Frequently asked Questions About SSDI and
Work Incentives for NJ Residents in 2004
1- Q: If I am working with someone who
receives a check from Social Security, how can I be sure
whether or not it is an SSDI benefit?
A: If a person started receiving SSDI (Social Security
Disability Insurance) prior to 1997, she/he will generally
receive the check on the third of the month. If the person
started receiving SSDI after 1997, his/her check should
come on the 2nd, 3rd or 4th Wednesday of the month. It will
come on the Wednesday that corresponds closest to date of
the month on which the individual was born. For example,
if the person was born on the 1st of any given month, he/she
would receive the check on the 2ndst Wednesday of the month.
If the individual was born on the 30th, she/he would receive
the check on the last Wednesday of the month (the 3rd or
4th one-- depending on the month). To find out for sure,
a beneficiary may want to go to his or her local Social
Security (SSA) office (with identification) and ask for
a benefits statement or a copy of the "award letter."
It is also a good idea for the person to get the name of
his or her "claims representative". Eventually
the individual will need to report earnings to Social Security
after she/he starts earning money.
2- Q: If the person I'm working with gets a job, should
he or she be concerned that he/she will lose benefits?
A: There are two issues involving benefits
that should be addressed in order to support a person's
decisions about work. The first is the SSDI cash benefit
and the second are the individual's medical benefits.
3- Q: What do I need to know about the SSDI check?
When someone is found eligible to receive
SSDI, they also are eligible for a nine month Trial Work
Period (TWP). That is, nine months in which the person works
without jeopardizing their SSDI benefits. These nine months
do not have to be consecutive. A Trial Work month is any
month in which the person earns $570 or more. When the person
has used nine Trial Work Period months within a five -year
period the TWP is ended. Since the Trial Work Period month
amount has changed significantly over the years, it's important
to review the past five years of the person's work history
or check with SSA to see if the person has used any Trial
Work months in the last five years.
After a person has exhausted the nine TWP
months, SSA will due a disability review to determine if
the person has been engaging in SUBSTANTIAL GAINFUL ACTIVITY
(SGA). The figure that constitutes SGA is indexed yearly;
the current figure is $810 a month.
(There are two organizations that can provide counseling
for people with issues involving Social Security, they are:
The United Cerebral Paisy Association of NJ @ NJWIN32,
njwins@cpofni.org
-The Epilepsy Foundation of New Jersey@
(866) 946-7465
Njwins@efnj.com
To see what office covers your area visit: Http//www.efnj.com/program/njwins.shtml
Representatives from these organizations
can help the beneficiary understand his or her benefits
situation and create a plan. They can also educate and counsel
individuals about other government benefits affected by
earnings.)
4- Q: What happens after the review?
A. If the beneficiary's monthly earnings
have been exceeding what SSA considers to be Substantial
Gainful Activity (SGA), she/he will receive three more months
of a disability check and then the benefits will terminate.
If the person's earnings don't exceed SGA, then the SSDI
will continue. The figure that constitutes SGA is indexed
yearly; the current figure is $810 a month. Essentially,
when the TWP months are used consecutively, a beneficiary
will keep his or her SSDI benefits for the first year of
work. This is only true Whether or not the person is engaging
in SGA, if his or her disabling condition continues after
the TWP, the EXTENDED PERIOD OF ELIGIBILITY (EPE) will begin.
5- Q: What is the Extended Period of Eligibility?
After the 9th TWP month, the 36-month Extended
Period of Eligibility begins. If someone is unable to sustain
earnings over SGA because of disability, she/he will be
eligible for a check for any month that gross earnings are
less than SGA (again, that's $810 in gross earnings a month).
For example, if the person that you are working with earns
$700 in March of 2003, $1000 in April and May, and then
$700 again in June, he/she would be eligible for a check
for March and June because earnings were less than $810
(SGA) but not April and May.
6- Q: So during the EPE, if the person's earnings are
under SGA, they keep their benefits, right?
A: Yes
7-Q: What happens after the 36 months?
A: The first month after the 36 months
of EPE ends, if the individual's earnings exceed SGA, he/she
will lose eligibility for the SSDI cash benefits.
