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Work After Disability
By Jeffrey A. Rabin, Esq.

A frequent question from former clients who have been awarded a period of disability and disability insurance benefits, and from persons calling our office, is what work they can perform after the award and still remain eligible for Social Security Disability Insurance (SSDI) benefits. This article will review the basic social security rules concerning earnings after a finding of disability.

Returning To Work While On SSDI
Trial Work Period (TWP)

The first return to work benefit for persons on SSDI is the trial work period (TWP), during which you may test you ability to work and still be considered disabled, and still receive your monthly SSDI benefits. The TWP lasts for nine months, but these months do not have to be consecutive. You use up your trial work period by working nine months in any 60-month block of time.

For example, if your onset date for disability was in 2000 and you worked three months in 2002, three months in 2003 and three months in 2005 you will have used up your trial work period. Those months would total nine months in a 60-month block of time. If, however you worked two months in 2001, three months in 2005 and three months in 2007, by 2007 the months you worked in 2001 would no longer count since they were outside of the 60-month period.

The chart below shows the maximum gross monthly income to qualify for the TWP for the last 15 years. Each year the amount shall be adjusted by the Cost of Living Adjustment calculation.

The Social Security Administration (SSA) generally does not consider work done without pay to be services toward a TWP if it is done merely as therapy or training, or if it is work usually done in a daily routine around the house or in self care. Self-employed individuals have a much more difficult analysis when determining TWP months since, in addition to gross earnings, the SSA will look at the nature, value, and number of hours spent working.

The SSA will not consider your disability ended until you have performed TWP services for at least nine months. However, after the TWP has ended, SSA will conduct a Continuing Disability Review (CDR) to determine whether you are still disabled.

Extended Period of Eligibility (EPE)

Once the TWP is complete, you are entitled to an Extended Period of Eligibility (EPE) if the SSA considers you to be medically disabled after a CDR. The EPE provides a safety net for another three years as work continues.

As you continue to work after your TWP, and your gross monthly earnings exceed the current definition of substantial gainful activity (in 2004 it will be $810 monthly gross income) no SSDI benefits will be paid.

However, if in any month during that 36-month period you are unable to earn at least $810 gross income in a month, your SSDI cash benefits are started again without filing a new application. For example, if you have used up your TWP and are now in your EPE in 2003, and your hours are reduced in a month so that you only earn gross wages of $750 in the month, you will be eligible for SSDI benefits for that month.

Note: There must be diligent reporting of income on a month-by-month basis when you return to work. You must be able to "prove" all earnings were reported. We suggest mailing a certified letter, return receipt requested, with a copy of your paycheck stubs, each month.

Extended Medicare Coverage

Medicare continues during both the TWP and the EPE. You can also retain your Medicare coverage for another four and a half years after your EPE. That means you can return to work on SSDI and keep Medicare coverage for more than eight years, even if you are no longer receiving an SSDI monthly benefit. This extension was enacted to help remove the lack of health insurance as a barrier for the disabled wanting to return to work.

RETURNING TO WORK ON SSI

Eligibility for SSI required proof of total disability, and proof of limited assets and virtually no income. Once an SSI recipient returns to work and receives income, eligibility is changed.

The basic formula for an SSI recipient returning to work is: the first $85 earned in a month is disregarded; after that, the SSI benefit is reduced by $1 for every $2 earned. For example, an SSI beneficiary receiving $552 a month works part time and earns $285 during the month will have a partial reduction of the SSI check. The first $85 is disregarded; the balance of $200 causes a reduction of $100 in that month's SSI check. Therefore the beneficiary will receive $452 in SSI benefits, along with the $285 earned, for a total monthly income of $837- a significant improvement over the basic SSI grant.

NOTE: The reporting requirements and recommendations are the same as those made above for persons on SSDI.

NOTE: Work earnings may have an impact on Medicaid and food stamp eligibility, and for that each person must check with their state's public assistance departments.

IMPAIRMENT RELATED WORK EXPENSES (IRWEs)

In order to be able to return to work, some people require special equipment, custom devices, particular medications, job coaching, or incur other expenses directly related to their medical impairment and work. To the extent a beneficiary incurs these IRWEs, and they are NOT reimbursed by any third party (such as Medicaid, Medicare, private insurance, prescription cost waivers), the amount of earnings each month will be reduced by the amount the beneficiary actually pays. The need for these IRWEs must be supported by the treating physicians, they must relate to ameliorating the specific impairment and allowing the beneficiary to return to work.

NOTE: SSA will look very carefully at claims for IRWEs so careful record keeping is required. Make certain that your treating physician agrees with the need for the expense, and keep copies of all receipts, canceled checks, and other proof of the expenses.

TICKET TO WORK PROGRAM

Many disabled beneficiaries would like to return to work, but cannot perform the work they have done in the past. Until recently, access to extensive vocational rehabilitation and training was limited. The Ticket to Work will allow people on SSDI and SSI to access approved private vocational rehabilitation programs whose services will be paid by the SSA. These services can include programs that will help people secure and maintain self-supporting employment. Education, training, and other vocational rehabilitation services may be included. This greatly expands the ability of beneficiaries to learn new skills, new trades, and develop the talent necessary to return to work.

The Ticket to Work was begun in several test states, and now should be available nationwide. The SSA has hired a company known as Maximus to serve as "Program Manager" and run the Ticket to Work program. Disability beneficiaries will receive a paper "Ticket" in the mail, which will contain some personal information and information on the Ticket to Work Program. This Ticket can then be taken to an approved "Employment Network," which is the name for the private vocational rehabilitation providers. These Networks will then review the medical limitations and mutually decide with the SSI beneficiary whether the services available from that Employment Network are appropriate. Information on the Program Manager and on local Employment Networks will be on the Ticket received in the mail, and at www.ssa.gov.

Use of the Ticket is voluntary and, as of January 1, 2001, the SSA will be precluded from conducting a Continuing Disability Review on anyone using a Ticket. This is an important consideration for persons receiving benefits who are improving and may be facing a CDR. Participation in the Ticket to Work program will allow you to continue receiving benefits, while also receiving the training and new skills needed to return to the work force.

This article was written by Jeffrey Rabin, an attorney in the Chicago area and the principal of Jeffrey A. Rabin & Associates, Ltd. Mr. Rabin concentrates his practice in the nationwide representation of disabled individuals seeking SSDI and SSI benefits. Mr. Rabin can be reached toll free at 1-888-529-0600, or via email at jeff@rabinsslaw.com.