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Neighborhood Legal Services, Inc. |
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Neighborhood Legal Services, Inc. |
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TICKET TO WORK AND WORK INCENTIVES
IMPROVEMENT ACT OF 1999
Work Incentive Improvement Act Provisions - AT a Glance
Ticket to Work and Work Incentives Advisory Pane (12 Members)
• will advise the President, Congress, and
SSA on issues related to work incentives
programs, planning, and assistance
• submits annual reports to President and
Congress; final report, due eight years
after Act becomes law, is to
include recommendations for legislation and
administrative actions
Elimination of the Work-Triggered Continuing Disability Review (CDR)
• eliminated effective 1/1/02 for
persons who have received SSDI benefits for
at least 24 months
• no CDR may be scheduled solely as a
result of the individual's work activity
• SSDI recipients will still be subject to
regularly scheduled CDRs, not triggered
by work activity; and to
termination of benefits if they perform substantial gainful
activity (SGA) by earning more than
$800 in 2003
• NOTE: Under the new Ticket provisions,
an individual will not be subject to a
CDR during the period for which he
or she is using a ticket
Expedited Reinstatement of Disability Benefits
SSDI benefits shall be reinstated without a new application if:
SSI benefits shall be reinstated without a new application if:
• individual became ineligible for SSI
due to earned income (or earned and
unearned income) for 12 or more
consecutive months;
• files request for reinstatement within
60 months of the last month of entitlement;
• disability is same as (or related to)
the disability that was the basis for their original claim;
• that disability renders the individual
incapable of SGA; and
• individual satisfies SSI's non-medical
requirements (i.e., SSI's income and resource rules). <>
"Provisional Benefits" pending reinstatement
• up to six month of SSDI or SSI benefits
paid while reinstatement application is pending
• if SSA eventually determines that the
individual was not entitled to reinstatement,
any resulting overpayment cannot be
recovered unless SSA determines that the
individual knew or should have
known that he or she did not meet the
reinstatement requirements
Work Incentives Outreach Program
• a community-based work incentives
planning and assistance program established
through grants, cooperative
agreements, and contracts
• up to $23 million is allocated for each
fiscal year, 2000 through 2004
• disbursed by SSA through a competitive
process, based on the population of SSDI
and SSI beneficiaries within
a state
• grants, cooperative agreements, and
contracts will range between $50,000 and $300,000
• any public or private agency or
organization qualifies for funding
What services are to be provided by a funded program?
• a program is expected to "select
individuals who will act as planners"
• "planners" will provide
information, guidance, and planning to SSDI and SSI
beneficiaries regarding:
(1) federal and state work
incentive provisions;
(2) adequacy of health insurance
benefits offered by an employer; and
• programs will prepare and disseminate
written information explaining work incentives.
Establishment of complimentary resources within SSA
• SSA must establish its own "corps
of trained, accessible, and responsive
work incentive specialists
... who will specialize in [SSDI and SSI] work
incentives ... for the
purpose of disseminating accurate information ..."
• SSA is also required to provide training
and technical assistance to the agencies
receiving funding under this
section.
State Protection and Advocacy Program
• SSA is authorized to fund each state's
Protection and Advocacy (P&A) System
to provide "work
incentives assistance" to SSDI and SSI beneficiaries
• Act is vague about what services are
authorized under this new program. It states
only that services may include:
(1) "[I]nformation and advice
about obtaining vocational rehabilitation and
employment services"; and
(2) "[A]dvocacy or other
services that a disabled beneficiary may need to secure
or regain employment."
•Funding available: $7 million per year for fiscal years
2000 through 2004; minimum funding
to a state is $100,000.
Extended Medicare Coverage for SSDI Recipients
• this provision is effective October 1,
2000
• currently, SSDI recipient entitled to
continued Medicare during nine-month trial work
period and for an additional
39 consecutive months following the ninth trial work month
• during entire 48-month period, Medicare
Part A coverage is automatic and Part B
continues to be optional and
subject to premium payment ($58.70 per month in 2003)
• new law extends Medicare eligibility for
an additional 54 months (total = 93 months)
Expansion of the Optional State Medicaid Buy-In Program
Background
• optional program created by section 4733
of the Balanced Budget Act of 1997
• designed to provide health insurance to
working people with disabilities who,
because of relatively high
earnings, cannot qualify for Medicaid under another provision
• eligible individuals must be in a family
whose net income (i.e., after SSI exclusions)
is less than 250 percent of
the federal poverty level
• states can increase the resource limits
to as high as $14,000
• states, at their option, can charge
premiums or other cost-sharing charges
How the Act changes the current Buy-In program
• allows states to offer a Medicaid
buy-in to persons with disabilities who work
and have earnings greater than 250
percent of the poverty level
• state could require some individuals to
pay the full premium as long as the premiums
do not exceed 7.5 percent of the
individual's total income
• states must require a 100 percent
premium payment for individuals with
adjusted gross incomes greater than
$75,000 unless states choose to subsidize
the premium using their own funds
• second option allows states to cover
individuals who continue to have a severe
disability, but lose eligibility
for SSI or SSDI because their medical condition improves
SSDI Demonstration Projects and Studies
Extension of SSDI demonstration project authority
• currently, SSA has authority to
conduct SSI demonstration projects, to test waivers
of SSI rules to encourage
individuals to work; similar SSDI authority expired in 1996
• provisions reestablish SSA's
demonstration or waiver authority to test new work
incentives for SSDI recipients
designed to encourage them to work
• SSA authorized to waive compliance with
any SSDI provisions for demonstration projects
• Department of Health and Human Services
(HHS) is authorized to waive compliance
with any Medicare provisions as
necessary for demonstration projects
SSDI demonstration projects based on benefits reduction formulas
• SSA required to conduct
demonstration projects to evaluate program under which
SSDI reduced by $1 for each $2 of
earnings "that is above a level to be determined
by [SSA]."
• SSA and HHS authorized to waive any SSDI
and Medicare provisions as necessary
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