|Questions and Answers for People Who Get SSI or SSDI and Are Returning to Work||
Last updated: December 2009
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 should always report your earnings to the Social Security Administration (SSA), and you should talk to a claims representative before you start working, so you will know what and when you have to report. Keep a copy of any pay stubs you submit and a record of when you reported the earnings to SSA.
No. Or at least not right away. You can receive your entire SSDI check during your "trial work period." Your trial work period is nine months long. Any month you earn more than $720 will be counted as one of the nine months of your trial work period. The nine months don't have to be all at the same time. Social Security will count any months you work in a five year period as part of the trial work period.
Note: On January 1, 2001, the Trial Work Period amount rose from $200 a month to $530, and the amount has risen by $10-20 increments on January 1st of every year since then, until it reached $720 on January 1, 2010. For any months worked before January 1, 2001, the trial work period amount is $200.
Once you have accumulated 9 months of trial work, then Social Security will start looking at months in which you make more than $1000, as of January 1, 2010. If you earn more than $1000 per month, Social Security will consider that "substantial gainful activity." Note: The substantial activity amount (SGA amount) has steadily increased over the last few years. Up until July 1, 1999, the SGA amount was $500. It was increased to $700 on July 1, 1999. It was then increased to $740 on January 1, 2001, $760 on January 1, 2002, $790 on January 1, 2003, $810 on January 1, 2004, $830 on January 1, 2005, $860 on January 1, 2006, $900 on January 1, 2007 and $940 on January 1, 2008. This amount will increase annually every January 1st.
You will be able to keep your SSDI benefits for 3 more months after your trial work period ends if you are earning over SGA. Then, if you continue working and make more than $980 a month, your SSDI check will stop.
It depends on whether Social Security thinks you are still disabled. During the three months after your trial work period, Social Security will look at your medical records to see if your health has improved enough that you are no longer considered disabled. If Social Security finds that you are still disabled, then you will be covered under what Social Security calls an "Extended Period of Eligibility" for the next 60 months. You will automatically be eligible for your SSDI check in any month during the Extended Period of Eligibility in which your earnings [INVALID] below $980.
On the other hand, if Social Security looks at your medical records and decides that they show "medical improvement" then they will send you a notice saying that they no longer consider you disabled. Then the only way you will be able to get your SSDI benefits back will be by appealing (and winning) or applying all over again.
No. Social Security will assume that you are still disabled. They can’t use the fact that you’re working to prove otherwise. But they can (and will) look at your medical records to decide if you are still disabled. Some people will clearly still be disabled. However, if you have improved so that you really are functioning a lot better, then there is a real risk that Social Security might conclude that your condition has medically improved and you are no longer disabled under their rules.
Subsidies: If your employer pays you and you are not really doing the work that would be required of you, (because your employer wants to be nice to you) your "earnings" could be considered as a subsidy and the money would not be counted as income.
Business related expenses: Self-employed persons can deduct the reasonable cost of business-related expenses from monthly gross earnings.
Impairment Related Work Expenses (IRWEs): These are expenses that are necessary to go to work and stay on the job. These include most drugs and medical services. IRWEs can also include items such as personal attendant care, medical or prosthetic devices, residential modifications and special transportation (such as cab fare). All IRWEs can be deducted from gross monthly earnings to get below the $980 a month SGA. SSA must approve any IRWEs.
Example: You earn $950 a month in gross wages. Because of your disability, you must take medication to allow you to get to and perform your job. This expense costs you $300 a month out of your pocket. Your countable wages for SSA purposes are therefore $650 ($950 minus the $300 prescription costs). Since your countable wages are less than $980 per month, your SSDI benefits will continue.
$950 (gross monthly earnings)
- $300 (medication costs)
$650 (countable wages)
No. The Trial Work Period only applies to people who get SSDI. Your SSI check will be affected as soon as you go back to work. But you may still be able to keep some of your SSI check, even if you work more than 9 months.
SSI is called a "means-tested" program. It is only available to people who have little or no income or assets. As your income goes up, your SSI check goes down, or ends altogether. But Social Security wants people on SSI to work, so they don’t count some of the money you earn when they are calculating how big your SSI check will be. Social Security calls income you earn from employment or self-employment Earned Income.
The first $20 of any earned or unearned income you have is subtracted. In addition, SSA subtracts $65 plus 50% of the remaining earned income. This is called the earned income disregard.
