Frequently Asked Questions

This is often the first question people ask. Part of the answer depends on whether you are receiving Title II Benefits or Supplemental Security Income (SSI). Social Security has set up different work incentives and safety net for each of these programs.

If you are receiving both SSI and SSDI, you will be able to use both sets of incentives. A Certified Benefits Counselor can talk with you about your own benefits and work goals to help you understand more.

Not necessarily. If your SSI payment is reduced to $0 by your earnings, the 1619(b) rule may  enable you to keep Medical Assistance as long as (1) your earnings  stay below the Maryland State Threshold or a higher individual threshold if your medical expenses are higher than average and/or you receive publicly-funded attendant care, (2) you continue to meet the other requirements for SSI (not medically improved, not  exceeding limits on resources or unearned income) and (3) you continue to use Medical  Assistance at least annually. If you lose SSI for reasons other than earnings (e.g., you receive too much unearned income or you medically improve), however, 1619(b) will not protect your Medical Assistance.

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Continued Medicaid Eligibility 1619(b)

Yes. For example, you may use a Plan for Achieving Self Support (PASS) for expenses to reach a work goal and Impairment-Related Work Expenses (IRWE) for continuing, work-related expenses incurred due to your disability. If you are a student under age 22, you may use the Student Earned Income Exclusion (SEIE) at the same time you use a PASS or IRWE’s.

In some cases, yes. If you receive too much unearned income (such as SSDI) to ordinarily qualify for SSI, you may use a PASS to reduce your “countable” unearned income low enough for you to meet the SSI income limits. A PASS helps you qualify for SSI in this situation. By qualifying for SSI, you are also automatically eligible for Medical Assistance (Medicaid). A PASS may also be used to exclude countable resources by designating them for PASS expenses. This can also help you qualify for SSI.

Yes. If you meet all the other criteria for SSI eligibility (disability, resource limit, unearned income limit) but receive earnings too high to qualify for SSI, you may use BWE to reduce your countable earnings low enough to receive a SSI payment and Medical Assistance.

The Social Security Administration defines “substantial gainful activity” or SGA as the performance of significant physical and/or mental activities in work for pay or profit, or in work of a type generally performed for pay or profit, regardless of the legality of the work. Within the context of this definition, each of the following words or phrases has a specific meaning:

• “Significant activities” are useful in the accomplishment of a job or the operation of a business, and have economic value.
• Work may be considered “substantial” even if it is performed on a part-time basis, or even if the individual does less, is paid less, or has less responsibility than in previous work.
• Work activity is “gainful” if it is the kind of work usually done for pay, whether in cash or in kind, or for profit, whether or not a profit is realized.

During the 36-month EPE, you may receive your Title II payment any time your earnings fall below SGA without reapplying. This is especially helpful for people who need more than the 9-month Trial Work Period (TWP) to be sure they can succeed in a job. For example, a SSDI beneficiary who has not worked since s/he became eligible for SSDI starts a job earning above SGA. The first nine months would be his/her Trial Work Period, and s/he would keep SSDI payments. The next three months would be his/her Grace Period, and s/he would still keep SSDI payments. The next 33 months would be the remainder of his/her EPE, and s/he would not receive SSDI. However, if his/ her earnings fell below SGA any month during (or the month after) the EPE, s/he would get SSDI back without reapplying. In short, the worker would have 45 months (the 9-month TWP plus the 36-month EPE) to “prove” himself/herself on a job before risking the permanent loss of SSDI.

Yes. In fact, if any of your work-related expenses qualify as IRWE’s (needed for work, incurred due to disability, paid for by individual and not reimbursed, of reasonable cost), you may use the same expense to both reduce your countable earnings (to keep more SSI) and to keep earnings below SGA (to keep SSDI).

The Ticket to Work and Work Incentives Improvement Act (TWWIIA) of 1999 created an important work incentive called Expedited Reinstatement (EXR). EXR is a way for a beneficiary to return more quickly to Social Security disability benefits when his or her work significantly reduces or stops. The former beneficiary must have the same or a related disability as the earlier entitlement, and the person must again be unable to perform SGA. EXR permits individuals to receive provisional payments while Social Security is processing the reinstatement request.