|Questions and Answers for People Who are Returning to Work and are Receiving SSI or SSDI||
Last updated: June 2015
Working and Social Security
Discrimination in the Workplace
Confidentiality and Disclosure
The Family and Medical Leave Act
Other Financial Issues for People Returning to Work
Checklist for Returning to Work
Yes. You must always report your earnings to the Social Security Administration (SSA). You should talk to a claims representative before you start working. A claims representative will let you know what to report and when you have to report earnings. Keep a copy of all pay stubs you receive or submit to SSA and a record of when you report the earnings to SSA. Always let SSA know when you start or stop work or if there are any changes in your earnings.
No, not right away. You can receive your entire SSDI check during your "trial work period." Your trial work period is the first nine months you work in a five year period. The nine months do not have to be all at the same time. Any month you earn more than $780 (or work 80 if you are self-employed) counts as one of the nine months.
Once you have worked 9 months, SSA decides if are doing "substantial gainful activity" (SGA). You are doing SGA if you make more than $1,090 per month ($1,820 if you are blind).
If you earn more than the SGA amount, you can keep SSDI benefits for 3 months after your trial work period ends. If you continue to work and make more than $1090 a month, your SSDI check will stop.
It depends on whether you are still disabled. During the three months after your trial work period, SSA will look at your medical records to decide whether you are still disabled.
No. Social Security will assume that you are still disabled. They cannot use the fact that you are working to prove otherwise. They will look at your medical records to decide if you are still disabled. If your health has improved and you are functioning better, then SSI might decide that you are no longer disabled under their rules.
No, Not all earnings count towards the limits. There are some deductions that lower that amount of income that counts.
Subsidies: Your earnings may be a subsidy if your employer still pays you but you are not doing all of the work that would be required of you. These payments do not count as income.
Business related expenses: If you are self-employed, you can deduct the reasonable cost of business-related expenses from monthly earnings.
Impairment Related Work Expenses (IRWEs): These are expenses that you have to pay so that you can do your job. They can include:
SSA must approve all IRWEs. If approved, they do not count toward your monthly earnings.
Example: You earn $1100 a month in gross wages. You have a disability. You must take medication so you can perform your job. This expense costs you $300 a month out of your pocket. Your countable wages for SSA purposes are $800 ($1100 minus the $300 prescription costs). Since your countable wages are less than $1090 per month, your SSDI benefits will continue.
$1100 (gross monthly earnings)
-$300 (medication costs)
$800 (countable wages)
No. The Trial Work Period only applies to people who get SSDI. Going back to work might lower your SSI check right away. But, you may still be able to keep some of your SSI check even if you work more than 9 months.
SSI is only available to people who have little or no income or assets. As your income goes up, your SSI check goes down or stops completely.
SSA wants people on SSI to work, so they do not count some earnings when they calculate how much money you get from SSI. The first $20 of your income does not count. SSA also subtracts $65 plus half of the remaining earned income. This is called the earned income disregard.
Your SSI benefits will start again without a new application if:
If you work for more than 12 months after your SSI or Medicaid stopped and then lose your job, you need to reapply for SSI.
No. Once your earned income is roughly twice the monthly SSI benefit rate, you will no longer be eligible for SSI. In 2008, this figure was $1,433 per month--or higher if you have deductions.
Example: You receive $674 from SSI. You go back to work and earn $600 a month in gross wages. SSA will lower your benefit check by $257.50 because you made more money. Your SSI benefit will now be $416.50. But, because you also earned $600 by working, your total monthly income will be $1016.50. You have improved your monthly income by $416.50 by going to work.
Remember, deductions come out of your gross wages before you subtract the income disregard of $85, and then take half of the remainder. That gives you a larger SSI benefit.
The Plan for Achieving Self Support (PASS) program allows disabled SSI and SSDI beneficiaries to receive SSI. With PASS, any income that you use to pursue a work goal is excluded from your earned income. This will increase the amount you receive from SSI.
Anyone interested in pursuing a PASS must submit an application to their local SSA office. SSA must approve your application before your income will be excluded. You should have someone familiar with PASS help you with your application.
Unfortunately, the two programs have different rules and both apply to you.
