SUPPLEMENTAL SECURITY INCOME (SSI) WORK INCENTIVES
WHAT ARE WORK INCENTIVES?
One of our highest priorities is to help people with disabilities achieve independence by helping them take advantage of employment opportunities. Work incentive employment supports help disabled and blind SSI recipients go to work by minimizing the risk of losing their SSI or Medicaid benefits.
Some incentives allow us to not count some of your income or resources.
Other incentives let you continue to receive Medicaid coverage even though you are not receiving SSI cash benefits.
You may be entitled to take advantage of more than one work incentive program. Depending on the types of income you receive, it will change the amount we do not count and the SSI benefit amount.
EARNED INCOME EXCLUSION
We do not count the first $65 of earned income plus one–half of the amount over $65. Therefore, we reduce your SSI benefit only $1 for every $2 you earn over $65.
STUDENT EARNED INCOME EXCLUSION
If you are a student under age 22, as explained on trusts, we may exclude up to $1,900 of gross earnings in a month (but not more than $7,670 in calendar year 2020) in figuring your countable income.
|For more information, see the SSI Spotlight on Student Earned Income Exclusion.|
IMPAIRMENT–RELATED WORK EXPENSES
If you are disabled, we may exclude from your earned income any out-of-pocket expenses you pay for certain items and services that relate to your disability that you need in order to work as long as the cost is reasonable. It does not matter if you also use these items and services for non-work activities. For example, we can deduct the costs of co-pays, medications, counseling services, car modifications, assistive technology that people with disabilities use for employment-related purposes; such as software applications, computer support services, and special tools which have been specifically designed to accommodate the person’s impairment or attendant care services. We call these expenses impairment-related work expenses (IRWE), and can deduct the cost of them as long as the cost is “reasonable”, that is, it represents the standard charge for the item or service in your community. However, if somebody reimburses you for these expenses, we cannot exclude them from your earned income.
We will exclude IRWE from your earned income when we figure your SSI monthly payment amount. This means your SSI benefit could go up.
We may also consider these items when we figure your earnings in order to decide if you are doing substantial work. We only look at Substantial gainful activity (SGA) when you first apply for SSI. If you are receiving SSI and go to work, SGA is not an issue. However, we do have to figure your countable income.
|For more information, see the SSI Spotlight on Impairment–Related Work Expense.|
WORK EXPENSES FOR BLIND PERSONS
If you are blind, we will deduct any part of your earned income that you spend to be able to work (such as for transportation, taxes, or special equipment) from the amount of income we use to figure your SSI benefit. The expense does not have to be related to your blindness.
|For more information, see the SSI Spotlight on Impairment–Related Work Expense.|
PLAN TO ACHIEVE SELF–SUPPORT (PASS)
If you are blind or have a disability, you may set up a plan to set aside income or resources to meet expenses for reaching an employment goal. You may also exclude part of your ineligible spouse’s income and resources.
If you are a child living with your parent(s), you may also exclude part of your parents' income and resources.
Unlike impairment-related work expenses, you may use a PASS to exclude unearned income and resources as well as earned income and use that money to meet the expenses of reaching your occupational goal.
We do not count income or resources set aside under a PASS when figuring the SSI benefit amount. You cannot use your SSI payment to pay the expenses necessary to reach your occupational goal. This is because you must use the SSI to pay ordinary living expenses.
You can use a PASS to establish,maintain, or increase SSI benefits.
|See the SSI Spotlight on Plans to Achieve Self-Support] (PASS).|
TICKET TO WORK
The Ticket to Work and Work Incentive Improvement Act of 1999 (Public Law 106-170) provides several important opportunities for people ages 18 through 64 who receive Social Security disability or SSI benefits and who want to go to work or increase their earnings. To find out more about this program, see our website www.ssa.gov/work.
One of the opportunities provided by this law is the “Ticket” program. The Ticket program is available in all States. Under the Ticket program, you may be eligible to receive free employment services from an approved employment support service provider of your choice. Our term for an approved service provider is an “employment network.” Or you can choose to work with your State Vocational Rehabilitation Agency.
The employment network will work with you to come up with a plan designed to help you reach your work goals. We pay the employment networks for helping you achieve certain earnings-related milestones and outcomes; there is no cost to you. The ultimate goal is to help you find a good job, a good career and a better self-supporting future.
While you are participating in the Ticket program, we will not conduct regularly scheduled continuing disability reviews to see if your disabling condition has improved.
Under the Ticket to Work legislation, beneficiaries who are interested in returning to work can also receive free benefits counseling from Work Incentive Planning and Assistance (WIPA) projects. WIPA projects are community-based organizations that will help you understand the employment supports that are available to you, how work will affect your benefits, and enable you to make informed choices about work.
