SSDI Work Incentives

If you’re getting Social Security Disability Insurance (SSDI), it’s because your disability prevents you from going to work and earning enough to cover your expenses. However, you may want to give work a chance. It is possible that maybe if you just had a bit of time and knew that you wouldn’t lose your benefits, you could succeed at a job.

That’s why Social Security has made program rules and incentives that can help you get a job without having to worry that you’ll lose the benefits you need. For most people who get SSDI benefits, these work incentives function as a 3-stage process that begins when you get a job that pays more than the Substantial Gainful Activity (SGA) limit:

1. The Trial Work Period (TWP) lets you work and get benefits at the same time, no matter how much you make.
2. When the TWP ends, the 3-year Extended Period of Eligibility (EPE) starts and lets you work and get benefits for every month that you do not earn more than the SGA limit ($1,180 in 2018, $1,970 if you’re blind).
3. For 5 years after you get your last SSDI cash benefits, Expedited Reinstatement (EXR) will let you quickly get back on SSDI if your income drops below the SGA limit and you’re still medically disabled. You won’t have to completely reapply.

These 3 incentives mean that you can get a job and see how it goes. If it goes well, you’ll be in a better financial situation than before. If it doesn’t go well, you will be able to get SSDI benefits and be in the same situation you were in before you tried working.

Trial Work Period (TWP)

Social Security allows every person on SSDI a 9-month Trial Work Period (TWP) to try working. During your TWP, you can work and earn any level of income (even if it is more than the Substantial Gainful Activity (SGA) limit — $1,180 in 2018, $1,970 if you’re blind) and keep your full SSDI benefits.

Your TWP is 9 Trial Work months occurring within a 5-year window. Your 9 Trial Work months may occur consecutively (one right after another) or sporadically (not one right after another) within the 5-year window. The window stays open until you have used up all 9 Trial Work months. During your TWP, you will continue to get your full SSDI benefits, no matter how much you earn.

Extended Period of Eligibility (EPE)

Once you’ve used up all 9 Trial Work months, your Trial Work Period is over and your 3-year Extended Period of Eligibility (EPE) begins.

When your gross monthly earnings are less than or equal to the Substantial Gainful Activity (SGA) limit ($1,180 per month in 2018, $1,970 if you’re blind), you will keep getting SSDI benefits.

During your EPE, the first time you earn over the SGA limit in a month, your 3-month Grace Period begins. During the Grace Period, you will keep getting SSDI cash benefits no matter how much you earn. After your Grace Period ends, your SSDI benefits will be $0 in any month that you earn above the SGA limit.

If you are not earning above the SGA limit when your 3-year Extended Period of Eligibility (EPE) ends, you will continue to get SSDI benefits. If you are earning more than the SGA limit, you will no longer get SSDI benefits, but you will be able to get back on SSDI if your income drops below the SGA limit and you are still disabled. More about what happens after the EPE ends is discussed later in this article under Expedited Reinstatement.

Notes:

• It is always important to report any changes in work and income to Social Security right away to avoid overpayments.
• It is also important to report when your earnings are below the SGA level. Contact Social Security and ask that your benefits be "reinstated." If you don’t, you won't get SSDI benefits, even if your earnings are less than the SGA limit.

Expedited Reinstatement (EXR)

After you use up your Trial Work Period and Extended Period of Eligibility (EPE), your SSDI benefits stop if you are earning above the Substantial Gainful Activity (SGA) limit. Expedited Reinstatement (EXR) allows you to get up to 6 months of temporary SSDI cash benefits if your income drops back below the SGA limit.

During those 6 months, Social Security will conduct a medical review to see if you still meet their definition of disability. If you do, your benefits can start again without you having to reapply. If you are not considered to be disabled, your temporary SSDI cash benefits will stop. If you have questions about Expedited Reinstatement, talk to a Benefits Specialist.

Deductions

During your Extended Period of Eligibility (EPE) and the period of Expedited Reinstatement (EXR), there are some ways to lower the amount of earnings Social Security counts to figure out if you’re over the Substantial Gainful Activity (SGA) limit. These are called “deductions.” Here we’ll talk about the most common deductions that can help you lower your gross monthly earnings below the SGA limit, so that you can work and keep getting your SSDI benefits check.

Note: These deductions cannot be used during the Trial Work Period (TWP).