If you lose your job within 12 months after your SSI benefits were stopped because your earnings were too high, and you are still disabled, your SSI benefits would start again without a new application. If you work for more than 12 months after your SSI or Medicaid stopped and then lose your job, you may need to reapply for SSI.
No. Once your earned income is roughly twice the monthly SSI benefit rate, plus the $85 in disregards, you will no longer be eligible for SSI. In 2008, this figure is $1,433 per month--or higher if you have business-related expenses or Impairment Related Work Expenses (IRWEs).
Example: You receive $674 from SSI (in 2009). You go back to work and earn $600 a month in gross wages. SSA will subtract the first $85 of the $600 to get $515. Then SSA subtracts 50% of the remainder (50% of 515) to get $257.50. Then SSA subtracts the $257.50 from the $674 SSI benefit to get $416.50, which is how much you can get in SSI. Thus you have earnings of $600 from your employment, and SSI benefits of $416.50, for a total monthly income of $1016.50. You have improved your monthly income by $416.50 by going to work.
Remember, if you have a subsidy, business related expenses, or IRWEs, you would deduct them from your gross wages before you subtract the income disregard of $85, and then take 50% 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 by excluding from their SSI eligibility and benefit calculations any income or resources used to pursue a work goal. Anyone interested in pursuing a PASS must submit an application to their local SSA office (there is an application form that is not mandatory to submit, but you are advised to use it), and the PASS must be approved by SSA before your income and resources will be excluded. You should have someone familiar with PASS help you with your application.
Unfortunately, both programs have different rules, and both apply to you. For example, you will have a 9 month trial work period for SSDI, and if you are earning over $1000 a month after your trial work period, you will lose your SSDI benefits, but you could have some SSI benefits after the 9 months if your earnings are low enough. It is more likely that you will lose your SSI benefits first, though, since your SSI benefits probably do not amount to much of your total benefits.
You can request an Expedited Reinstatement of Benefits, including Medicare and Medicaid, without filing a new application. Beneficiaries must be unable to work because of their medical condition.
The Request for Expedited Reinstatement must be filed with the Social Security Administration within 60 months from the month their benefits were terminated due to work. In addition, they may receive temporary benefits, as well as, Medicare and Medicaid for up to six months while their case is being reviewed. If they are found not disabled, these benefits would not be considered as an overpayment.
Under the Ticket to Work Program, Social Security Beneficiaries, who have been determined disabled as an adult and are receiving cash benefits, can receive help in obtaining rehabilitation and vocational services to help them go to work and achieve their employment goals. The Ticket to Work Program also removes barriers that require people with disabilities to 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 – Office of Rehabilitation Services is also an Employment Network.
DHFS – ORS is also offering assistance with questions by calling (800) 795-9973 (V) or (800) 524-9904 TTY
Even though you're feeling better, there is probably no issue more important than knowing 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 your [INVALID]natives are.
When you look for a job, look for one with a good health insurance plan. A good plan should cover your doctor and hospital bills with little or no deductible or co-payment, it should cover your prescriptions, and it shouldn't have a waiting period for pre-existing conditions. You'd also like to have the option of choosing a plan that's not an HMO so that you can keep your existing doctors and not have to worry about getting approval from someone every time you need a specialist.
Large employers are more likely to have plans that don't exclude pre-existing conditions. Large employers may also be more likely to offer several plans so you don't have to be in an HMO. Most full-time government jobs have good health insurance. Most unionized employers and many not-for-profits offer good health insurance. But there are also many small companies that offer good health insurance plans, and many large ones that only offer a bare-bones HMO plan.
You probably won't make a good impression in an interview if you spend a lot of time asking about health insurance. But it's all right to ask about fringe benefits generally and when you actually get an offer, by all means 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. The new rules apply to any employer that has at least two employees in its group plan.
HIPAA says that the longest any employer can exclude a pre-existing condition is 12 months. More importantly, HIPAA says that if you already had group health insurance for at least 12 months, (or 18 months if you are joining your group plan late), then when you switch jobs, or start a new one, your new health insurance has to cover your pre-existing condition right away. Even people who have been on Medicaid or Medicare have some protection under HIPAA. If your new job has a pre-existing condition limitation, and your employer says it applies to you, check with an attorney to find out if HIPAA can help you.
