Very often in the human services field we encounter people who want to help but just are not equipped. Their desire to make a difference in another’s life or situation prompts them to pass on bits of information that they themselves have learned, experienced or heard. As often happens in the casual transfer of information, something gets lost in the translation. It is due to this fact that myths often occur and in that occurrence, people believe them to be fact. The intent to help can some time become a hindrance because of information that has no factual basis.
When we give the “Social Security Myths Tips Tricks and How to Make It Work” trainings, the first thing we say is, “If someone tells you something concerning Social Security, ask them to show you the documentation.” When it comes to Social Security, accurate information is essential in positively affecting another person’s life when that person is, more often than not, living below the poverty level. We quote Social Security’s documents when we do these training and provide the attendee with the actual SSA forms and tell them where they can find the actual statute. We want the providers, consumers and family members who attend our trainings to be as informed as possible so as to streamline and make positive their experience with the Social Security system, and to assist others in getting away from the myths that have made them afraid to try to succeed. So many have been afraid of what they have heard that has absolutely no solid fact or basis.
One of the biggest myths is that people on benefits can’t work or they will lose their benefits. How scary is that for someone who wants a purpose to their life but hears “you can’t or else”? The fact of the matter is, the Social Security Administration actually wants people to be able to work so that they may reach a level of ability that would allow them to be become self-sufficient. If they can become self-sufficient, they can then contribute back to the system by working and paying taxes. We cannot tell you how many people have said to us over the past few years, “I can do that? I can really go back to work without risk to my benefits my wellbeing?” (They actually become very excited and enthusiastic) or “How come I have been told all of this time I cannot work?”
Yes! You can go to work or back to work. The Social Security Administration has developed a number of work incentives to make this possible. In fact, most of these incentives have been present in the system for many, many years. People haven’t known about them because they haven’t had the need or desire to research them, sometimes it’s easier to just believe what you’re told. To quote the SSA Red Book, “One of the biggest concerns SSI beneficiaries have about going to work is the possibility of losing Medicaid coverage.”
To further quote the Red Book, “Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy people. It covers children, the aged, blind, and/or disabled and other people who are eligible to receive federally assisted income maintenance payments.
Thirty-two states and the District of Columbia provide Medicaid eligibility to people eligible for Supplemental Security Income (SSI) benefits. In these States, the SSI application is also the Medicaid application. Medicaid eligibility starts the same months as SSI eligibility.
What happens to Medicaid coverage if an SSI recipient works? If a recipient’s State provides Medicaid to people on SSI, the recipient will continue to be eligible for Medicaid. Medicaid coverage can continue even if a recipient’s earnings along with other income become too high for an SSI cash payment.
How does a recipient qualify? To qualify a recipient must: (1) Have been eligible for an SSI cash payment for at least one month; (2) Still be disabled; (3) Still meet all other eligibility rules, including the resources test; (4) Need Medicaid in order to work; and (5) Have gross earned income that is insufficient to replace SSI, Medicaid, and any publicly funded attendant care.
One of the most exciting programs the SSA has to prevent this is Continued Medicaid Eligibility or “1619b”. Section 1619(b) of the Social Security Act provides some protection for these beneficiaries. To qualify for continuing Medicaid coverage, a person must: (1) Have been eligible for an SSI cash payment for at least 1 month; (2) Still meet the disability requirement; (3) Still meet all other non-disability SSI requirements; (4) Need Medicaid benefits to continue to work; and (5) Have gross earnings that are insufficient to replace SSI, Medicaid and publicly funded attendant care services.
This means that SSI beneficiaries who have earnings too high for a SSI cash payment may be eligible for Medicaid if they meet the above requirements. SSA uses a threshold amount to measure whether a person’s earnings are high enough to replace his/her SSI and Medicaid benefits. This threshold is based on the: amount of earnings which would cause SSI cash payments to stop in the person’s State; and average Medicaid expenses in that State.
If a SSI beneficiary has gross earnings higher than the threshold amount for his/her State, SSA can figure an individual threshold amount if that person has: Impairment Related Work Expenses; or Blind Work Expense; or A Plan to Achieve Self Support; or a Personal attendant whose fees are publicly funded; or Medical expenses above the average State amount.
Section 1619b also provides for a beneficiary to resume SSI payments should they ever relapse into their disability again without reapplying for the benefit. In other words, if a person should start work and lose their Medicaid because the made too much money, but not over their state’s threshold, (in New York for 2009 the threshold is $43,421) they can ask SSA to implement 1619b. Should that same person have a relapse of their disability, say 4 years down the road, provided they are still receiving the 1619b benefit, they can simply notify their local SSA field office and say “I am no longer working due to my disability” and their benefit will automatically start the next month and they will receive a check without reapplying. If a person living in New York is making over the $43,421 threshold but under $55,000 annually, they are eligible for the Medicaid Buy in offered through the NYS Department of Health. For more information on the Medicaid Buy In for Working People with Disabilities or MBI WPD, visit the NYS Department of Health’s website at www.health.state.ny.us.
So there really is no reason not to try and go back to work. The outcome is safer than most think and depending on the ambition of the person on benefits, success could be within reach where fear and failure seemed to dominate over one’s desires and dreams.
To learn more about what is available for Social Security recipients, visit www.ssa.gov or attend one of the many trainings throughout NY given by the NYS OMH Bureau of Consumer Affairs. For a schedule of trainings or to be put on an e-mail list, contact Tom O’Clair at coratpo@omh.state.ny.us