For example, if you are earning over $1090 a month after your trial work period, you will lose your SSDI benefits. But, if your earnings are low enough, you could still have some SSI benefits. It is more likely that you will lose your SSI benefits first.
You can request an Expedited Reinstatement of Benefits, including Medicare and Medicaid, without filing a new application. You must be unable to work because of your medical condition.
You must file the Request for Expedited Reinstatement with SSA within 60 months of when your benefits stopped. While SSA reviews your case, you may receive temporary benefits and Medicare and Medicaid for up to six months. If SSA decides you are not disabled, these benefits will not count as an overpayment.
The Ticket to Work Program helps disabled Social Security beneficiaries receive rehabilitation and vocational services. These services can help them go to work and achieve their employment goals. The Ticket to Work Program also removes barriers that make people with disabilities choose between health care coverage and work.
If you would like assistance with getting a job, need vocational rehabilitation services or support services you can take your ticket to an Employment Network. You can find out about Employment Networks in your area from Maximus at (866) 968-7842.
The Illinois Department of Healthcare and Family Services (DHFS) – Office of Rehabilitation Services is also an Employment Network. They can answer your questions by phone at (800) 795-9973 or (800) 524-9904 (TTY)
Even though you are feeling better, it is important to know that your medical expenses will be covered even if you go back to work. Right now, your health care expenses may be covered by Medicare, Medicaid or both. This chapter discusses how each of those programs may be affected if you return to work and what alternatives are available to you.
When you look for a job, look for one with a good health insurance plan that:
You may want to avoid an HMO plan so that you can keep your existing doctors. HMO plans may also make you ask for approval every time you need a specialist.
Large employers are more likely to have plans that don't exclude pre-existing conditions. Large employers are also more likely to offer several plans so you can avoid an HMO. Most full-time government jobs have good health insurance. Most unionized employers and many not-for-profits offer good health insurance. There are also many small companies that offer better health insurance plans than some large employers.
You may not want to ask about health insurance in your job interview, but it is okay to ask about fringe benefits. After you have a job offer, you can ask for a detailed description of the salary and benefit package.
Exclusions for pre-existing conditions can be a serious problem for people with disabilities who go back to work. However, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) made it much harder for group health insurance companies to refuse to cover pre-existing conditions.
HIPAA says that the longest any employer can exclude a pre-existing condition is 12 months. If you had group health insurance for at least 12 months (or 18 months if you are joining your group plan late) before switching jobs, your new health insurance has to cover your pre-existing condition right away. This does not apply if you received medical advice, care, diagnosis, or treatment in the 6 months before you enrolled in the new plan.
Even people who have been on Medicaid or Medicare have some protection under HIPAA. If your employer says a pre-existing condition limitation applies to you, check with an attorney to find out if HIPAA can help you.
If you have a break of more than 63 days in your present insurance, then you can't count the months before the break toward your pre-existing exclusion period. This may affect you if you are on Medicaid and start a job without health insurance.
If you have Medicare, you will probably be able to keep your Medicare coverage after you return to work. You will keep your Medicare for at least the first 12 months you work. Then, if you are still considered disabled, you will be able to keep your Medicare if you continue to work.
For the first 8.5 years after you return to work, your Part A (hospitalization) coverage will be free (This includes the Trial Work Period). You will only pay for the Part B coverage which is probably coming out of your Social Security check now. After the 8.5 years, you can continue to buy Medicare coverage if you are still disabled, but you would have to pay both Part A and Part B premiums.
If you get SSI now, you probably also have a Medicaid card. The income limits for Medicaid in Illinois are very low, so it is hard to keep your Medicaid benefits when your return to work.
There are two groups of people who now get SSI and who can keep Medicaid when they go back to work:
1619(A): If you earn a little over $980.83 per month, you should still get a small SSI check every month. People who work and make over $980.83 per month and still get an SSI check can continue their Medicaid under a special program called 1619(a).
If you meet those requirements, SSA will automatically put you in the 1619 program. You should check with the SSA to make sure. SSA should also notify the Department of Healthcare and Family Services (DHFS) that you are on the 1619 program. The DHFS should continue your Medicaid eligibility without a spend down.
Very few people in Illinois get their Medicaid under the 1619(a) program, but it's an important benefit for low-income workers. If you are working and getting an SSI check, make sure that your local Medicaid office continues your benefits. You should contact an attorney if the DHFS puts you in a spend down or terminates your Medicaid coverage.
