Subsidies and Special Conditions - Brian S. Dennis, MS, CRC Ticket to Work Program Coordinator - Iowa.gov

Subsidies and Special Conditions

     Brian S. Dennis, MS, CRC
Ticket to Work Program Coordinator

Social Security isn’t all knowing

         They base decisions on what you tell them.
             And tell them in a timely manner

Disability Benefit Programs
 Social Security Disability Insurance (SSDI)

 Supplemental Security Income (SSI)

 Both SSDI and SSI = Concurrent Benefits

Overview of Social Security Benefit
Programs
Title II Social Security Disability    Title XVI Supplemental Security
Insurance (SSDI)                       Income (SSI)
     • Entitlement program based            • Funded by federal tax dollars,
        upon insured status                   not Social Security trust fund
     • 3 different forms – SSDI, CDB        • Needs-based program based
        and DWB                               upon financial eligibility
     • Comes with Medicare                  • Comes with Medicaid
        coverage                              coverage
     • Amount of benefit varies             • Set full benefit amount ($794)
     • Received on 3rd of month             • Received on 1st of month
     • Income counted when it’s             • Income counted when it’s
        earned.                               received.
     • Pay Periods matter                   • Pay Days Matter

Wages and Social Security Benefit
Programs
Title II Social Security Disability    Title XVI Supplemental Security
Insurance (SSDI)                       Income (SSI)
     • Income counted when it’s             • Income counted when it’s
        earned.                               received.
     • Earnings are based on when           • Earnings are based on when
        you worked; not when you are          you actually paid.
        paid.                               • For SSI recipients; monthly
     • Earnings estimates: hourly             wages are the total gross of all
        wage x hours per week x 4.33          paychecks received in a
     • For example: $10/hr x 30 hrs           calendar month.
        per week x 4.33 = $1,299
        gross estimate
     • Use a calendar

Subsidy or Special Conditions
• Value given to the natural and/or paid support received on the
  job due to a person’s disability.

• SSA deductd the value of subsidies and special conditions from
  monthly reported earnings.

• Subsidy or Special Conditions
   • Participants “earn” less than 100% of their wages
   • Participants receive additional assistance

• Does not change the wages the individual is paid.

SSDI

Substantial Gainful Activity

                   Substantial Gainful Activity (SGA)
                      • Performance of significant
                         physical and/or mental
                         activities in work for pay or
                         profit.

                       • Working enough to support
                         yourself

                       • The “limit”
                           • $1,310 (non-blind)
                           • $2,190 (blind)

Social Security Disability Insurance
Three Phases

               Trial Work Period -- Income over $940 triggers it for 2021. Allows you
               to work and still receive benefits. 9 months, non-consecutive. NEVER
               jeopardizes cash benefits

               Extended Period of Eligibility – 36 months. Cash benefit determined by
               whether you earn above or below Substantial Gainful Activity (SGA) –
               For 2021, $1,310 for non-blind/$2,190 for blind

               Expedited Reinstatement – 60 months. Work income over SGA results
               in termination. A contacting SSA reinstates provisional (temporary)
               benefits.

When to consider a Subsidy
or Special Condition
• Individual has used all or almost all of their Trial Work Period
  (TWP) months

• They are working a job which is above or near Substantial
  Gainful Activity (SGA)
   • $1,310 (non-blind)
   • $2,190 (blind)

• They receive “extra help” on the job

• The value of the extra help would impact SGA

Subsidy vs Special Condition
Subsidy:                       Special Conditions:
• Assistance or job            • Professional supports and
  modifications based on the     assistance provided to assist
  disability                     in maintaining employment.
• Increased                    • Does not need to paid for
  supervision/training from      directly by the individual
  co-workers or management     • Job Coaching
• Reduced tasks or job
  customization
• Accommodations/Job
  sharing

Determining the value of the
 Subsidy/Special Condition
• Ultimately determined by SSA

• Subsidy:
    • Information provided by the employer
    • Job Description and Duties
    • List and describe the assistance given
    • Employer gives value to the subsidy (dollar amount or percentage)
    • More detail the better
    • Typically, only done once.

• Special Conditions (Job Coaching)
    • Paid Service (VR or Medicaid)
    • Monthly Value of coaching is based on hours served
    • Cost of coaching is based on the rate of the employee not the Job Coach
    • Provide monthly with Paystubs

• Do the math!!!

Example: Zoe’s Subsidy

• Zoe works at a local medical clinic and experiences Cerebral Palsy and seizures.
  She earns $1,500 per month.

• Subsidy Details:
    • Some reduced tasks
    • Zoe works slightly slower than her co-workers in the same position
    • Zoe receives extra supervision due to the seizures

• The employer provides details related to the subsidy and states that Zoe’s
  subsidy is valued at 15% per month. (Zoe “earns” 85% of her wages)

• SSA accepts this and Zoe’s countable income is $1,275 ($1,500 x .85) per month
  (below SGA)

• Zoe maintains her SSDI benefits.

Example: Brooklyn’s Special Condition

• Brooklyn works at a bookstore and experiences a Brain Injury and earns
  $1,440 per month

• Special Condition Details:
    • Receives 30 hours of Job Coaching per month.
    • Brooklyn earn $12 per hour

• The value of the Job Coaching is $360 ($12 x 30)

• SSA accepts this and Brooklyn’s countable income is $1,080 ($1,440-$360)
  per month (below SGA)

• Brooklyn maintains her SSDI benefits.

How to Begin the Process

• Assemble the team
   • Contact a Benefits Planner
   • Make sure to involve partners (employers, job coaches, payees,
     guardians) for any needed documentation and planning.
   • Make that a subsidy/special exists and will be beneficial
   • May need to blend in additional work incentives

• Contact SSA (1-800-772-1213)
   • Request a Work Review by contacting Social Security
   • Receive a Work Activity Report (SSA 821)
   • Indicate Special Conditions (page 5)

Questions?

Brian S. Dennis, M.S., CRC
WIOA Program Coordinator-Disability Services
Phone: 515-725-3666
Brian.Dennis@iwd.iowa.gov