There is one other important thing you need to know about HIPAA. First, 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 can be a problem for people on Medicaid who start doing temporary or part-time work, or start back to work in some other 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 eight and one-half years after you return to work, your Part A (hospitalization) coverage will be free. (This includes the Trial Work Period). You'll only pay for the Part B coverage which is probably now being deducted from your Social Security check. After the eight and one-half years, you can continue to buy Medicare coverage if you are still disabled, although then you would have to pay both Part A and Part B premiums.
If you get SSI now, you probably also have a Medicaid card which you use at the doctor's office, for hospitalizations, and to buy your prescriptions. It's very hard to keep your Medicaid when you return to work, because the income limits for Medicaid in Illinois are so low.
There are two groups of people who now get SSI and who can keep Medicaid when they go back to work. If you earn a little over $940 per month, you should still get a small SSI check every month after Social Security makes adjustments for your earnings. People who work and make over $940 per month and still get an SSI check can continue their Medicaid under a special program called 1619(a).
It works this way: when you earn over $940 a month in gross earnings, and report it, SSA will automatically put you in the 1619 program, although you should contact SSA to confirm this. SSA will use the earned income disregards and exclusions (discussed in the chapter about SSDI and SSI) to determine the amount of SSI benefit. SSA should also notify the Department of Healthcare and Family Services that you are on the 1619 program. The Department of Healthcare and Family Services should continue your Medicaid eligibility without a spenddown.
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, be sure that your local Medicaid office is continuing your benefits. (You should contact an attorney if the Department of Healthcare and Family Services puts you in a spenddown or terminates your Medicaid coverage.)
There are also a few people who can make up to approximately $31,200 and keep their Medicaid. If you have been on SSI and Medicaid, and are still seriously disabled even though you're working, Social Security can put you on a special list that will let you keep your Medicaid benefits without a spenddown. This program is called 1619(b). To be eligible for continued Medicaid coverage under 1619(b) you must meet the following conditions:
If you think you might be eligible, tell the Social Security worker to evaluate you for "1619(b)" benefits. Your Medicaid benefits should not be terminated by the Department of Healthcare and Family Services until Social Security makes the 1619(b) determination.
Individual health insurance policies will be 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 has a variety of 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 doesn't apply to people who have been on another group health insurance program for at least 18 months and haven't had a break of insurance more than 63 days long. So 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 man run $247 to $2,080, depending on your age, whether you elect the PPO policy, and the amount of your annual deductible. Still, these costs are inexpensive compared to the costs of some 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 State of Illinois Department of Healthcare and Family Services administers a Health Benefits for Workers with Disabilities Program, formerly known as the Medicaid Buy-In. This program allows people with disabilities who are working to enroll in Medicaid, or stay in Medicaid without a spenddown, by paying a monthly premium of no more than $100. The rules state that income needs to be below 200% of the Federal Poverty Level (in 2012 annual income below $22,340 or $1,861 per month for an individual. These amounts change every year). The assets limit is $10,000 versus the $2,000 limit for regular Medicaid. Questions about the program and requests for applications can be directed to the Department of Healthcare and Family Services at 1-800-226-0768; Health and Disability Advocates at 312-223-9600 or The AIDS Legal Council of Chicago at 312-427-8990.
If you go back to work, you may be concerned that you will be discriminated against because of your status as a person with a disability, or you may need some accommodation in order to go back to work. The Americans with Disabilities Act (ADA) makes it unlawful to discriminate in employment against a qualified individual with a disability if the person can perform the essential functions of the job with or without a reasonable accommodation. The ADA makes it unlawful to discriminate in all employment practices, including:
Social Security counts the gross monthly wages you earn only for the Trial Work Period months. For months after the ninth month of the Trial Work Period, SSA recognizes certain expenses that can be deducted from gross monthly wages to reduce monthly income below the substantial gainful activity level.
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 for educational background, employment experience, skills, licenses, and any other qualification standards that are job related. 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. Factors to consider are:
A reasonable accommodation is any change or adjustment to a job or work environment that permits a qualified applicant or employee with a disability to participate in the job application process or to do the job successfully and that does not [INVALID] undue hardship to the employer.
For example, reasonable accommodations may include:
If you need an accommodation, you must request one. It is not up to the employer to try to anticipate or assume that you need one.
Undue hardship means that an accommodation would be unduly costly, extensive, disruptive, or would fundamentally [INVALID] the nature or operation of the business. Among the factors to be considered are the cost, the employer's size, financial resources and the nature and structure of its operation.