1619(B): If you qualify for 1619(b), you may be able to keep your Medicaid benefits without a spend down. To be eligible for continued Medicaid coverage under 1619(b) you must:
If you think you might be eligible, ask you Social Security worker to evaluate you for "1619(b)" benefits. The DHFS should not decide on your benefits until you know whether you qualify for 1619(b).
Individual health insurance policies are expensive and hard to find for people with disabilities. The State of Illinois offers a health insurance plan called I-CHIP (Illinois Comprehensive Health Insurance Plan) for people who cannot buy other health insurance. I-CHIP offers different plans with a wide range of deductible amounts. It also offers a plan for people on Medicare that includes prescription drug coverage.
There are two major problems with I-CHIP insurance. First, for most people, it includes a six month exclusion for pre-existing conditions. That means that your pre-existing conditions would not be covered for the first six months. The exclusion does not apply to people who have been on another group health insurance program for at least 18 months and have not had a break of insurance more than 63 days long. If you are just now losing your COBRA insurance, you may qualify for I-CHIP without the six-month exclusion.
The second problem with I-CHIP is that it can be expensive. For people living in the Chicago area, monthly premiums for a single person range from $247 to $2,080. Still, these costs may be less than the cost of you prescription drug treatment. If you can afford the premiums, and have no other source of insurance, I-CHIP may give you the coverage you need to return to work.
The Illinois DHFS administers the Health Benefits for Workers with Disabilities Program. This used to be called the Medicaid Buy-In. It allows people with disabilities who are working to be in Medicaid without a spend down. It requires a monthly premium of $100 or less. To qualify, you must have the following:
Questions about the program and requests for applications can be directed to:
The Americans with Disabilities Act (ADA) prevents employers from discriminating against a qualified individual with a disability if the person can perform the essential functions of the job with a reasonable accommodation. The ADA makes it unlawful to discriminate in all employment practices, including:
Under the ADA, a person has a disability if they have a physical or mental impairment that substantially limits a major life activity.
A qualified individual must satisfy the job requirements, including:
The ADA does not interfere with an employer's right to hire the best qualified applicant. The ADA does not impose any affirmative action obligations.
Essential functions are the basic job duties that an employee must be able to perform to be considered for the job. Factors that could make a function essential include:
A reasonable accommodation is any change or adjustment to a job or work environment that helps a qualified employee with a disability do the job successfully. It also cannot create an undue hardship to the employer.
For example, reasonable accommodations may include:
If you need an accommodation, you must request one. Your employer does not have to make accommodations unless you ask.
Undue hardship means that an accommodation would be too costly, extensive, disruptive, or would change the business. This depends on:
No. You only need to tell you employer if you need a reasonable accommodation to perform the essential functions of the job.
NO! It is unlawful to ask you if you are disabled. It is also unlawful to make you take a medical examination before making a job offer.
After a job offer is made, you may be required to have a medical examination but only if everyone else who will be working in the job category also must have an examination. A job offer may depend on the results of the medical exam. If the employer does not hire you because a medical examination reveals your disability, they must be able to show that:
They should not know if you do not tell them. You employer must keep medical information confidential and keep it in separate medical files. If you have HIV, the AIDS Confidentiality Act prohibits anyone from disclosing your status without your consent.
The Family and Medical Leave Act of 1993 (FMLA) allows eligible employees to take reasonable leave for:
The Act requires covered employers to provide up to 12 weeks of leave per year.
If 50 or more people work for your employer for at least 20 work weeks in the year, it is a covered employer. If you have been employed 1,250 hours during the 12 month period preceding, you are eligible.
If you know you will need time off, you must tell your employer at least 30 days before your FMLA leave begins. If 30 days’ notice is not possible, you must tell them as soon as you can--generally at least two days’ notice.
Probably. An employer may require that a request for leave under FMLA be supported by certification from your health care provider.
No, unless your company has a paid leave policy or a short-term disability plan.
During any leave under the FMLA, Your employer must maintain your health coverage. They have to pay health plan premiums the same as when you are not on leave, but not more.