Impairment Related Work Expenses (IRWEs)

Impairment Related Work Expenses (IRWEs) are things you pay for yourself that are related to your disability and that you need to work. Social Security doesn’t count earned income that you use to pay for these expenses when they calculate your income. IRWEs include things like:

• Medication
• Adaptive equipment
• Vehicle modifications
• Personal care attendant costs
• Special transportation costs

Social Security must approve the items that you want counted as IRWEs. You can use this form to request that Social Security approve your IRWEs. If the IRWEs are approved, Social Security will deduct these expenses from your income when they are calculating your SSI benefits amount or figuring out Substantial Gainful Activity. That makes it more likely that you will continue to get SSDI benefits.

Subsidies and Special Conditions

Subsidies and special conditions are supports you get on the job that result in you getting more pay than the actual value of the services you perform. A subsidy is support that you get from your employer; special conditions are generally supplied by someone other than your employer, for example, a Vocational Rehabilitation agency.

Social Security considers subsidies and special conditions when they make an SGA decision. They only use earnings that represent the real value of the work you do to decide if your work is at the SGA limit. This is good for you because if Social Security decides that you have a subsidy or special conditions, you can earn more while still getting benefits.

Subsidies or special conditions may exist if:

• You get more supervision than other workers doing the same or a similar job for the same pay
• You have fewer or simpler tasks to complete than other workers doing the same job for the same pay, or
• You have a job coach or mentor who helps you perform some of your work.

If you think you get a subsidy, talk to Social Security about it. They may ask you to get a letter from your employer, so they can document that you get a subsidy. If you think special conditions may apply to you, talk about it with Social Security. Also talk to your mentor or job coach — they may need to supply documentation so that you can be recognized as having a special condition.

Unincurred Business Expenses (Self-Employment)

Unincurred Business Expenses are contributions made by others to your self-employment business effort. Examples include things like:

• A friend working for free
• A government agency paying for some of your business expenses
• Someone giving you things of value — such as office space free of charge

Social Security deducts the value of any unincurred business expenses from your net income when deciding if you have reached the SGA limit for any given month. Social Security uses fair market value to assess the value of any unincurred business expenses.

Plan to Achieve Self-Support (PASS)

A Plan to Achieve Self-Support (PASS) lets people who get Supplemental Security Income (SSI) save money for a work-related goal. Income that is put into a PASS does not count as earnings by SSI and the money you save is not counted as resources.

If you get SSDI benefits, it only helps you if you also get SSI benefits or if you would qualify for SSI benefits if you put some of your earnings into a PASS. For more information on Plans to Achieve Self-Support, click here.

Continued Payment - Section 301

Section 301 lets you continue to get SSDI benefits, even if you no longer meet Social Security’s criteria for being disabled, as long as you are participating in an approved Vocational Rehabilitation (VR) program that is expected to help you become self-supporting.

Programs and providers that are usually approved for Section 301 include:

• Ticket to Work providers
• The Missouri Division of Vocational Rehabilitation
• Support services that use individualized written employment plans
• A Plan to Achieve Self-Support (PASS)
• An Individualized Education Program (IEP) (persons ages 18 – 21)

To find out if a specific provider or program is approved under Section 301, talk to a Benefits Specialist or visit your local Social Security office. You can also call Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY).

SSI Work Incentives

If you’re getting Supplemental Security Income (SSI), it’s because your disability prevents you from going to work and earning enough to cover your expenses. However, you may want to give work a chance. It is possible that maybe if you just had a bit of time and knew that you wouldn’t lose your benefits, you could succeed at a job.

That’s why Social Security has made program rules and incentives that can help you do so without having to worry that you’ll lose the benefits you need. You can try out getting a job, earn some money, and even save up some money in the bank without losing your SSI benefits. Here we’ll explain how.

When SSI figures out how large a benefit to give you, they look at how much money you make. The Earned Income Exclusion means that SSI doesn’t count the first $65 of your earnings in a month. After that, SSI only counts half of the rest of your earnings. So, if you get a job, SSI counts less than half of your earnings when determining your SSI payment amount.

Earned Income Incentives

When SSI figures out how large a benefit to give you, they look at how much money you make. The Earned Income Exclusion means that SSI doesn’t count the first $65 of your earnings in a month. SSI also doesn’t count an additional $20 of general income, which could be earned income or unearned income, including some benefits such as Social Security Disability Insurance (SSDI). After that, SSI only counts half of the rest of your earnings.

The bottom line: If you get a job, SSI counts less than half of your earnings when determining your SSI payment amount.

1619(a)

Generally, to qualify for SSI, you must have a disability that prevents you from working. However, after you have been on SSI for a while, you may find that you are able to do some work. If that happens, 1619(a) allows you to keep getting SSI benefits, even when you have earned income above the Substantial Gainful Activity (SGA) limit.