Another provision of the Ticket to Work legislation is the Protection and Advocacy for Beneficiaries of Social Security (PABSS) program. PABSS organizations are located in all states and territories and serve beneficiaries who want to work by helping to remove barriers to employment. PABSS organizations assist beneficiaries with understanding employment rights, reasonable accommodations, and can assist with complaints about an employment network or your State Vocational Rehabilitation Agency.
You can find a list of employment networks in your area and other information on this program at: www.ssa.gov/work or by calling 1-866-968-7842 (TTY 1-866-833-2967).
Another provision of the Ticket to Work and Work Incentive Improvement Act of 1999 (see above) expands the States' options under the Medicaid buy–in program for working individuals with disabilities.
States can cover working individuals with disabilities who are at least age 16, but less than 65 year of age using income and resource limits set by the State; and
States can provide Medicaid to employed individuals covered under the group described above, who lose that coverage due to medical improvement, but who still have a medically determinable severe impairment.
The Social Security Administration and the Centers for Medicare & Medicaid Services (CMS) are encouraging States to participate in this program.
HOW TO APPLY
To apply for assistance under this rule, you should contact the State medical assistance (Medicaid) office in your area to find out if your State participates or plans to participate.
BENEFIT CONTINUATION FOR PEOPLE WHO WORK SECTION 1619(a) OF THE SOCIAL SECURITY ACT
Section 1619(a) provides that, even if you are working at or above the SGA level, you may be able to continue to receive cash payments and Medicaid benefits. Your benefits will not necessarily stop just because of work. To qualify, you must have been eligible for an SSI payment for at least one month before you begin working at the SGA level; you must still be disabled; and you must meet all other eligibility rules, including the income and resource tests.
MEDICAID WHILE WORKING: SECTION 1619(b) OF THE SOCIAL SECURITY ACT
Section 1619(b) provides that, in most cases, even if your earned income (after the applicable exclusions) is too high to permit an SSI cash benefit, you may still be eligible for Medicaid as long as you need Medicaid in order to work and your earnings are under a “threshold” amount. https://www.ssa.gov/disabilityresearch/wi/1619b.htm. In certain cases you can have an individual threshold amount. See www.ssa.gov/redbook/index.html for more information about individualized thresholds.
|For more information, see the SSI Spotlight on Continued Medicaid Eligibility for People Who Work.|
REINSTATEMENT WITHOUT REAPPLYING
If you are eligible for Medicaid under Section 1619(b), you remain eligible for SSI and may begin receiving cash benefits again without a new SSI application if your earnings drop.
SSI AND EXTRA HELP WITH MEDICARE PRESCRIPTION DRUG COVERAGE
If you receive SSI and you have Medicare you are automatically eligible for prescription drug coverage and Extra Help with your prescription drug coverage costs. You will not be required to file a separate application. You will be able to select a prescription drug plan. If you do not select a plan on your own, Medicare will enroll you in a plan with no premium to make sure you get help paying for your prescription drugs. You can join, switch, or drop a Medicare prescription drug plan at any time.
If you need information about Medicare prescription drug plans or how to enroll in a plan, visit www.medicare.gov/part-d/ or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. You also can request information about your State Health Insurance Assistance Program (SHIP). SHIP is a national program that offers free help with your Medicare questions.
SPECIAL BENEFITS FOR SOME INSTITUTIONALIZED BENEFICIARIES
If you are eligible under Section 1619 of the Social Security Act and you enter a medical institution, you are eligible for a regular SSI benefit for up to 2 months.
EXPEDITED REINSTATEMENT (EXR) OF BENEFITS
EXR is a safety net for people who successfully return to work and lose their entitlement to SSI benefits and payments. If your cash payment ended because of your work and earnings, and you stop work within 5 years of when your benefits ended, we may be able to start your benefits again.
EXR allows you to receive up to 6 months of temporary cash benefits while we conduct a medical review to determine whether we can reinstate your benefits. You may also be eligible for Medicaid during this provisional benefit period. To get payments while we make our decision and to meet the reinstatement requirements, your previous SSI eligibility must have terminated because of excess earned income or a combination of earned and unearned income, and you must:
be unable to work at the SGA level due to your medical condition;
be unable or become unable to perform SGA in the month of the EXR request;
have a current impairment(s) that is the same as, or related to, your original disabling impairment(s); and
request EXR within five years from the month your benefits stopped.
Please also see our section on EXPEDITED REINSTATEMENT.
