21. Understanding SSA Pt 2 - Work Incentives

Few people enjoy walking on a tightrope, but that is what working while depending on SSI for benefits feels, lose your balance and everything falls to the floor.

We continue our episode with Hillary Hatch, helping us to understand the work incentives offered through SSI.  Resources mentioned in this episode can be found ON OUR WEBSITE 

Transcript

Steve: 0:10

Hi, this is Steve. I've never been good at playing chess. Actually, I have never tried to be good at playing chess. It's not that I don't find the game interesting from a spectators point of view at least. I love the movie The Queen's gambit. And I can appreciate how for some people, the game of chess is fascinating. It's just my frustration when I make moves that seem sensible, only to have them black, encountered by my seven year old opponent over and over again, until the ultimate checkmate, which for me happened shortly after the third or fourth move it seems. During the introduction of our first episode on Social Security, I compared the rules and regulations around SSI SSDI and IRS gi eligibility to walking through a corn maze. But we learned that the blue book is a very reliable eyeline resource that provides explanations of the rules and in laypersons terms, the blue book provides examples for applying these rules to your own situation. We also learn that not everyone at Social Security is an expert in all aspects of disability, and that individual circumstances can vary dramatically from one individual to another. In these cases, requesting an appointment with a qualified expert on the topic of concern is certainly within your rights. Today we talk with Hillary hatch about work incentives for SSI and SSDI. How they're sometimes similar and and other aspects, very different from each other. among a number of other things, we'll talk about substantial gainful activity, trial work periods, the importance of work activity reports, right to work, Medicaid, and the red book, which is the Bible for disability work incentives. Like the blue book, it's written in language that even I can understand along with examples that anybody can easily relate to their own situation. Let's face it, this can be complex, maintaining disability benefits, especially Medicaid, while doing your best to work, and not violate any of the rules that would jeopardize the benefits you depend upon is tough stuff. It's kind of like walking through a minefield. I hope you find this episode beneficial. I learned a lot speaking with Hillary and I'm sure I still have much more to learn, but it sure helps knowing where to seek the answers and the help you need to navigate through the process. We'd love to have you consider supporting our show. There are three ways you can support the podcast. Number one, tell your friends and other family members living with disability about us. You can do this by referring them to www.nlwk.com. That's n lucky.com is the easiest thing to do. Or you can send them a link to this podcast episode. Number two, subscribe to our podcast on Google Apple, Spotify, Amazon. Wherever you get your podcasts from the platform of your choice. You'll be notified when each new episode is released. And there's no fee for this. Number three become a supporter through patreon.com slash and Locky. For about the price of one small cinnamon Dolce latte a month, you can become a sustaining member of navigating life as we know it. And our memberships are sugar free, gluten free, and 100% vegan, please check out patreon.com slash and lucky and consider supporting our work by becoming a sustaining member. And now on to our interview with Hillary hatch on disability work incentives. We are back today talking with Hillary hatch about can you work while receiving SSI and SSDI pillory Welcome back. Yeah, we're going to start off by talking about substantial gainful activity. And to get us started today we have a few questions from Mandy of Grand Haven, Michigan, the kind of relate to substantial gainful activity,

Mandy: 4:16

how much earned income can a person have and still retain their full SSI income or at least part of their SSI.

Hillary Hatch: 4:24

So substantial gainful activity, which is actually part of the definition of disability is very important when we're talking about work incentives and employment support and people returning to work while they are receiving benefits. We consider work substantial if it involves doing significant physical or mental activities or combination of both. And we really look at it in the dollar amount. So for this year for 2020, for an impairment, that is anything other than blindness The SGA amount, the substantial gainful activity amount is $1,260 per month. And then for individuals that are blind, that dollar amount is $2,110. Now, this amount usually changes a little bit each year. But as we move through some of the information I'm going to be providing I'm going to be mentioning SGA. And I'll be mentioning that $1,260 amount with our work incentive and employment support programs, work incentives, really our employment support provisions that assist our beneficiaries with moving from Benefit dependency to independence. They're designed to help individuals enter the workforce for the first time, maybe re enter the workforce doing the same job that they did before or doing something different in all, well, knowing that they're not going to lose their eligibility for cash payment, or they're not going to lose their Medicare or Medicaid. So that's really what our work incentives are designed to do is to help individuals return to work while they are receiving benefits, and not be fearful of losing their benefit, and losing their entitlement to their Medicare or Medicaid.

Steve: 6:25

I think a lot of people probably don't realize that Medicaid doesn't just pay for health issues. Medicaid pays for personal attendance and people that might be requiring to have personal attendant to help them get ready for work in the morning or get out of bed even so that Medicaid becomes critically important because they cannot function without having some kind of assistance in that is all paid for by Medicaid. See we're going back to work would be a disincentive unless you had some way to be able to get weaned into a working condition without losing very critically essential benefits.

Hillary Hatch: 7:00

Right. And a lot of times, that's what I hear from families is that it's not so much the cash benefit that they're concerned about the concern for making sure they still maintain eligible for their Medicaid and for their Medicare. That's that's the biggest piece for a lot of families.

Steve: 7:19

Can you tell us about the red book, this sounds really exciting, I must have a refund plot to it.

