WORK AND SOCIAL SECURITY
Q IF I GO BACK TO WORK WHILE RECEIVING EITHER SSDI OR SSI BENEFITS, DO I HAVE TO TELL SOCIAL SECURITY?
A 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.
AM ON SSDI. IF I GO BACK TO WORK, WILL I LOSE ALL OF MY SSDI BENEFITS?
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 $530 will be counted as one of the nine months of
your trial work period. Note: On January 1, 2001, the Trial Work Period amount
rose from $200 a month to $530 a month. Any months worked before January 1,
2001, the trial work period amount is $200. The nine months donít 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.
you have accumulated 9 months of trial work, then Social Security will start
looking at months in which you make more than $740, as of January 1, 2001. If
you earn more than $740 per month, Social Security will consider that
"substantial gainful activity." Note: On January 1, 2001, the $740 a
month rose from $700 a month. Earnings in any month between July 1, 2022 and
January 2001, substantial gainful activity is $700 a month. On July 1, 1999, the
$700 figure rose from $500. Earnings in any month before July 1, 2022 will be
have to fall below the $500 level in order to not count as substantial gainful
WILL I LOSE MY SSDI BENEFITS AT THE END OF MY TRIAL
will be able to keep your SSDI benefits for 3 more months after your trial work
period ends. Then, if you continue working and make more than $700 a month, your
SSDI check will stop. Note: On January 1, 2001, the $740 figure rose from $700.
Q CAN I GET MY SSDI CHECK BACK AGAIN IF I LOSE MY JOB AFTER THE TRIAL WORK PERIOD?
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 36 months. You will automatically be eligible for
your SSDI check in any month during the Extended Period of Eligibility in which
your earnings drop below $740.
On January 1, 2001, the $740 a month figure rose from $700.
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.
SO DOES THAT MEAN THAT JUST BY GOING BACK TO WORK
SOCIAL SECURITY IS GOING TO ASSUME THAT I AM NOT DISABLED AND TERMINATE MY
A No. Social Security will assume that you are still disabled. They canít use the fact that youíre 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.
DO ALL OF MY EARNINGS COUNT TOWARD THE $530 OR $740 LIMITS, OR ARE THERE
A 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.
On January 1, 2001, the $740 figure rose from $700.
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 $740 per month, your SSDI benefits will continue.
$950 (gross monthly earnings)
- $300 (cab fare)
$650 (countable wages)
I RECEIVE SSI INSTEAD OF SSDI. DO I STILL HAVE A 9 MONTH TRIAL WORK PERIOD?
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.
WHAT WILL HAPPEN TO MY SSI CHECK IF I GO BACK TO WORK?
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 donít 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.
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 I QUIT OR LOSE MY JOB, HOW SOON CAN MY SSI BENEFITS START AGAIN?
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.
DOES THIS MEAN I CAN EARN AS MUCH AS I WANT AND STILL RECEIVE 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 2001,
this figure is $1,244 per month--or higher if you have business-related expenses
or Impairment Related Work Expenses (IRWEs).
You receive $530 from SSI (in 2001).
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 $530 SSI benefit to get $272.50, which is how much you can get in SSI. Thus you have earnings of $600 from your employment, and SSI benefits of $242.50, for a total monthly income of $872.50.
You have improved your monthly income by $372.50 by going to work.
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.
WHAT IS A
"PASS" PLAN THAT I HAVE HEARD ABOUT?
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.
I RECEIVE BOTH SSDI AND SSI BENEFITS. WHICH WORK INCENTIVES APPLY TO ME?
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 $740 a
month after 12 months, you will lose your SSDI benefits, but you could have some
SSI benefits after the 9 months if your earnings are low enough. Note: On
January 1, 2001, the $740 figure rose from $700. 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.
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 or Medicaid, or
both. This chapter discusses how each of those programs may be affected if you
return to work, and what your alternatives are.
SHOULD I LOOK FOR IN A WORK HEALTH INSURANCE PLAN?
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
WHERE ARE JOBS WITH GOOD HEALTH INSURANCE?
employers are more likely to have plans that don't exclude pre-existing
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.
DO I FIND OUT WHAT KIND OF INSURANCE A PROSPECTIVE EMPLOYER
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.
WHAT IF THE
EMPLOYER'S HEALTH INSURANCE PLAN WON'T COVER
A Exclusions for pre-existing conditions can be a serious problem for people with disabilities who go back to work. Recently, 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.
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.
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.
WILL I BE ABLE
TO KEEP MY MEDICARE COVERAGE IF I GO BACK TO WORK?
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.
Starting on October 1, 2000, 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.
know, Medicare doesn't cover prescription drugs. Unless you've got some way to
pay for your prescriptions, Medicare alone won't be enough to assure you access
to all the health care you need as a person with a disability.
