the TWP last?

The TWP continues until you accumulate nine TWP service months (not necessarily consecutive) within a rolling 60-month period.

What happens when you complete your TWP?

After you complete your TWP, you begin your Extended Period of Eligibility (EPE) (see EPE.) During the EPE, we evaluate your work and earnings to decide if you can work at the substantial gainful activity (SGA) (see SGA).

What else do you need to know about the TWP?

  • You are not eligible for disability benefits or a TWP if you work at the SGA level within 12 months of the start of your impairment(s) and before we approve your claim for disability benefits. This is because your impairment does not meet our definition of (see HOW DO WE DEFINE DISABILITY).
  • We can consider medical evidence that might demonstrate your medical recovery at any time. Therefore, it is possible for your benefits to stop due to your medical recovery before the end of your TWP.
  • We will not conduct a continuing disability review if you are participating in the Ticket to Work program and you are using your Ticket (see TICKET TO WORK).
  • Unsuccessful Work Attempts do not apply during the TWP (see UWA).

Usually, we adjust the dollar amount of TWP “services” each year based on the national average wage index.

Does the TWP apply to Supplemental Security Income (SSI)?

No. A TWP does not apply to the SSI program.

Extended Period of Eligibility (EPE) (SSDI eligible)

What is the EPE?

The EPE begins the month after the Trial Work Period (TWP) ends, even if you are not working that month. The first 36 months of the EPE is the re-entitlement period.

How does the EPE help you?

During the 36-month re-entitlement period, you get benefits for all months your earnings or work activities are below the substantial gainful activity (SGA) level as long as you continue to have a disabling impairment. We suspend cash benefits for months your earnings are over the SGA level. If your earnings fall below the SGA level in the re-entitlement period, we can start your benefits again. (This is a different rule than Expedited Reinstatement (EXR) that we describe on EXPEDITED REINSTATEMENT.)

What happens the first time you work above SGA?

The first time that you work above SGA in the EPE, we will decide that you no longer meet the requirements for disability due to work, and we say that your disability "ceased”. We will pay benefits for the month your disability ceased and the following two months. We call this the grace period. If your earnings fall below SGA and you are still in the 36-month re-entitlement period, we can restart your benefits without a new application.

Can you continue to receive benefits after the 36-month re-entitlement period ends?

If you are not working above SGA and are eligible for a benefit payment for the 37th  month of the EPE, you will continue to receive benefits until you:

  • Work a month at the SGA level, or
  • Medically recover.

What happens if you work after the re-entitlement period ends?

Your benefits will end if you work above SGA after the 36-month re-entitlement period. However you may be able to start your benefits again if you stop work within the next five years (see EXR on EXPEDITED REINSTATEMENT.)

Do you get an EPE under Supplemental Security Income?

No. The EPE applies only to persons who receive Social Security Disability Insurance cash benefits.

Unincurred Business Expenses (Self-Employment) (SSDI eligible)
What are unincurred business expenses?

“Unincurred Business Expenses” are contributions made by others to your self-employment business effort. For example, if the state vocational rehabilitation agency gives you a computer for your business, or a friend works for your business as unpaid help, these are “unincurred business expenses”.

We generally follow the Internal Revenue Service (IRS) rules to figure your net earnings from self-employment. The IRS only allows you to deduct expenses you actually paid or incurred debt. When we make a substantial gainful activity 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, it must be an item or service that the IRS would allow as a legitimate business expense if you had paid for it.

Do unincurred business expenses affect your Supplemental Security Income (SSI) payments?

No. We do not deduct unincurred business expenses from earnings when we figure your SSI payment amount.

Continuation of Medicare Coverage (SSDI eligible)

What is Continuation of Medicare Coverage?

Most persons with disabilities who work will continue to receive at least 93 consecutive months of Hospital Insurance (Part A); Supplemental Medical Insurance (Part B), if enrolled; and Prescription Drug coverage (Part D), if enrolled, after the nine-month Trial Work Period (TWP). 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. (93 months is seven years and nine months.)

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 substantial gainful activity, but not be medically improved.

Medicare for Persons with Disabilities Who Work (SSDI eligible)
Can you buy Medicare coverage?

Yes. After premium-free Medicare coverage ends due to work, you can buy continued Medicare coverage, as long as you remain medically disabled. If you have limited income and resources, you may be eligible for state assistance with these costs under various Medicare Savings Programs. Your state Health and Human Services agency makes the determination about whether you qualify for this help.