Hillary Hatch: 7:23

So the Red Book is very exciting, at least for me, because my expertise is work incentives. And that's what the that's what the Red Book is all about. I refer to it all the time. Of course, we have, you know, all of our policies, and the laws and references that we look up all the time. And actually, all of you, the public can look it up on our website as well, like the Red Book is a lot easier to understand even for myself, if I need a quick reminder on something or responding to an email, I will often reference the Red Book instead of looking it up in our policy manual. It really serves as a general reference tool designed to provide a working knowledge of our work incentive for both the SSDI program and the SSI program. So the red book contains information and the work incentives for individuals that are receiving SSDI or SSI. I do want to say that our red book we used to publish every year, so there would be a 2019 version, there would be a 2020 version, we're not doing that anymore. That means there's also a supplement that corresponds to the red book. So for example, the year specific dollar amounts are no longer included. So I've already talked about substantial gainful activity, and that this year, that amount is $1,260 per month. In our red book, we don't specifically state that yearly amount anymore, we will just say SGA. To know what that SGA amount is, you have to also get our supplement, which is available on our website. When you go to WWW dot SSA dot Govt. If you go to our search box, and you put in the red book, you'll click on that first link, the red book will come up. And then right next to it will be that supplement and it'll say what's new in 2020. And that's where all the year specific information will be. And we update that supplement the beginning of each year.

Steve: 9:38

And it is not in language that is designed for a certain group of people that know all the acronyms it's easy to use. The people that work for Social Security and for all the other organizations are good hard working people but sometimes there's so much to know in so many areas to be a specialist in that some things might not come across as being accurate. It's always Good to know as much as you can.

Hillary Hatch: 10:02

Exactly. And when I give presentations, you know, to our staff about our work incentive programs, I always try to explain it to them, telling them that our role is to help our beneficiaries become successful in their return to work journey, and to recognize that that success is going to look different for each person. For some individuals, they that are receiving benefits, they will be able to return to the workforce become self sufficient, again, in no longer need benefit. For other individuals, they're going to be on benefits for the rest of their life and maybe only be able to work part time or a few hours here and there. And that's okay, both scenarios are okay. And in order for an individual to be successful in whichever scenario, we have to make sure, as an agency that we are providing correct information, that we're able to direct individuals to the tools and resources that are available to them. But just like you said, unfortunately, we are not always giving the correct information. And being a self advocate is so important in the red book is going to be a great resource. If you are receiving benefits or your child receiving benefits and are returning to work and you have questions you know about that process or about how it's going to impact the benefit referencing the red book will be extremely helpful, especially when you're working with the local office to report wages, or whatever it may be. That Redbook will be helpful to help with that process and make sure that the local office is giving you the correct information. Next, we're

Steve: 11:45

talking about subsidies, special conditions, Impairment Related work expenses and work activity. This is where it gets confusing for me, my son has always been permanently disabled. So I haven't had to deal with these personally before, but could you explain subsidies and special conditions and Impairment Related work expenses and work activity report? Sure. So

Hillary Hatch: 12:05

when it comes to the subsidies and the special conditions, and the Impairment Related work expenses, those are all types of work incentives, and we document those on the work activity report. So that word activity report is an is an actual form, where we are using that to document the real value of work. And so subsidies, special conditions, Impairment Related work expenses, those are all work incentives that can be utilized in order for us to figure out what that real value of work is. So sometimes the dollar amount that an individual earns is over SGA. But one of these work incentives may apply. And so that dollar amount is then under SGA, which can be very beneficial to individuals that are receiving benefits. So I'm going to go over each one of those, and then I will give you an example of how it can be beneficial. First, I'm going to talk about subsidies and special conditions and just what their definitions are. So a subsidy is support provided by an employer that may result in receiving more pay than the actual value of the services performed. And then a special condition refers to support an on the job assistance provided by an employer or by someone other than the employer, such as vocational rehabilitation. Because of this support, a person may receive more pay than the actual value of the services performed. And Impairment Related work expenses are very similar. So with Impairment Related work expenses, we can deduct the cost of certain Impairment Related items and services that are needed to work from the gross earnings when we are determining if work is over SGA or under SGA. But in order for something to qualify as an impairment related work expense, the individual must have to pay for the items themselves, they must have to pay cash. So in other words, know in kind payment. Examples would include wheelchairs, certain transportation costs, specialized work related equipment, medication, here's an example of how this would work. So let's say an individual is is working, they're receiving Social Security disability benefits, and they're working, and they're making 13 $100 per month, and as gross wages. But the monthly copay for their medications is $100. Well, we're going to deduct $100, from the gross wages, which brings it down to 12 $100. And that's what is going to be counted as income. This is really important in regards to the initial claim process and also Somebody is already receiving benefits. This plays an important role when we're determining that countable income. So for an initial claim, if an individual is filing for benefits, whether it's disability benefits, or SSI benefits, and they're making 13 $100 a month, we would think to them, Well, no, you don't qualify for benefits, you might, you may meet the definition of disability, but you're able to make over $1,260 per month, we can take your claim, but it's not an automatic denial. But then they say, Well, hey, I have to take these medications in order to work, I pay $100 per month out of pocket, that brings them under the SGA level. So we would take their claim, we would send it to the medical examiner's, and we would process the claims and the regular procedures that we utilize, it wouldn't be an automatic denial. And the way that we obtain this information is by obtaining what we call that work activity report. So it's used to document the work activity in the work incentive when we're making those SGA determinations. And this is something that the beneficiaries will complete. They complete it when we do an initial claim. And then they will also complete it when they are receiving benefits. And they report to us that they have returned to work, we oftentimes, depending on the situation, we'll ask them to fill out one of these work activity reports. And that's where they would document the information that they're paying out of pocket for medications, or data subsidy or special conditions does exist. So we can determine whether or not they're over that SGA limit under that SGA limit

Steve: 16:43

is that filled out monthly or just on an as needed basis, or when there's a change in circumstances,