No. Unless you need a reasonable accommodation to perform the essential functions of the job, it is not necessary to disclose your health condition.
NO! It is unlawful to ask an applicant whether he or she is disabled or to require the applicant to 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 be conditioned on the results of the medical exam. If you are not hired because a medical examination reveals your disability, the employer must be able to show that the reasons for exclusion are job related and necessary for the conduct of their business. They must also be able to show that there was no reasonable accommodation available that would make it possible for you to do the job.
They shouldn't know if you don't tell them. The results of all medical examination or information from inquiries about a disability must be kept confidential by your employer and maintained in separate medical files. In addition, if you have HIV for example, the AIDS Confidentiality Act prohibits anyone from disclosing your status without your consent.
The Family and Medical Leave Act of 1993 (FMLA) entitles eligible employees to take reasonable leave for medical reasons, for the birth or adoption of a child, or for the care of a child, spouse, or parent who has a serious health condition. The Act requires covered employers to provide up to 12 weeks of leave per year.
In general, any employer who employs 50 or more employees is covered. Any employee who has been employed an average of 25 hours per week for at least 12 months is eligible.
An employee must provide at least 30 days advance notice before FMLA leave is to begin if the need for the leave is foreseeable. If 30 days notice is not workable, notice must be given as soon as practicable--generally at least two days’ notice.
Probably. An employer may require that a request for leave under FMLA be supported by certification issued by the employee's health care provider.
No, unless your company has a paid leave policy or a short-term disability plan.
During any leave under the Act, an employer must maintain your health coverage under any group health plan. An employee is obligated to pay health plan premiums while on leave ONLY to the same extent as when not on leave.
Often, leave will be taken in large segments of time or the full 12 weeks. However, when medically necessary, leave may be taken on an intermittent or reduced schedule basis. This may include periods of an hour or several days at a time.
Many people's financial situations change dramatically when they become disabled and can no longer work. You may be collecting long-term disability insurance from a former employer. You may have unpaid bills or have recently filed for bankruptcy. This section addresses these financial issues for people who are now returning to work.
Every long term disability policy is different. Some say that all of your benefits end if you go back to work. If your policy says that, you should be very sure of yourself and your ability to work before you give up those benefits. But many policies now include provisions that encourage you to go back to work. They may allow you to work part-time without losing your benefits. They may keep your eligibility status active, so that you have a period to "try out" work before you lose your benefits. They may provide that if you go back to work you'll get benefits in any month in which your income [INVALID]s below a certain level.
The only way to know what your plan allows is to read it carefully. If you are at all uncertain about what your plan allows, be sure to consult with 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. You may owe money for uncovered medical expenses, school loans, car loans, credit cards, utility bills, health club memberships, or any other expense. When you were ill, and your only income was Social Security, you may have been advised that you were "judgment proof" and may have written to your creditors telling them that you could not pay. Or you may have already been [INVALID]d bankrupt so that your debts were wiped out.
If you go back to work, you will no longer be judgment proof. If your creditors go to court and get a judgment against you they can garnish your paycheck or your bank account. There are laws limiting how much money a creditor can take out of your paycheck. If you make less than $348.75 a week after taxes, then your creditors cannot garnish your paycheck. If you make more than that, however, they can take up to 15% of every paycheck. So if you make $400 per week after taxes, your creditors can garnish $50 every week, or about $200 per month.
If going back to work means that you will suddenly be faced with lots of old bills you cannot pay, then this might be a good time to consider filing for bankruptcy. There are two forms of bankruptcy--Chapter 7, which wipes out all of your old debts, and Chapter 13, which [INVALID]s a plan for paying off some or all of your old debts. 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.
If you have already filed for bankruptcy, then you probably know that you can't file a second Chapter 7 bankruptcy for eight years. If there are now other people you owe money to, then returning to work means that you have to be prepared to pay those bills.
Chapter 13 bankruptcy is available to people who have filed either Chapter 7 or Chapter 13 bankruptcy in the past.
This checklist should remind you of some of the important issues you need to consider when you return to work. This checklist is strictly a practical one. It does not deal with issues such as job satisfaction, possible job-related stress, or your personal health issues. Often, of course, these factors may be more important to you as you make your decision than the practical factors described here.
If you are now on SSI:
If you are now on SSDI:
After your trial work period ends, will you be making more than $940 per month after Impairment - Related Work Expenses are deducted?
If you will be making more than $940 per month after the end of your trial work period, can you:
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 (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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