To qualify, you must:

• Have been eligible for SSI benefits for at least one month before you began working above the SGA level ($1,180 in 2018, $1,970 if you’re blind)
• Still be disabled
• Meet all other eligibility rules, including SSI’s resource limits ($2,000 if you’re single, $3,000 for couples)

You are single. You have been getting SSI benefits for 6 months and you just got a new part-time job. Even though you are now working and earning more than the SGA limit, 1619(a) means that you may continue to qualify to get SSI benefits. Social Security applies the SSI formula to figure out your countable income:

Countable Earned Income Example:

Your Earned Income	$1,300
Minus the $20 General Exclusion	- $20
Minus the $65 Earned Income Exclusion	- $65
Subtotal
Divide by two	÷2
Your Countable Income
SSI Benefit Calculation
SSI Maximum Benefit	$750.00
Minus Total Countable Income	-
Your SSI Benefit

Even with 1619(a), when your countable income goes above the maximum SSI payment amount (also called the Federal Benefit Rate; $750 in 2018), your SSI benefits will go down to $0. However, you may still qualify for 1619(b), which is an incentive that lets you keep your MO HealthNet coverage, even though you no longer get SSI benefits. 1619(b) is discussed in more detail here.

Student Earned Income Exclusion (SEIE)

The Student Earned Income Exclusion (SEIE) helps students keep more of their SSI checks while they work and are in school. If you are a student under the age of 22, SSI won’t count any of your earnings when figuring out your SSI benefits amount, unless you make more than $1,820 per month.

There is a maximum exclusion of $7,350 per year in 2018. To read more about the Student Earned Income Exclusion, click here.

Impairment Related Work Expenses (IRWE)

Impairment Related Work Expenses (IRWEs) are things you pay for yourself that are related to your disability and that you need to work. Social Security doesn’t count earned income that you use to pay for these expenses when they are calculating your income. IRWEs include things like:

• Medication copays
• Adaptive equipment
• Vehicle modifications
• Personal care attendant costs
• Special transportation costs

To see a list of deductible and nondeductible IRWEs from Social Security’s Red Book, click here.

Social Security must approve the items that you want counted as IRWEs. You can use this form to request that Social Security approve your IRWEs. If the IRWEs are approved, Social Security will deduct these expenses from your income when they are calculating your SSI eligibility or benefits amount.

Blind Work Expenses (BWEs)

Blind Work Expenses (BWEs) can only be used by people who get SSI benefits and who are blind. If you are blind, Social Security doesn’t count earned income that you use to pay for expenses when you work. BWEs include things like:

• Transportation costs to and from work
• Guide dog expenses
• Income taxes

Social Security must approve the items that you want counted as BWEs. You can use this form to request that Social Security approve your BWEs. If the BWEs are approved, Social Security will deduct these expenses from your income when they are figuring out your SSI eligibility or benefits amount.

Plan to Achieve Self-Support (PASS)

A Plan to Achieve Self-Support (PASS) lets you save money for a work-related goal that will help you be more self-sufficient. Usually, your SSI benefits go down when you get income from other sources, like a job or Social Security Disability Insurance (SSDI). But with a PASS, Social Security does not count income or resources set aside in the PASS when figuring out your SSI eligibility or benefits amount. That means you can save up money and keep getting your SSI benefits at the same time.

You can use a PASS to:

• Help pay for the cost of school or training
• Start a business
• Pay for equipment, support services, and other expenses related to your goal

To set up a PASS, you must do the following:

• Be on SSI or become eligible for the SSI program as a result of an approved PASS application. (If you are not eligible for SSI benefits because of the limit on resources, you may be able to move those resources into a PASS and become eligible.)
• Have a source of income other than SSI (for example, Social Security Disability Insurance (SSDI) cash benefits or wages from a job).
• Have a work goal that eventually will help you earn enough money to lower or get off Social Security disability benefits.
• Be able to write a plan that shows how saving a certain amount of money will let you reach your work goal. Social Security has staff called PASS Cadre who can help you write your PASS plan.
• Be under age 65. You may be able to set up a PASS if you are 65 or older, if you were getting SSI cash benefits based on disability or blindness in the month before your 65^th birthday.

The PASS plan is about your work goal, what you want to achieve, and what you need to get there. After you write your PASS, you ask Social Security to approve it. Your plan must have a realistic goal that considers your abilities, experience, and educational background.