Hillary Hatch: 16:50

we would fill it out when there is a change in circumstances, we definitely would have it completed at the time of an initial claim. For individuals that are filing for SSDI or SSI. If they're working, if they're not working, then we don't need that information. But if if work is involved with the initial claim process, they would fill it out. Individuals would also be asked to complete the form. Once they're receiving benefits. If they go back to work, start working a new job, then they would they need to report that information to Social Security. And then we would have them complete that form if they are working over SGA. And this, this is for individuals that are receiving Social Security Disability only when they are returning to work. And they report that to us. That's when we would have them complete this form. Or if they are changing to a new job job duties are different, we would also have them complete this form. But for individuals that are receiving SSI, once they're already on benefits, if they report to us that they have started working, they actually do not have to complete the form. And that is because with the SSDI program SGA is going to impact whether or not they receive their disability payment with the SSI program, any sort of work is going to impact the payment. So we're not looking at the SGA amount. Once a person is already receiving SSI, if they're working, it's going to impact their payment regardless of how much they're making. And I will talk more about that when we get into some more detailed information about employment support, particularly for the SSI

Steve: 18:44

program only. Okay, there's the word work activity report completed add aligners and paper,

Hillary Hatch: 18:51

it can be completed either way, individuals can complete it online and submit it or they can also fill out a paper work activity report. And even a lot of times, we'll complete those reports over the telephone with the individual. So what happens frequently, especially at larger office Field Office sizes. So for example, like the Grand Rapids office, that's a pretty large field office. So an individual may call in to report that they started working. And the person that answers that general line most likely isn't a specialist in SSDI. And in the work program, so what they will do is they'll take in the information, and then they send it to the specialist that works on that workload. And so what the specialists will do, they will then look at the information that was submitted. And then, if needed, they're going to reach back out to the beneficiary and say, Hey, I see here that you started working, I need some more information. And at that time, if needed, that work activity report is needed. The representative from the field office can actually fill out that form with the individual right over the top To where we completed over the phone,

Steve: 20:03

just wanted to clarify in the impaired pyramid work related expenses. There's a number of things on there that would fall into the category of durable medical equipment, wheelchairs, things like that, which are largely paid for. So it's only out of pocket expenses if this is covered by insurance or some other benefit, correct?

Hillary Hatch: 20:22

Yes, that's correct. It's only for out of pocket expenses.

Steve: 20:25

And one other clarifying question, you mentioned about subsidies. If the employer is providing some modification to the job or the environment for someone to the disability to be able to work that that reduces the value of their work.

Hillary Hatch: 20:41

The individual would indicate that to us through that work activity report, there is a question there about subsidies. If the individual says, Well, yeah, my my employer allows me to take more frequent breaks, or my my employer allows me to work fewer hours, but I still get paid the same amount as anyone else that would indicate to us that a possible subsidy exists. So then we send a form directly to the employer, asking if there's a subsidy that exists in the employer, based on their answers to those questions on the form. It could be, you know, a 30% subsidy a 50%. subsidy, it's just going to depend on what the employer tells us. And then we would apply that subsidy to the to the gross monthly wages. So the actual countable wages is going to be less based on what that subsidy is. So if it's a 30% subsidy, then the gross wages we're going to reduce by 30%. And whatever that dollar amount is, is what would be the countable income.

Steve: 21:49

So the subsidy is not counted as something on top of income, it's actually deducted from income.

Hillary Hatch: 21:55

Correct? It's deducted from income.

Steve: 21:59

It's a trial work period. That's where I really get confused. Can you explain how the trial work period works?

Hillary Hatch: 22:04

Yes, I can definitely explain the trial work period, hopefully in a way that you will all understand. If you don't, I will refer you to the Red Book, actually, page 30 of the red book where the employment support start. For SSDI beneficiaries. The trial work period is only for individuals that are receiving SSDI benefits. Essentially, what the trial work period does is it allows SSDI beneficiaries to test their ability to work. And while they're doing so they're going to receive their full benefit, regardless of their earnings. So it doesn't matter if they're over SGA, they're still going to receive their full SSDI benefits. Their Trial Work Period start when gross earnings are more than $910. And this is the amount for 2020. So$910, or working more than 80 hours a month in self employment would also indicate a trial work period month. So an individual has nine Trial Work Period months, if they make over $910. In gross wages, they have utilized a trial work period month, and they're still going to receive their their disability benefit, they have just used one of their nine allowable months, it doesn't matter if they make $911. Or if they make $5,000. For one month, they have utilized the trial work period months, and they're still going to get their full Social Security disability benefits. And they have nine of those months, those nine months do not have to be consecutive, it is nine months within a 16 month rolling period is the trial work period. So nine months, within a 16 month rolling period, after an individual has used all of those Trial Work Period months, though they have used up all of those nine months, they then go into what we call the extended period of eligibility, or EP, it doesn't matter if they're working or not once that ninth Trial Work Period month has been used, the very next month is when the extended period of eligibility begins. And this is essentially a three year re entitlement period. So when we're looking at that 36 months or three year period, with with the EP, if work is the low SGA. So if they're working and they're making under that $1,260 per month, they are going to be do their disability benefit. If they are over that SGA amount. They are not due their disability benefit. It could fluctuate. It's just all going to depend on you know how much the individual Make in again, that EP begins with the first month after the trial work period. And once that 36 month period has ended, if the individual works over SGA, after that 36 month period, then their disability benefits with terminate. So one of the visuals that I have in the PowerPoint, it shows the trial work period, the extended period of eligibility, it kind of like this blue arrow thing. And you can see the very first part shows the trial work period. So after that nine month trial work period, it goes into another color of blue. And that's the extended period of eligibility, that's the 36 month period, after that 36 month period, the EP can continue until that SGA is performed. So after that 36 month period, as soon as a beneficiary makes over SGA, their benefits will terminate, if they never were involved, or SGA, after the 36 months, like the EP continues on forever, during their whole time that they're receiving benefits. If they're staying under SGA, then they're still in their EP after that 36 month period.

Steve: 26:22

Now, if somebody is in the extended period after the 37th month, and they're making more than SGA, so their benefit terminates, what happens to like Medicaid coverage? And if for some reason they abruptly could not work? Do they have to go through the whole process? Again, are they automatically qualify?