Who is eligible to buy Medicare coverage?

You are eligible to buy Medicare coverage if:

  • You are not yet age 65; and
  • You continue to have a disabling impairment; and
  • Your Medicare stopped due to work.

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 $437 in 2019. However, you may qualify for a reduction in this premium (see below).

Premium Supplementary Medical Insurance (Part B) is available at $135.50 per month in 2019 (or higher depending on your income). Social Security will tell you the exact amount you will pay for Part B in 2019.  For more information, see link for “How much does Part B cost?”: https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html.

You can buy Part A separately without Part B. You cannot buy Part B unless you also buy Part A. Premium Prescription Drug coverage (Part D) is also available.

Do you qualify for a reduction in your monthly Part A premium?

You may qualify for a 45 percent reduction in the monthly amount of your premium for Part A. You qualify for the reduced premium of $240 in 2019 if you:

  • Have 30 or more quarters of coverage on your earnings record; or
  • Have been married for at least one year to a worker with 30 or more quarters of coverage; or
  • Were married for at least one year to a deceased worker with 30 or more quarters of coverage; or
  • Are divorced, after at least 10 years of marriage, from a worker who had 30 or more quarters of coverage at the time the divorce became final.

When can you enroll?

You may enroll:

  • During your initial enrollment period (the month you are notified about the end of your premium-free health insurance and the following seven months); or
  • During the annual general enrollment period (January  through March 31 of each year); or
  • During a special enrollment period. You can enroll at any time while you are working, covered under an employer group health plan, still have a disabling impairment, or during the 8-month period that begins with the first full month after your employment or group health plan coverage ends, whichever occurs first.

For Part D, you may enroll (or change plans) during the annual coordinated election period (October 15 through December 7 of each year). The effective date for the enrollment is January 1 of the upcoming year. There also will be special enrollment periods for some situations.

How does it work with an employer’s group health plan?

Generally, if you purchase Part A and maintain your employer’s 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 Part A premiums for some working persons with disabilities. You qualify if you:

  • Are eligible to enroll in Medicare Part A for persons with disabilities who work; and
  • Meet certain income and resource standards; and
  • Apply for assistance with your state Medicaid agency; and
  • Are ineligible for Medicaid on any other basis.


Persons with disabilities who work should contact their state health and human services agency for information. See HELP WITH MEDICARE PART A PREMIUMS for more information about state help with Medicare Part A premiums.

SSDI at a Glance - What Happens When You Go to Work (SSDI eligible)

Social Security Disability Insurance (SSDI) employment supports can help you protect your cash and medical benefits while you work. When your benefits end because of your work and you have to stop working later, employment supports can make it easy to begin receiving benefits again. You should view all of the SSDI employment supports as a total package to fully appreciate the multiple levels of support available to help you achieve your goal of greater economic independence.

Beginning the Process - The Trial Work Period (TWP)

Your TWP is a time when you can test your ability to work. During your TWP, we pay you disability payments no matter how much you earn. Details on the TWP are on TWP.

How it works:

  • Lasts for nine months
  • The nine months do not have to be in a row
  • Must take place within 60 months (five years)

For 2019, the monthly earnings amount that we use to determine if a month counts as a TWP month is
$880 per month. The 2019 self-employment earnings or activity that we use to determine if a month counts as a TWP month is $880 per month or 80 hours per month.

The Next Step – The Extended Period of Eligibility (EPE)

Your EPE starts the month after your TWP ends. Details on the EPE are on EPE.

How it works:
After your TWP ends, you get a 36-month EPE. Whether we can pay you during this period depends on how much you work and earn.

During your EPE:

  • We can pay you for any month your work and earnings are not at a substantial gainful activity (SGA) level, and
  • We can pay you for the first month that your work and earnings are substantial and for the next two months.  Your benefits will terminate if your work is substantial in any month after your EPE ends.

Your Safety Net-Expedited Reinstatement (EXR)

EXR is your safety net if your cash benefits end because of your work. If you make less money or you have to stop working because of your disability, we may be able to restart your benefits right away if

  • You stop working above the SGA level, and
  • Your disability is the same as or related to your current disability, and
  • You make your request within 5 years of when your benefits end. Details on EXR are on EXR.

What About Medicare

If your disability payments stop because of your work, the Medicare coverage you have can continue if your disability still meets our rules. It can continue for at least 93 months after your TWP ends. Details on Continuation of Medicare Coverage are on CONTINUATION OF MEDICARE COVERAGE.