8- Q: What happens if the person is
only able to work at SGA for say, six months or a year,
after the EPE ends, will he/she have to 'start from scratch'
to get the SSDI back?
A: SSA has made some progressive regulation
changes in the past few years under the guidance of the
"Ticket to Work and Work Incentives Improvement Act."
The Act established a five-year reinstatement period for
beneficiaries who have lost benefits due to earnings. That
means that if a person is unable to work due to his/her
disability within five years after the EPE, the individual
can receive at least six months of benefits while SSA does
a disability determination. If the person is unable to work
due to disability, she/he will be reinstated.
9- Q: Are there other any other incentives
that may smooth a transition back to work?
IMPAIRMENT RELATED WORK EXPENSES (called
IRWE) allow a person to deduct income that is spent on items
that are needed by a worker with a disability in order to
maintain employment. These can be helpful to eligible beneficiaries
during the EPE. If a person has to spend money to compensate
for their disability in order to work, SSA will exclude
the IRWE amount when determining SGA. For example, if someone
earns $1000 a month but she/he spends $300 a month for disability-
related transportation in order to get to work, SSA will
disregard that amount and consider the earnings to be $700.
Since countable income is less than SGA, the individual
would receive an SSDI check. For more information about
IRWE see:
http://www.ssa.gov/work/ResourcesToolkit/workincentiveschart.html#IRWE
Another employment "support"
that may apply to some individuals involves what are called
"Subsidies" or "Special Conditions".
If an individual receives some sort of special consideration
from the employer (e.g. more frequent supervision, reduced
productivity standard) or has a job coach/personal assistant
that helps the person maintain productivity, SSA may consider
their earnings to be subsidized. Their countable income
would be reduced by the value of this subsidy. This may
bring their countable income below Substantial Gainful Activity.
For more information:
http://www.ssa.gov/work/ResourcesToolkit/workincentiveschart.html#SASC
10- Q: So we have talked about the check, what about
health care?
A: It is frequently the situation that
people who receive SSDI are eligible for two types of health
care, Medicare and Medicaid. Medicare is a federal health
care benefit that an SSDI beneficiary is eligible for after
24 months of receiving an SSDI benefit. Medicaid (also referred
to as Medical Assistance) is administered by the state and
is generally provided to individuals with disabilities who
have low income and resources. Medicaid and other state
related health care programs generally provide the health
care services that many people with disabilities require.
11- Q: So what happens to an individual's Medicaid coverage
if his or her income increases because of work?
A: New Jersey has a Medicaid Buy-in program, called NJ WORKABILITY
Medicaid which means a person can pay a monthly premium
of up to $25 and be eligible for full Medicaid coverage
with earnings up to about $47,340 a year. For more information
call (888) 285-3036.
12- Q: What happens to person's Medicare?
A: A person will retain his or her Medicare
benefits throughout the TWP -- regardless of earnings. As
long as the beneficiary is still considered 'disabled,'
she/he is eligible for Medicare at least 93 months after
the end of the Trial Work Period. If the person's earnings
never exceed SGA, Medicare eligibility will continue.
13- Q: Anything else?
A: Some of the beneficiaries attending
your program may be receiving information from Social Security
about the "Ticket To Work." To learn more about
this opportunity for your program participants and your
agency, go to… http://www.ssa.gov/work/Ticket/ticket_info_SerPro.html
14- Q: How do I find out more?
To find out more about Work Incentives
go to Social Security's Web site at www.ssa.gov/work. Some
particularly helpful URLs on the Social Security site are:
- http://www.ssa.gov/work/ResourcesToolkit/workincentives.html
-
http://www.ssa.gov/work/ServiceProviders/providers.html
- http://www.ssa.gov/work/Beneficiaries/activity.html#NewJersey
It may also be helpful to have copies of these SSA publications
handy for reference:
- Work Incentives for People with Disabilities (Redbook),
Pub- 64-030
- SSI - A Guide for Groups and Organizations, Pub- 05-11015
- A Desktop Guide to Social Security and SSI Work Incentives,
Pub, 05-11002
These brochures may also help you understand SSA terminology
so you can more effectively advocate for the participants
attending your program should you assist them in their dealings
with SSA.
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