Hillary Hatch: 26:45

That's a great question. So although cash benefit may end because of work, there is continued health insurance that is possible. So for most beneficiaries who work, they're going to be entitled to at least 93 consecutive months of Medicare of the Part A and Part B. And Part D, if they were enrolled in Part B and Part D, there is no premium for that part A there is going to be the premium for the part B and for the Part D if they have it, the 93 months start the last month of the trial work period. So that's when that 93 month period starts, again, that Medicare, Medicare coverage can continue the 93 months. But to qualify for that continuing Medicare coverage, the beneficiary must have already had Medicare, so they had to have been entitled to Medicare. And they must be working at the SGA level. So in other words, their benefit had to have that because of their work. And not because of any other reason not because they there was medical improvement. But their benefit ended because of their work. So they still have to qualify medically, in order for that continuation of Medicare to take place. If something happens where they are working, working, working and not receiving benefits, you know, doing great, and something happens where they're no longer able to work, they can be re entitled to benefits. It's called expedited reinstatement, or you may have heard the term e xR. So an individual doesn't have to file an initial claim. It the process is similar to an initial claim. But the process is expedited. And during that process, we can actually pay benefits and continue that Medicare coverage. Well, that decision is being made, we still have to get a medical decision. But while we're waiting for the medical examiner's to make that decision to say, yes, benefits can be reinstated, we can actually pay a monthly cash benefits and Medicare during that time we call those provisional payments.

Steve: 28:59

Question because the individual involved in the disability here might require some benefits that are paid for by Medicaid but not paid for by Medicare, like attendant care, that they keeping their Medicaid benefits of this trial period of work.

Hillary Hatch: 29:15

Yes, yes, they would still keep their Medicaid through the trial work period. We these work incentives that the trial work period and the extended period of eligibility that doesn't have any impact on whether or not the person would be entitled to Medicaid or

Steve: 29:32

not. But they'd still be bound by the $2,000 of countable assets.

Hillary Hatch: 29:37

But the extended period of eligibility and the trial work period only applies to Social Security Disability beneficiaries. So for social security purposes, there is no asset limit for Medicaid there is and that's what you're you're talking about. $2,000 asset limit for Medicaid. Yes.

Steve: 29:57

Yes. So that's waived for them. So they keep that Medicaid during this trial work period, their earnings will be too high to qualify for Medicaid. And I don't know what happens in terms of the asset limitations.

Hillary Hatch: 30:08

I don't know if the asset limit rules. But I do know, and I don't know a lot about it, because it's a different agency. But I do know that individuals could qualify for freedom to work Medicaid, which is a different type of Medicaid for individuals that are working. And I believe that the, the asset limit is different for different types of Medicaid. Okay,

Steve: 30:36

you actually explained it in a way that I pretty much understand it. So you did a good job. Really come up with 93 months of extended by one at 100 or 95? I'm just Is there any rationale behind that? That makes any sense? Okay. I had to ask, though, I'm sorry. SSDI summary of returning to work wanted to just give us the highlights, again, there's a trial work period extended period of eligibility, Medicare. Anything else to add to that? No.

Hillary Hatch: 31:07

That's just basically the snapshot of someone that's returning to work and is receiving disability benefits. They have the trial work period, the extended period of eligibility and the continuation of Medicare.

Steve: 31:20

And that would all be in the red book, correct?

Hillary Hatch: 31:22

Yep, that will all be in the red book.

Steve: 31:24

And now we changed completely because SSI only employment supports are very, very different than SSDI. To kick off our conversation about the impact of working on SSI benefits, we have a questio from Mandy of Grand Haven

Mandy: 31:39

How much earned inc me can a person have and sti l retain their full asset by i come, or at least part of heir SSI check,

Hillary Hatch: 31:47

The SSI employment support, are going to be found on pages 36 through 42, of the red book, and I will explain some of them, I definitely won't explain all of them, but probably the ones that you would encounter most frequently. One of the things that is important to understand before we really talk about work incentive is how income impacts the SSI benefit. When a person is receiving SSI. And they're working, there is a calculation that we use to determine what the SSI benefit amount will be based on that person's wages. And there's certain exclusions that we apply to that formula, there's really no good reason why we do it. Other than that, how Congress passed the law at the time. And that's what we still do today. So with the income exclusion, we do not count the first $65 of earnings received in a month plus one half of those remaining earnings. So this means that we are counting less than one half of the earnings when we are determining the SSI payment amount. And I will give you an example of this as well. We do apply this exclusion in addition to a $20 General income exclusion, we apply that $20 General income exclusion first, to any unearned income, if an individual does not have unearned income, if they only have earned income, so they get SSI, and their only other income is from work, we apply the $20 exclusion there, plus the $65 exclusion, if they are working in get SSI, and have unearned income, let's say Social Security Disability they're receiving as well. We take that$20 exclusion and we apply it to the SSDI amount. And then when we're determining how we're going to count the wages, it's only $65 that we exclude, instead of the 20 plus the 65. So for an individual that's receiving SSI, let's say they're working and their gross wages for the month are $385. And that's their only income. So we're going to subtract $20 from the 385. And then we're going to subtract $65 from the 385, which gives us even 300. We divide that in half, and that's what the countable income is. So $150 is what is a countable income. So we take the SSI benefit amount, which is 783 for this year, and we subtract the $150 and the remainder is $633. And that's what the SSI benefit amount would be. So this person would get an SSI benefit amount of $633 plus their gross wages of $385. That's how the earned income exclusion is applied when we're determining the SSI payment amount.

Steve: 35:00

Playing the best by saying it doesn't make any sense Congress passed it. That's just the way it is.

Hillary Hatch: 35:04

Yeah. Good examples in the red book, where it shows the breakdown of the math and how we determine the SSI payment amount based on wages. And it will also show an example of how we determine the SSI payment amount for someone who is working and also has unearned income. So that red book really does have some great examples in there. And I think there are examples to that individuals can understand, which is huge, to be able to understand what social security is talking about. I know it doesn't happen as often as we would like it to, but they're regular. It should be a pretty useful tool in regards to that.