EFFECT OF WORK ON MEDICAL REVIEW
Effective January 1, 2002, Social Security will not conduct a continuing disability review of a disabled beneficiary based on work activity alone. This provision applies to SSI recipients who have received Social Security disability benefits for at least 24 months. This provision does not apply to SSI only beneficiaries. If you receive SSI only, we will conduct regularly scheduled medical reviews, unless you are using your Ticket to Work. As long as you are using your Ticket to Work, participating in the program, and making progress toward your vocational goals we will not conduct a medical review. For more information, please see our section on the TICKET TO WORK program.
CONTINUATION OF BENEFITS AFTER MEDICAL CESSATION (SECTION 301 BENEFITS)
You may continue getting SSI benefits even after we determine that your disability or blindness ceased if you are participating in:
a program under the Ticket to Work Program;
an approved Plan to Achieve Self-Support (PASS);
an approved program of vocational rehabilitation services, employment services, or other support services; or
an approved educational or training program;
we determine that your completion or continuation in the program for a specified period of time, will increase the likelihood that you will successfully return to the workforce and no longer require disability or blindness benefits.
In addition, if you are a student aged 18 through 21, you may continue getting SSI benefits after we determine that your disability or blindness ceased if you are participating in an Individual Education Plan (IEP) with an approved educational institution.
MEDICAID BUY–IN PROGRAM FOR WORKING PEOPLE WITH DISABILITIES
What is Medicaid Buy–in? Medicaid Buy–in is designed to provide Medicaid to working people with disabilities who, because of relatively high earnings, cannot qualify for Medicaid under one of the other provisions.
Who is eligible? States are allowed to provide Medicaid to these individuals by creating a new optional eligibility group.
Although some States may have more liberal income limits, in most States individuals may become eligible if:
They are in a family whose net income is less than 250 percent of the national poverty guideline for a family of the size involved (for example, the 2020 Federal Poverty Guideline for a family of 3 is $21,720, so the limit for this program would be $54,300);
except for their earnings, they would be considered eligible for SSI; this includes meeting the definition of disability; and
Each State determines its own definition of a “family.” All SSI exclusions apply to the determination of family income, including the earned income exclusions.
Individuals are not required to have been receiving SSI benefits to be eligible for this Medicaid Buy–in provision. However, the State must make a disability determination if an individual was not an SSI recipient. SGA (wages or self–employment) is not a consideration when States make this determination.
The 2020 Federal Poverty Guideline for an individual is $12,760. The net income limit for Medicaid Buy-in for an individual is income of less than 250 percent of $11,880, that is, less than $31,900.
For example, if Joe Green's annual income is earnings of $42,765, he meets the net income limit (after the SSI earned income exclusions) and is eligible for Medicaid Buy–in if his State participates (as long as he meets all other eligibility factors for SSI benefits).
$42,765.00 earnings divided by 12 months = $ 3,563.75
$3,563.75 monthly earnings
-$85.00 general and earned income exclusion
-$1,739.38 exclusion of half remaining earned income
$1,739.37 monthly countable income, or $20,872.44 a year.
In this example, Mr. Green's net income of $20,872 is below 250 percent of the poverty guideline for an individual (less than $31,900).Are there premiums? States are allowed (but not required) to charge eligible individuals premiums or other cost–sharing charges. These charges may be set on a sliding scale based on income. Each State makes the decision about the premiums or other cost–sharing charges.
How do I get more information? To find out more about Medicaid in your
State, call your State medical assistance (Medicaid) office. You may find information on how to contact your State Medicaid office on the Centers for Medicare & Medicaid Services website at www.medicaid.gov/medicaid/by-state/by-state.html
To find out if your State has a Medicaid Buy-in plan, contact your State Medicaid office.
HOW TO FIND OUT MORE
Most Social Security offices have a Work Incentive Liaison (WIL) who works with outside organizations that serve disabled and blind people. Please contact your local office for the name and telephone number of the WIL.
Also available to provide assistance are Area Work Incentives Coordinators (AWIC). AWICs are experienced employment support experts who:
- Coordinate and/or conduct public outreach on work incentives in their local areas;
- Provide and/or coordinate and oversee training on SSA’s employment support programs for all personnel at local Social Security offices;
- Handle sensitive or high profile disability work-issue cases, if necessary; and
- Monitor the disability work-issue workloads in their areas.
Information on how to contact your local AWIC is available at https://www.ssa.gov/redbook/eng/resources-supports.htm#a0=1.
For more information on work incentives, see the SSI Spotlights on:
The "Red Book" (a summary guide to employment supports), is available online at: www.ssa.gov/redbook/.
The Red Book is also available on audiocassette, Braille, large print, and CD. It contains additional information on both SSI and Social Security disability work incentives. In addition, the above site, along with www.ssa.gov/work, provide information on our efforts to help people with disabilities enter the workforce in employment or self–employment. There are sections about vocational rehabilitation programs, employment support, legislation, employment programs, health care for people with disabilities, and much more.