CAN I KEEP MY
MEDICAID BENEFITS IF I GO BACK TO WORK?
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 over $740 per month, but under $1,244 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 $740 per month and still get an SSI check can continue their Medicaid under a special program called 1619(a).
works this way: when you earn over $740 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 Human Services that you
are on the 1619 program. The Department of Human Services should continue your
Medicaid eligibility without a spenddown.
few people in Illinois get their Medicaid under the 1619a 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 Human Services puts you in a
spenddown or terminates your Medicaid coverage.)
There are also a few people who can make up to approximately $23,271 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:
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 Human Services until Social Security makes the 1619(b)
CAN I BUY MY OWN HEALTH INSURANCE IF I CAN'T QUALIFY FOR A GROUP POLICY?
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.
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.
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 $141 to $1269, depending on
your age, whether you elect the PPO policy, and the amount of your annual
deductible. The Medicare prescription drug policy that most people choose costs
$111 per month for a man under age 30 living in the Chicago area. 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.
GOING BACK TO WORK Ė DISCRIMINATION IN THE WORKPLACE
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:
IS CONSIDERED A DISABILITY UNDER THE ADA?
the ADA, a person has a disability if they have a physical or mental impairment
substantially limits a major life activity.
WHAT DOES THE ADA MEAN BY "QUALIFIED"?
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.
HOW ARE ESSENTIAL FUNCTIONS DETERMINED?
A Essential functions are the basic job duties that an employee must be able to perform. Factors to consider are:
WHAT IS A REASONABLE ACCOMMODATION?
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 create undue hardship to the employer.
For example, reasonable accommodations may include:
HOW DO I GET AN ACCOMMODATION?
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.
WHEN DOES A REASONABLE ACCOMMODATION BECOME AN UNDUE HARDSHIP?
A Undue hardship means that an accommodation would be unduly costly, extensive, disruptive, or would fundamentally alter 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.
MUST I DISCLOSE
MY HEALTH STATUS TO MY EMPLOYER?
No. Unless you need a reasonable accommodation to perform the essential
functions of the job, it is not necessary to disclose your health condition.
EMPLOYER ASK QUESTIONS ABOUT MY HEALTH OR REQUIRE A MEDICAL EXAMINATION AS A
CONDITION OF EMPLOYMENT?
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.
IF MY EMPLOYER KNOWS ABOUT MY DISABILITY, WILL MY COWORKERS KNOW?
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.
FAMILY AND MEDICAL LEAVE ACT
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.
WHO IS COVERED?
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
MUST I PROVIDE BEFORE TAKING LEAVE?
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
DO I HAVE TO
DISCLOSE MY OR MY FAMILY MEMBER'S MEDICAL CONDITION?
An employer may require that a request for leave under FMLA be supported by
certification issued by the employee's health care provider.
WILL I GET PAID
DURING MY LEAVE?
unless your company has a paid leave policy or a short-term disability plan.
WHAT ABOUT MY HEALTH INSURANCE DURING MY LEAVE?
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.
DO I HAVE TO
TAKE MY LEAVE ALL AT ONCE?
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.
FINANCIAL ISSUES FOR PEOPLE RETURNING TO WORK
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.
I GET LONG TERM
DISABILITY BENEFITS FROM MY COMPANY. WILL I LOSE THEM IF I GO BACK TO WORK?
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 drops below a certain
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.
I GOT BEHIND ON
MY BILLS WHEN I HAD TO QUIT WORK. WILL I HAVE TO START PAYING ON ALL THOSE OLD
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 declared bankrupt so that your debts were
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 $213 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 $300 per week after taxes, your
creditors can garnish $45 every week, or about $180 per month.
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 creates 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
have already filed for bankruptcy, then you probably know that you can't file a
second Chapter 7 bankruptcy for six 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
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.
(applications, appeals, reporting work)
Contact your closest office or call (800) 772-1213; TTY (800) 325-0778
Illinois Department of Human Services (processes Medicaid applications, income reporting, and appeals)
your local office or call (800) 720-4166
Comprehensive Health Insurance Plan (I-CHIP)
discuss SSI/SSDI representation, including assistance on Return to Work issues
or to get speakers on SSI/SSDI issues or Return to Work issues)
223-9600; TTY (800) 427-0766
PEOPLE WITH HIV:
AIDS Drug Assistance Program
Department of Public Health, AIDS Activity Section
(to get help paying COBRA premiums)
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)
Assistance Foundation of Chicago,
HIV/AIDS Project (legal assistance for low-income Chicago residents with HIV)
Foundation of Chicago
(to get a case manager or to learn about and discuss AIDS advocacy issues)
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
BACK TO TOP