Steve: 35:43

Mandy also has a question about maintaining Medicaid eligibility on SSI.

Mandy: 35:48

How much income can they have and still qualify for Medicaid,

Hillary Hatch: 35:52

the amount an individual can make and still qualify for Medicaid, it varies from state to state. And that threshold amount, it changes each year. So for this year, for 2020, that amount for the state of Michigan is $36,887. That's for 2020.

Steve: 36:14

Student Earned Income Exclusion.

Hillary Hatch: 36:16

Earned Income Exclusion is a little bit different than the regular earned income exclusion. The Student Earned Income Exclusion is, again only for individuals that are receiving SSI and only for individuals that are under age 22, in regularly attending school. So for those individuals, we do not count up to 19 $100 of earned income per month, when we determine that SSI payment amount. And that maximum yearly amount is $7,670. That means if your son or daughter is in college for at least eight hours a week, or in grades seven through 12 for at least 12 hours a week, or in a training course to prepare for employment for at least 12 hours a week. That is what we consider regularly attending school. They're receiving SSI and they're under age 22. And they're working, we will exclude up to 19 $100 per month of that income. So that means they can still get their full SSI benefit amount, it will not be reduced. If they fall under the Student Earned Income Exclusion.

Steve: 37:28

But it's not 1900 times 2 months the yearly exclusion f maximum is 767

Hillary Hatch: 37:34

Yeah, correct. There is a yearly maximum and that's the 7670.

Steve: 37:39

Section 1619. A is what

Hillary Hatch: 37:43

section 1619 A and section 1619. b are very similar under Section 1619. A this is in regards to Medicaid, both the 1619 eight and 1619 B for individuals that are receiving SSI. When their earned income is at the SGA level or above the SGA level, they can still receive an SSI payment, and they can receive their Medicaid, they're going to keep their Medicaid as well. So under 1619, a, a beneficiary can receive their gross income from work, they're going to have an SSI payment, which is calculated based on their wages, and they're also going to be entitled to Medicaid. That's what 1619 A is 1619 B is almost the same thing, except the individual's income from working is too high to qualify for an SSI benefit. So under 1619 B, an individual will receive their income from gross wages, they're not going to receive an SSI payment, because their wages are too high. But they're still going to maintain eligibility for Medicaid, even though they're not getting an SSI cash payment. That was 1619

Steve: 39:04

is that a test on this later is there?

Hillary Hatch: 39:09

If there is I will let you use the Red Book,

Steve: 39:13

an open book test. I always like those those were pretty cool, except they were far harder. In terms of reporting work, you said you can do this online. And for me if I was a person disable working, that would be a godsend. I think it's a huge step in the right direction for making things easier and making them more timely. Could you explain how the work reporting requirements work and how you can do that using a mobile app?

Hillary Hatch: 39:39

Yeah, we have a few different ways individuals can report work to Social Security work does have to be reported. Whether you're receiving SSI or SSDI. It's very important to report the work to social security and for individuals that are receiving SSI or SSDI. Or if a person And is receiving both SSI and SSDI. They can report their wages and mine by creating a my Social Security account. And there is an online wage reporting tool within the my Social Security account. Only the person recording the wages has to have that my Social Security account. So for example, if you are the rep payee for your son or daughter, you can report wages for your son or daughter by going into your own social security account, or my Social Security account. And your son or daughter's name is going to appear as the person that you are paying for, you're going to click on their name, you're going to see report wages, you're going to just follow those prompts. And you're able to report wages online for the individuals that you are paying for. We also have a mobile app, and a telephone wage reporting system that can be utilized. But both the mobile app and that telephone wage reporting system are for individuals receiving SSI only. So this is only for SSI recipients with the mobile wage app, individuals can download the SSI wage reporting app onto their smartphone, which will allow them to report their wages each month with the telephone wage reporting app. For individuals receiving SSI, they can report their monthly earnings over the telephone, they do have to contact the Social Security Office. First, for all three of these methods, whether it's reporting online, using the mobile wage app or the telephone wage reporting app, we have to get the employer established in the system. So if you want to report your wages, using the wage reporting tool through the my Social Security account, you still have to contact social security to tell us that you started working. And one thing that we will need is the employer identification number. So that Ei n number, we have to add that to the system. Once that gets reported, the individual should then be able to go online and start recording, you know, it's in real time. So they should be able to start recording once we get that information. There's also the old fashioned way of mailing or faxing, and those pay stubs to the local field office as well. But definitely the most convenient, easiest way to report is by utilizing that online wage reporting tool through my Social Security account,

Steve: 42:34

I had heard stories in the past of people and he had to do this before they got high tech by mailing in a report and possibly the pay stubs. Also, adjustments would make three or four weeks in advance and be retroactive. And that sounds like a real confusing situation to me, where you earn too much, you got a reduction in your check later on your your disability check probably at a time when you really needed it because maybe later your income went down. It just seemed like a very clumsy way to be reporting in arrears all the time and the processing time. This seems to be like very, very timely. And I think that would really help somebody out with cash flow.

Hillary Hatch: 43:11

Definitely, you know, the income fluctuate so much by utilizing the online wage reporting tool, it's going to make everything a little more timely, hopefully streamline that process more. So they're not giving, getting the overpayment notices, and the underpayment notices and the constantly changing that benefit amount.

Steve: 43:31

Which brings us to another parent in Grand Rapids. She has a son that's 40 years old, who is disabled. Yet he works part time at Walmart. And he's been collecting SSDI from his father's work record for many years. Recently, he was notified that he had been overpaid to the tune of $70,000. And social security wants him to pay it back. Is that how they are?