Often, leave is taken for long periods of time or the full 12 weeks. However, when medically necessary, you may take your leave by reducing your schedule. This may include periods of an hour or several days at a time.
Your financial situation can change dramatically when you become disabled and can no longer work. This section addresses financial issues for people returning to work, including:
Every long term disability policy is different. Some policies stop benefits if you return to work, but many other policies do not. If the policy stops when you return to work, make sure you are able to work before you give up your benefits under the policy. Some long term disability policies may allow you to work part-time without losing your benefits. These policies may keep your eligibility status active, so that you have a period to "try out" work before you lose your benefits. The policy may give benefits in any month in which your income is below a certain level.
The only way to know what your plan allows is to read it carefully. If you are not sure about what your plan allows, talk to an attorney or someone at the plan office before you make a change that may cause you to lose these benefits.
People who are very ill often have debts. When you were ill, and your only income was Social Security, you were "judgment proof" and may have written to your creditors telling them that you could not pay. Or, you may have already filed for bankruptcy so that your debts were wiped out.
If you go back to work, you will not be judgment proof anymore. If your creditors go to court and get a judgment against you, they can garnish your paycheck or your bank account. Laws limit how much money a creditor can take out of your paycheck. In Illinois, if you make less than 45 times the minimum rate per week after taxes, then your creditors cannot garnish your paycheck ($8.25 x 45 = $371.25). If you make more than $371.25, they can take up to 15% of every paycheck. So if you make $400 per week after taxes, your creditors can take $60 every week, or about $200 per month. However, if you make $300 after taxes, your creditors cannot take anything.
If going back to work means that you will have lots of old bills you cannot pay, then you might want to file for bankruptcy now. There are two forms of bankruptcy:
If you are considering filing for bankruptcy, you will have to see an attorney to help decide which form is right for you and represent you in bankruptcy court.
This checklist should remind you of some of the important issues you need to consider when you return to work. It does not deal with issues such as job satisfaction, possible job-related stress, or your personal health issues. Of course, these factors may be more important to you as you make your decision than the practical factors described here.
Social Security Administration (applications, appeals, reporting work)
Contact your closest office or call (800) 772-1213; TTY (800) 325-0778
Illinois Department of Healthcare and Family Services (processes Medicaid applications, income reporting, and appeals)
Contact your local office or call (800) 720-4166
Illinois Department of Public Aid (processes Health Benefits for Workers with Disabilities applications)
Contact your local office or call (800) 226-0768 (V) or (877) 204-1012 (TTY)
Illinois Comprehensive Health Insurance Plan (I-CHIP) (800) 367-6410
Health and Disability Advocates, formerly the SSI Coalition (to discuss SSI/SSDI representation, including assistance on Return to Work issues or to get speakers on SSI/SSDI issues or Return to Work issues)
(312) 223-9600; TTY (800) 427-0766
City of Chicago, Mayors Office for People with Disabilities (312) 746-5743 (V) (312) 746-5713 (TTY)
Department of Healthcare and Family Services–Office of Rehabilitation Services (800) 807-6962 (V) (866) 444-8013 TTY
Department of Healthcare and Family Services – Office of Mental Health (866) 390-6771
Protection and Advocacy for Beneficiaries of Social Security (PABSS) – mediates issues regarding the Ticket to Work Equip for Equality, Inc. (800) 537-2632 (V) (800) 610-2779 TTY
Maximus – Program Manager for “The Ticket to Work” program (866) 968-7842
Illinois Department of Public Health, AIDS Activity Section (to get help paying COBRA premiums) (800) 825-3518
AIDS Legal Council of Chicago (legal assistance on issues related to your HIV status, including any of the topics discussed in this booklet, or for speakers on Return to Work or other legal issues affecting people with HIV) (312) 427-8990
Legal Assistance Foundation of Metropolitan Chicago, HIV/AIDS Project (legal assistance for low-income Chicago residents with HIV) (312) 347-8309
AIDS Foundation of Chicago (to get a case manager or to learn about and discuss AIDS advocacy issues)(312) 922-2322
Illinois AIDS Drug Assistance Program (ADAP) - (800) 825-3518
Note: This manual is not intended to substitute for legal advice. Please contact one of the legal resources noted above if you have specific questions about your case.
For a list of organizations in your area that may be able to help you, enter your zip code.
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