Once you have an approved PASS plan, you will need to open a separate bank account just for your PASS funds. You cannot put any money you get from SSI into your PASS account. Your SSI benefits should be used for basic expenses like food and housing. You must fund your PASS account with money from other sources, such as income from a job or money from a spouse or parent. You will use the money you have put into your PASS account to pay for approved expenses to reach your goal.

For more information about the PASS program, see the DB101 article on Building Your Assets and Wealth.

Continued Payment - Section 301

Section 301 lets you continue to get SSI benefits, even if you no longer meet Social Security’s criteria for a disability, as long as you are participating in an approved Vocational Rehabilitation program that is expected to help you become self-supporting.

Programs and providers that are usually approved for Section 301 include:

• Ticket to Work providers
• The Missouri Division of Vocational Rehabilitation
• Support services that use individualized written employment plans
• A Plan to Achieve Self-Support (PASS)
• An Individualized Education Program (IEP) (persons ages 18 – 21)

To find out if a specific provider or program is approved under Section 301, talk to a Benefits Specialist or visit your local Social Security office. You can also call Social Security at 1-800-772-1213 or 1-800-325-0778 (TTY).

Expedited Reinstatement (EXR)

Expedited Reinstatement (EXR) allows your SSI benefits to start again, without a new application, if they stopped because of work. EXR can be used by people who got SSI benefits in the past, but it is not very common because of the 1619(b) rules.

To be eligible for EXR, you must request it within 5 years of the last month that you were last eligible for 1619(b). If you have questions about Expedited Reinstatement, talk to a Benefits Specialist.

Property Essential to Self-Support (PESS)

Property Essential to Self-Support (PESS) is anything that you own and need to support yourself. Social Security does not count these things as resources when figuring out if you are eligible for SSI benefits. Three types of property can be excluded as PESS:

• Property that you use in a trade or business (for example, your inventory) or personal property you use for work as an employee (for example, tools or equipment)
• Up to $6,000 of the value of nonbusiness property that you use to produce something that helps with your daily living (for example, land that you use to produce vegetables that you eat)
• Up to $6,000 of the value of property if the property gives you a return of at least a 6% per year (for example, property you own and rent to someone else)

You must be using the property to support yourself or expect to start using it again within a reasonable period of time, usually 12 months.

Health Care Work Incentives

If you get health care benefits like Medicare or MO HealthNet, there are also incentives that make sure you continue to have good health coverage after you get a job.

Medicare

Many people with disabilities get Medicare health coverage, usually because they also get Social Security Disability Insurance (SSDI). If your income goes up while you’re on SSDI, your benefits can go down, though the work incentives described earlier in this article can help you to gradually try out working without fear of suddenly losing your cash benefits. Likewise, you can gradually try out working without fear of suddenly losing your Medicare coverage, thanks to the incentives described here.

Continuation of Medicare Coverage

Once you become eligible for Medicare, you can continue getting Medicare coverage for at least 93 months (or 7 years and 9 months) after your SSDI Trial Work Period (TWP) ends, if you are still disabled under Social Security’s guidelines. The 93-month period starts the month after the last month of your TWP.

Medicare for Persons with Disabilities Who Work

If you are still working after your Continuation of Medicare Coverage period ends, you may be able to buy continued Medicare coverage. You are eligible to buy Medicare coverage if:

• You are under age 65
• You continue to be disabled
• Your Medicare stopped because of work

For more information about buying Medicare continuation coverage, visit Medicare’s website or call them at 1-800-633-4227 or 1-877-486-2048 (TTY). The line is open 24 hours a day, 7 days a week. You can also talk to a Benefits Specialist.

MO HealthNet

Many people with disabilities get MO HealthNet health coverage. Some worry that if they make too much money or save up too much, they'll lose their health coverage. However, there are a few ways you can keep your MO HealthNet while working and earning more than the usual income limit:

1. You can get MO HealthNet with a spend down
2. You can get MO HealthNet through the Supplemental Security Income (SSI) 1619(b) rule
3. You can get MO HealthNet through a program called Ticket to Work Health Assurance (TWHA)

As with any type of MO HealthNet, to qualify through these you must:

• Have or apply for a Social Security number
• Live in Missouri and intend to remain in the state
• Be a United States citizen or an eligible noncitizen
• Have limited resources
  • For most MO HealthNet programs, including the spend down and TWHA, you must have less than $3,000 in available resources ($6,000 for couples).
  • For people who get MO HealthNet through 1619(b), the resource limit is the same as SSI’s, $2,000 for an individual, $3,000 for a couple.