Hillary Hatch: 43:54

It's a little bit different for each overpayment situation. For the SSI program, we withhold 10% of the benefit amount with the social security disability program or the SSDI program, we actually will send out a notice and we're going to withhold the entire benefit amount until the overpayment is repaid. However, an individual can notify social security and say and this usually what the cases where they say, Wait, wait, wait, you can't, you know, withhold my entire benefit. I need these benefits to survive to live so we can come up with a repayment agreement that typically has to be repaid within a 36 month period. That is how we would come up with the amount that we would withhold. If it's a large overpayment that is going to maybe even be more than the benefit amount. Then we would need that person to provide documentation of what their income and expenses are to come up with an amount where we're withholding it each month, just a small amount each month, so they're still able to receive the majority of their SSDI benefit that large has an amount doesn't happen too often. There is a scenario that recently came up where a parent contacted me in, she had received an overpayment notice for her son, that it was $70,000 or $80,000 that he owed to Social Security. And she wasn't sure know what happened. He was receiving Social Security disability benefit off of his father's record, he had been working, the local Field Office did a work review on his case, which is something that we often do, where we're often doing work reviews, once an individual has reported work. When we did the work review, we sent out a form to mom telling her that we were doing this work review, we process the case by averaging his wages. So we didn't have the actual pay stub, we didn't have a work activity report and file to know, were there any Impairment Related work expenses that existed? Was there a subsidy or a special condition that existed, we just took his yearly amount, and we averaged it. And we posted that on the work review that hit Those were his monthly earnings, and his monthly earnings based on us average, he was over SGA, because he was outside of his extended period of eligibility, he his benefits should have been terminated. So we sent out a notice saying your benefit should have been terminated two years ago, because that's when you started working over SGA after the EP, so this mother gets this notice, showing that her son is overpaid all this money because his benefits should have terminated no two years ago. And it was all based on the Social Security Office, just averaging his earnings. So once I talked to mine, and I got more information from her, it turns out that her son actually has Impairment Related work expenses that we can apply. So her son uses special transportation to get to and from work and the cost of his transportation expenses have been deducted from his gross wages. So now instead of him being over SGA, he's under SGA. So we go back into our work review system, and we document that those Impairment Related work expenses are there, so we never should have terminated his benefits. So that means he has benefits are continuing. And there is no overpayment for him. Because of those Impairment Related work expenses. It brought him under that SGA level. Wow. Yeah. And she asked to, you know, do I need to hire an attorney? What do I need to do? And I can't imagine, you know, the stress of that situation. And when you get to notice that, not only are benefits terminating, but now you owe us $70,000, in just that phone call me telling her, you know, you know, after we talked and she provided me some documentation, and me saying, hey, it looks like he's under SGA. Everything's gonna be okay. I actually, because I was added to office last week, I wasn't able to get back to her just yet. She knows that we're going to be able to fix it. She just doesn't know that that I've processed it yet. But she doesn't know that we're able to fix it and benefits will continue and there will be no overpayment. So that's good news.

Steve: 48:42

That is a wonderful Christmas present right there. No kidding. All right.

Alex Johnson: 48:50

Thanks for tuning in. This is Alex, your producer here to say hello and to let you know what's coming up next unlucky. On our next episode, we continue our series with brains discussing resources for families and overcoming barriers. Following that we have a special interview going over the arc of Michigan's tax guide, hopefully to help everyone as we progress through this year's tax season, which promises to be complicated enough by itself. Season One of unlucky continues to the first weeks of May, and then we'll be taking a short break to plan new episodes and research topics that you our listeners care about. If you'd like us to tackle anything specific in our next season, please reach out to us on Facebook or email contact at and locky.com and we will make sure it goes on the planning board. If you enjoy our series, please consider subscribing, sharing and if possible, supporting our podcast on Patreon. It takes a lot of work to bring you this content. And we do want to bring you the very best content we can. I'll let you return to the show now. Please have a wonderful listening experience.

Steve: 50:02

Then there's the my Social Security account you you've referenced that several times setting that up online. And I know having set my own up and set one up for my wife that it's quite easy to do, really. And it opens up a treasure of resources online, the calculators you mentioned, there's a lot there. And it is written in plain English, and it's very easy for most of us to to work through and find answers. How long does it take, do you think to set up on my my Social Security account?

Hillary Hatch: 50:29

Within minutes? Five minutes? Yeah, it's really, really quick, in order to set up the account, a person does have to have a valid email address, social security number, a US mailing address, and you have to be at least 18 years of age or older to establish one of those accounts.

Steve: 50:49

If you are the payee, like you mentioned, you can do that in your own social security account. This is indispensable if you have a disability situation, if you don't, I can see where it's helpful to have that information to check on it from time to time because the statements are mailed out anymore. But for reporting and everything else for disability, this is extremely important. And I can't recommend it any more highly than that.

Hillary Hatch: 51:10

Yeah, it really is a great resources for individuals that are receiving benefits for that online wage reporting. Also, a lot of times people need a benefit verification notice to give to another agency just to show verification of what their income is from Social Security. That's another feature that individuals can get through their my Social Security account. And even for individuals that don't receive benefits. By setting up an account. One of the features that is available, is requesting a replacement social security card. So for individuals that has a my Social Security account, and they misplace their social security card if they can request one through their online account.

Steve: 51:53

And I just did that yesterday, because I lost mine approximately 30 years ago, I haven't yet occurred. And a couple times it came up that you had to have a social security card and I said you got to be kidding me. That's not supposed to be for an identification. And I haven't had one for 30 years, but I'm getting one so cool. I do have one more question from Sandy who lives in Holland. And she said she was told by her bank, she had to give written proof from Social Security Administration stating that she is her son's rep payee. She tried to obtain a letter from SSA and Elaine but didn't find any place to do that. It'd be nice to have that accessible to the rep. payee. Did she miss something? Or is that not available? And when I set mine up for my son as the rep payee, I wasn't required to provide that information. So that's a big problem or what

Hillary Hatch: 52:42

yeah, I think each, each bank probably requires something a little bit different. A representative payee does have the ability to print and save a benefit verification letter for the individuals they are payee for. So that benefit, or that verification letter will stay no Jane Doe representative for so the payee should be able to utilize that to give to the bank to show that they are in fact, the representative payee.

