For many years people with disabilities were effectively penalized for taking a job. It was easy to see why such disincentives existed: Any income a person made above the limits set by the government was deducted from his or her benefits and jeopardized the only source of health insurance available to people with long-term health conditions.
Things have improved, however. Below are details on two Social Security programs designed to encourage people with disabilities to enter the job force without fear of losing health care benefits.
One is the Ticket to Work program, the other the Plan to Achieve Self-Sufficiency (PASS).
Working: The Ticket Program
The Ticket to Work and Work Incentives Improvement Act of 1999 was enacted on Dec. 17, 1999. The law modernizes the employment services system for people with disabilities so millions of Americans with disabilities no longer have to choose between taking a job and having health care.
* Increases beneficiary choice in obtaining rehabilitation and vocational services.
* Removes barriers that require people with disabilities to choose between health care coverage and work.
* Assures that more Americans with disabilities have the opportunity to participate in the workforce and lessen their dependence on public benefits.
Starting this year, Social Security and Supplemental Security Income (SSI) disability beneficiaries will receive a "ticket" they may use to obtain vocational rehabilitation and other employment support services from an approved provider of their choice.
The program is voluntary. The program will be phased in nationally over a three-year period. During the first phase, SSA will distribute tickets in 13 states: Arizona, Colorado, Delaware, Florida, Illinois, Iowa, Massachusetts, New York, Oklahoma, Oregon, South Carolina, Vermont, and Wisconsin.
Additional states will be announced in the near future. For more information call Maximus, Inc., the Ticket Program Manager at 1-866-968-7842 (TTY 1-866-833-2967).
The law expands Medicaid and Medicare coverage to more people with disabilities who work. States may provide Medicaid coverage to more people who are still working. States may permit working individuals with income above 250 percent of the federal poverty level to purchase Medicaid coverage. This provision creates an experiment in which medical assistance will be provided to workers with impairments who are not yet too disabled to work.
In addition, a Medicaid Infrastructure Grant program is available to support state efforts to increase employment options for people with disabilities. To find out if this provision is available in your state, call the state Medicaid office in your area.
The law expands Medicare coverage to people with disabilities who work. It extends Part A premium-free coverage for 93 months after the trial work period for most Social Security disability beneficiaries who work.
When a person's Social Security or SSI disability benefits have ended because of earnings from work, he or she may request reinstatement of benefits, including Medicare and Medicaid, without filing a new application.
An individual using a "ticket" will not need to undergo the regularly scheduled disability reviews. As of Jan. 1, 2002, Social Security disability beneficiaries who have been receiving benefits for at least 24 months will not be asked to go through a disability review because of the work they are doing. However, regularly scheduled medical reviews could still be performed and benefits could be terminated if earnings were above the limits.
The law directs Social Security to establish a community-based work incentives planning and assistance program to disseminate accurate information about work incentives and to give beneficiaries more choice. Social Security has established a program of cooperative agreements and contracts to provide benefits planning and assistance to all Social Security disability beneficiaries, including information about the availability of protection and advocacy services.
The law extends Social Security disability insurance demonstration authority for five years. Under the law, Social Security is required to conduct a demonstration project to test reducing Social Security disability insurance benefits by $1 for each $2 that a beneficiary earns over a certain amount. The implementation date for this demonstration will be announced.
Source: Social Security Administration
Preparing a PASS
The PASS (Plan to Achieve Self-Sufficiency) is a work incentive plan that allows you to work and keep your Social Security health care benefits. The plan is submitted to Social Security, usually with the help of a counselor, stating what the work goal is, what is needed to achieve it, how long that will take, and what it will cost.
The work goal can be anything you realistically expect to accomplish, and will generate adequate income for you, part or full time, at or away from home, working for wages or starting your own business.
The things you need to buy must be related to the goal -- training or tuition, a car or van for transportation, a computer or tools and supplies of your trade or business, day care for a child while you work or attend school, adaptive technology, etc.
Under regular Supplemental Security Income (SSI) rules, your SSI benefit is reduced by the other income you have. But the income you set aside for a PASS does not reduce your SSI benefit. This means you can get a higher SSI benefit when you have a PASS.
Ask your local Social Security office for a copy of PASS form, SSA--545--BK. The form collects most of the information we need to review your plan.
How to set up your plan: Choose a work goal. It should be a job that you're interested in doing and that you think you'll be able to do when you complete your plan. You also can set up a PASS to cover any costs for the vocational services, including testing.
Find out all the steps you need to take to reach your goal and how long it will take you to complete each step.
Decide what items or services you will need to reach your goal. Get several cost estimates for the things you need to achieve your goal.
Find out how much money you'll need to set aside each month in order to pay for them.
Note: If you're setting aside income for your plan, your SSI benefit usually will increase to help pay your living expenses. The people at Social Security can estimate what your new SSI payment will be if you set up your plan.
Keep any money you save for your goal separate from any other money you have. The easiest way to do this is to open a separate bank account for the money you save under your plan.
Include a business plan if you intend to start a business. Your business plan should explain:
* what kind of business you want to start (e.g., a hotdog stand, a design shop);
* how you will pay for your business;
* where you will set up your business (e.g., office at home, shared space);
* hours of operation;
* marketing your product or service;
* suppliers and customers will be; and
* expected earnings.
Complete all the questions on form SSA--545--BK, and sign and date it. Take or mail the form to your local Social Security office.
You may set up a plan yourself or get help from a vocational rehabilitation counselor; an organization that helps people with disabilities; the people at your Social Security office.
Some organizations charge a fee for writing a PASS. The Social Security office may be able to refer you to someone who does not charge a fee.
After you submit your plan, Social Security will review the plan to make sure it is
complete; decide if there is a good chance that you can reach your goal; decide if the things you want to buy to reach your goal are necessary and are reasonably priced; decide if any changes are needed and discuss those changes with you; and send you a letter to tell you if the plan is approved or denied.
If your plan is approved, Social Security will contact you from time to time to make sure that you are doing what your plan says you will do to reach your goal. Make sure that you keep receipts for the items and services you have bought under the plan.
If your PASS is denied, there is an appeal process.
Source: Social Security Administration
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