The amount of money you can make and whether you have to pay a monthly premium or spend money of your own for care depends on your situation. Here we’ll explain the differences between these 3 rules.

MO HealthNet with a Spend down

If you make more than MO HealthNet’s income limit, you may qualify for MO HealthNet with a spend down. A spend down is like an insurance deductible. With a spend down, you are responsible for part of your medical expenses each month before MO HealthNet will start paying for them.

Each month you have the option of meeting the spend down by paying for some of your medical expenses directly (like a deductible) or by paying your spend down amount to MO HealthNet (like a premium).

Whichever of these options you choose, every month when you meet the spend down, you will get MO HealthNet coverage. When you don’t meet the spend down, you won’t get MO HealthNet coverage. You may choose to meet the spend down some months and not in other months, if you do not have health care expenses every month.

SSI’s 1619(b) Program

For people on SSI, the 1619(b) program lets you work and keep MO HealthNet, even if you make too much money to get SSI cash benefits. If you are on this program, you will not have to pay a premium or meet a spend down.

In addition to the eligibility requirements listed earlier for all MO HealthNet programs, to qualify for MO HealthNet based on 1619(b) you must:

• Be found eligible for 1619(b) status by Social Security
• Have gotten MO HealthNet in the month prior to becoming eligible for 1619(b) status

To be eligible for 1619(b) status you must:

• Have been eligible for SSI cash benefits for at least 1 month
• Be working and have gross earnings below $37,188 per year
• Not be getting SSI benefits because you earn too much
• Still be considered disabled or blind by SSI
• Need MO HealthNet to be able to work
• Not make enough money to pay for the services you get with MO HealthNet benefits
• Respond to all Social Security requests for information

Note: When your income is counted, Social Security won’t count all of your income, thanks to various SSI work incentives. So you may be making more than $37,188 per year and still qualify for 1619(b).

MO HealthNet Ticket to Work Health Assurance (TWHA) Program

When you have a job and your income is more than regular MO HealthNet allows, you may be eligible for the Ticket to Work Health Assurance (TWHA) program. TWHA covers the same services that standard MO HealthNet covers, including visits to the doctor, hospital stays, medical equipment, home care services, and mental health services. The program encourages you to work and enjoy the benefits of working without having to worry that you’ll lose your health benefits.

In addition to the eligibility requirements listed earlier for all MO HealthNet programs, to qualify for TWHA you must:

• Be age 16 – 64
• Be working and paying Social Security and Medicare taxes
• Get Social Security disability benefits or considered disabled by the Missouri Department of Social Services (DSS) Family Support Division (FSD)
• Have gross income of $3,035 per month or less for an individual, $4,115 or less for a couple.
• Also meet countable net income limits. Your countable net income is calculated by the Family Support Division and includes various deductions from your gross income.

Depending on your gross income, you may have to pay a monthly premium for this type of MO HealthNet coverage. Premiums range from a minimum of $40 per month to a maximum of $206 per month, depending on your situation.

Subsidized Individual Coverage Through Healthcare.gov

If your income is too high to qualify for MO HealthNet, you should be able to buy individual health coverage through Healthcare.gov. If your family's income is at or below 400% of the Federal Poverty Guidelines (FPG), the government may help you pay for your plan through a tax credit. If your family's income is at or below 250% of FPG, the government will also help you get a plan that has lower copayments and other expenses.

Affordable Housing Earned Income Disregard (EID)

Many people with disabilities participate in housing programs that can make renting an apartment or purchasing a home more affordable. These programs include:

• Section 8
• Public Housing
• HOME Investment Partnerships Program
• Supportive Housing Program
• Housing Opportunities for Persons with AIDS (HOPWA)

If you have a disability and participate in one of these affordable housing programs and get a job, you may qualify for the Earned Income Disregard (EID).

The Earned Income Disregard (EID) is earned income that is excluded (not counted) as part of your annual income for rent calculation when you begin earning income or earn additional income. The EID allows your rent to stay the same when you start working. Here’s how it works:

• For the first 12 months after you start working, income from your job is not counted towards your rent, so the amount you pay in rent stays the same.
• In the second 12 months, your housing authority will only count half of your total work earnings towards rent.
• The exclusion period may be interrupted, but in no case may the total number of months between the beginning of the exclusion and the final month of exclusion be more than 48 months (or 4 years). After that, applicants cannot get the EID for rent.

Many, but not all, public and subsidized housing programs offer an EID. If you are thinking about getting a job, talk to your housing provider to see if this work incentive is available.