Steve: 53:11

Where do they get that letter?

Hillary Hatch: 53:12

Oh, that letter is available through the my Social Security account portal. So the representative payee would have to log into their own my Social Security account, and they would get the benefit verification letter for the person that they are payee for. Also, the local field office, when when we take an application at the at the local field office, we mail out to the payee, a notice which states that they have been selected to be the payee for this individual. I know that banks request that at times, too. So a person the payee could request, if they have just been selected as the payee, that's going to come pretty quickly. If they have been payee for you know, a long time. And maybe they're switching banks or something and they need that original notice. They can contact the local field office and we should be able to mail that out to them, because we store those notices in our system. Very good.

Steve: 54:15

Thank you. And just the last comment, I wanted to make her a question if people do find or suspected the information they got is not accurate. And they said at the office that they were entitled or were not entitled to something because of whatever. And they are a little bit like I mentioned earlier intimidated about challenging the professional in that environment. We have the red book to look for if it's a work related experience, what what recourse could they have other than trying to find an attorney or somebody else who has an experience is similar. Where do they go? Is there somebody that they can appeal to outside of the office where they were denied

Hillary Hatch: 54:56

if the person you know they're working with the local Field Office If and they feel that the information that was provided by the technician is wrong, or they're not understanding or something, they can always ask to talk to a manager or a supervisor, they can always ask to do that to talk to the manager to talk to a supervisor, if the individual received an actual notice of a denial, and some sort of decision, it's not always an initial claim, it's all kinds of decisions, where social security may send a notice that has appeal language on it. So there's always the form of Not always, but in most situations, there's a formal appeal process that an individual can can go to, before going that route, I would probably suggest asking to talk to the supervisor or asking talk to the manager, if they feel the information, you know, isn't correct, or they're not getting a response from the technician, they can always, they can always ask to talk to the manager or the supervisor. Also, if a person is receiving benefits, and there is a situation where, you know, they just feel that their representative didn't give them enough information, or they need more time, or they have more questions, they could actually schedule an appointment, we call it a post entitlement appointment. So for example, if you are the payee for your son or daughter, and you receive an overpayment notice, because your your son or daughter returned to work, and now benefits are going to terminate, and it's this mess, and you call the local office and know the person that you're talking to. Maybe they don't have, you know, expertise that Social Security Disability specialist has, maybe there's an SSI person, and they say, Oh, I'm looking at your, your letter. Yeah, this is what it says. And you're thinking, Well, yeah, I read that I know what it says I need more information, you can actually request an appointment, a phone appointment for someone at the local field office to call you on a set day and time in to go over that notice and to help guide you in determining what needs to be done and how to figure that situation out. Even sometimes I'll get questions from advocates in the community where it's a really technical case, and I just can't figure it out, I will tell the advocate, hey, please tell your client to call the local office and schedule a post entitlement appointment there. So they can talk with someone that has more technical knowledge than I do, and walk them through the process, explain it and help guide them on what to do next.

Steve: 57:38

What I can see it might be a little bit confrontational and more outside the comfort zone for some people sitting across from somebody to say, I want to talk to your boss, or your manager. But I know some people who do that, you know, a lot of probably more than would not Is it possible for them to go home and call up and explain that they want to talk to a manager?

Hillary Hatch: 57:56

Yeah, absolutely. Yeah, absolutely. If a person doesn't want to do it right there face to face, if they feel more comfortable going home and calling the local office and say that they want to talk to a supervisor or a manager, they definitely will be able to do so I'm sure the person answering the phone is probably going to want more information, you know, well, you know, what is the reason for calling Let me see if a manager is available, you know, the manager might not be able to talk to them right then and there, but should get back to them. I guess that would be one benefit of doing it face to face, you know that a manager or a supervisor is going to talk to you right then and there. But definitely over the phone would be okay, too.

Steve: 58:37

possible for somebody who no longer has trust or faith in the person they're working with to ask to work with someone else,

Hillary Hatch: 58:44

it is possible to ask to work with someone, again, I think the appropriate line of communication would go through would be to go through the supervisor or the manager and to explain the situation, in a way without just saying, you know, that field office technician is wrong. They're just wrong. You know, the manager or supervisor will definitely be sensitive to the issue and hopefully be able to provide another technician that could explain things in a different way, or, you know, just to help help assist with the process. And there's also I don't know that there is a formal complaint process online. I do know, at the local offices, there is like a survey card that can be completed and put in a Dropbox. And I know for a fact that there have been times where the public has submitted those, they go to our regional office. And I know for a fact that it does get back to the local Field Office and the manager will have a discussion with that employee that if there was a complaint filed against them, so it does, it doesn't it's not like it just goes nowhere. It really does come back to the employee and I'm not sure anyone has been fired because of that reason, but I do know that those complaints

Steve: 59:58

they are heard Gotta be a box, or can you do that online? Do you know?

Hillary Hatch: 1:00:03

I don't. I know that there's a there's the box in the office. I do not believe it's available online. I'm almost positive that it's not available online. But that's something that I can check on.

Steve: 1:00:15

Well, somebody could walk in a pre post Covidien, okay. Someone could walk in without an appointment and just get a card and walk out. Correct.

Hillary Hatch: 1:00:24

Yeah, yep. All right. Hey, Hillary, I

Steve: 1:00:27

really appreciate this. She gave me two hours of your time, I think this will be very helpful. Thank you.

Kerry Johnson: 1:00:45

Hi, this is Kerry, and welcome to the nlock a chat cafe, grab a cup f coffee or tea and pull up a hair. In a minute, Steve will e here. And we'll talk about he second interview with illary on work incentives. Who new Social Security Disability rograms could be so omplicated? That's a trick uestion. The answer is any amily with a young adult over he age of 18 that lives with isability. We hope these two pisodes answered a few uestions for you. But realize t may have also created a few ore. If you do have questions, lease go to our unlucky acebook page, and let us know hat they are. And we will do ur best to find the answers for ou. She's here. So let's start.

Steve: 1:01:29

Let's try a different format. today. You go first, what did you think stood out in our discussion?

Kerry Johnson: 1:01:35

Well, the blue book for determining disability and the red book for the work incentives. These two things are fabulous resources and are accessible on the ssa.gov website.

Steve: 1:01:50

You know what she mentioned I was I kept thinking back about my days in college, they still have these things, but the cliff notes where you can go back. And if you didn't read the whole book, you could find out exactly what was going on, because it broke down the plot basics. But this is more like a research because you can drill down on a particular topic, let's face it, most people have one or two areas of concern or interest when it comes to social security. They don't have all of these and it can be overwhelming. It is overwhelming. But in the blue book, in terms of determining eligibility for disability, or in the red book in terms of work incentives, you can find very clear examples that will mirror quite closely your own and the formulas to be able to work it out. And I think that brings an awful lot of clarity,

Kerry Johnson: 1:02:33

right? However, if it doesn't, it's okay to call for that clarification. Yes. They have people available at Social Security that are there to answer your questions.

Steve: 1:02:45

And like she said a couple times, I believe if someone calls up with a question about SSDI, and they get somebody on the phone, and that's not their area of expertise, then you have to make an appointment with somebody who is the expert at SSI, who will call you back, at least in today's environment. They handle us all because of COVID by phone calls, right? And they'll call you back and you will get somebody who knows all the answers with regard to that. Right.

Kerry Johnson: 1:03:13

And we did experience that call back. And it really worked out quite well.

Steve: 1:03:17

Yeah. Oh, yeah. They're nice, very, very cordial, very understanding,

Kerry Johnson: 1:03:21

and extremely helpful answered all questions. I know

Steve: 1:03:24

it's sometimes feels really uncomfortable. We want to think that we can have a competent conversation, but we don't even know where to begin. And but they understand that. Yeah, because it is complex. What I learned in these last two episodes is this thing is like a corn maze. What I use for the example and the first one, and the opening, it gets very complicated, very convoluted, but you're not going in there for an answer to 12 or 14 different questions. You're going in there with one or two problems. And they can find somebody who's been there done that it can help you walk through it.

Kerry Johnson: 1:03:58

Exactly. It's a matter of tailoring it to your specific needs. Exactly. And and it's really hard to just put out very beige smiles. Yeah. So it gives you some ideas. And I again, I thought the parent questions were phenomenal. Thanks so much for getting those together. For me,

Steve: 1:04:18

the my Social Security account is really important. I think it's something everybody should open one, whether you have a child with a disability or not, it gives you great information on retirement benefits and disability benefits. Especially if you do have a child with a disability. If you're the designated payee for your child, you have to have an account opened, that'll be posted on your account.

Kerry Johnson: 1:04:40

And also, I noticed that the the books are not listed on the homepage. But if you go to the search engine within the Social Security website and just type in blue book or red book, it will take you right to that resource,

Steve: 1:04:56

right so you go to the homepage ssa.gov or you can just type into the search engine, SSA Blue Book, SSA Red Book. It'll take you there, okay? I mean, it's they make it pretty easy to access. Because this stuff is so complicated that something's got to be easy about it. So that's about wraps it up for this week. I hope the two episodes in Social Security have been informative, if not somewhat confusing, right. But the good news is there are resources online to help you soar to the confusion. And there's human resources that you can access by simply making a call and setting up a phone interview. And that will be with a specialist on the specific issues you're attempting to resolve. Now, it might take you a couple hours or a long time to get through. So you take a cell phone, you you make the phone call, you get on the waiting list, and go clean the house or do something else or read a book and wait for them to say, Hey, you know we're ready. Or they'll call you back. Perhaps they'll give you a message for that doing a lot by phone today. And when we have that many people calling up trying to get answers to their difficult questions, you can imagine that these people are spending a lot of time on the phone and there are weights.

Kerry Johnson: 1:06:12

Yeah, for them. They ended

Steve: 1:06:15

well, we want to thank those people who help us with the production of this podcast, it takes approximately four to six hours of work or more, in some cases, to complete all the phases of production for 145 minutes and Locky podcast episode. I couldn't do this alone, I wouldn't even attempt to try it. I want to thank my lovely wife and co host Carrie

Kerry Johnson: 1:06:38

many things also to Alex, our producer who tracks our stages of production, and is always coming up with better and more efficient ways to produce the shell.

Steve: 1:06:48

And sometimes I even understand what he's talking about. But that usually I had to say hey, as long as it comes out the way it should, I don't have to know. And thanks to hollier website, guru and artistic director, she makes things look really pretty and very efficient and easy to find.

Kerry Johnson: 1:07:04

We also would like to thank Daniela Munoz our intern who manages our post recording communications with our guests, among other miscellaneous assigned tasks,

Steve: 1:07:14

but more than anyone, we all want to thank you for listening. As a reminder, we ask you to support our show in one or more of the following three ways refers to your friends. If any of this information has been helpful to you, please pass it on forward then the link let them know. Number two is subscribe on your favorite podcast platform, Google Apple, we're on all of them. And number three become a sustaining member@patreon.com slash en la WK ai for less than the price of one cinnamon latte a month. You could help us bring this program and expand it to everyone. Thank you.

Kerry Johnson: 1:07:54

Thank you