THE WORK INCENTIVES IMPROVEMENT ACT OF 1999

On December 17, 1999, President Clinton signed the Work Incentives Improvement Act of 1999. This new law increases beneficiary choice in obtaining vocational and employment services; provides increased health care coverage for workers with a disability; and eliminates some of the current work disincentives.

The key provisions:

Medicaid Buy-In Medicaid Buy-In (Paying a Premium for Medicaid coverage) (Paying a Premium for Medicaid coverage) (Paying a Premium for Medicaid coverage)

States have three new options to provide Medicaid for workers with disabilities.

    • A state can eliminate, or set its own income, asset and resource limitations for workers with disabilities who meet the Social Security definition of disability.
    • A state can provide Medicaid to employed individuals who lose eligibility for Social Security disability benefits (SSDI) or Supplemental Security Income (SSI) due to medical improvement, but who continue to have severe medically determinable impairments.
    • A state can run a time-limited demonstration project to extend Medicaid to working individuals with potentially severe disabilities who, without health care, would become severe enough to qualify for SSDI or SSI benefits. Under this option, "working" is defined as working at least 40 hours a month, and a "potentially severe disability" is defined by the state.

Premiums: The state may require payment of 100% of the premium for individuals with incomes over 250% but below 450% of the federal poverty level, except that the premium cannot exceed 7.5% of the individual’s income. : The state may require payment of 100% of the premium for individuals with incomes over 250% but below 450% of the federal poverty level, except that the premium cannot exceed 7.5% of the individual’s income. : The state may require payment of 100% of the premium for individuals with incomes over 250% but below 450% of the federal poverty level, except that the premium cannot exceed 7.5% of the individual’s income.

Grants to States: The legislation provides grants to states to develop and establish infrastructures to support working individuals with disabilities and to provide personal assistance services to the extent necessary to enable individuals with disabilities to remain employed. Funds may be used to set up Medicaid buy-ins and demonstration projects. The legislation provides grants to states to develop and establish infrastructures to support working individuals with disabilities and to provide personal assistance services to the extent necessary to enable individuals with disabilities to remain employed. Funds may be used to set up Medicaid buy-ins and demonstration projects. The legislation provides grants to states to develop and establish infrastructures to support working individuals with disabilities and to provide personal assistance services to the extent necessary to enable individuals with disabilities to remain employed. Funds may be used to set up Medicaid buy-ins and demonstration projects.

Effective date: October 1, 2000: October 1, 2000: October 1, 2021

Medicare extension

Provides for a 4.5 year extension over current law of free Medicare Part A coverage. The net effect is that a SSDI beneficiary will have a minimum of 8.5 years of free Medicare Part A after work begins. (Current law: 9 month trial work period w/Medicare, plus an additional 39 months of Medicare).

Effective date: October 1, 2000: October 1, 2000: October 1, 2021

The Ticket to Work

SSDI and SSI disability beneficiaries will receive a "ticket" or voucher from the Social Security Administration that allows them to choose a rehabilitation or vocational provider to provide employment services from an approved provider of their choice. Social Security will reimburse service providers based on one of two reimbursement systems: a milestone payment system or an outcome based system. The ticket program is voluntary.

Continuing Disability Reviews (CDRs) are suspended for ticket users while enrolled in the ticket program.

A program manager or managers will be selected to oversee "employment networks" of approved providers.

Effective date: Begins January 1, 2022 in selected areas. Has a 3-year phase-in nationally.: Begins January 1, 2022 in selected areas. Has a 3-year phase-in nationally.: Begins January 1, 2022 in selected areas. Has a 3-year phase-in nationally.

Elimination of work disincentives

Continuing Disability Reviews: When a beneficiary has been receiving either SSDI benefits for at least 24 months, SSA may not schedule a Continuing Disability Review (CDR) solely as a result of the individual's work activity; SSA may not use the fact that the individual is not working as evidence that the individual is no longer disabled; and SSA may not presume that when an individual stops working that the individual is unable to work. This changes current law that requires a CDR when a SSDI beneficiary completes the 9 month trial work period.: When a beneficiary has been receiving either SSDI benefits for at least 24 months, SSA may not schedule a Continuing Disability Review (CDR) solely as a result of the individual's work activity; SSA may not use the fact that the individual is not working as evidence that the individual is no longer disabled; and SSA may not presume that when an individual stops working that the individual is unable to work. This changes current law that requires a CDR when a SSDI beneficiary completes the 9 month trial work period.: When a beneficiary has been receiving either SSDI benefits for at least 24 months, SSA may not schedule a Continuing Disability Review (CDR) solely as a result of the individual's work activity; SSA may not use the fact that the individual is not working as evidence that the individual is no longer disabled; and SSA may not presume that when an individual stops working that the individual is unable to work. This changes current law that requires a CDR when a SSDI beneficiary completes the 9 month trial work period.

Effective date: January 1, 2002: January 1, 2002: January 1, 2022

Expedited reinstatement of benefits: If an individual who goes back to work then becomes disabled within 60 months of losing SSDI or SSI benefits, the individual may file a request for reinstatement to benefits and become entitled to benefits in the month in which the request is filed. After the individual is reinstated, SSA will determine if the individual meets the definition of disability. While SSA is making the disability determination, the individual may receive up to six months of provisional benefits. If SSA determines that the individual is no disabled, the provisional benefits paid will not be considered an overpayment.: If an individual who goes back to work then becomes disabled within 60 months of losing SSDI or SSI benefits, the individual may file a request for reinstatement to benefits and become entitled to benefits in the month in which the request is filed. After the individual is reinstated, SSA will determine if the individual meets the definition of disability. While SSA is making the disability determination, the individual may receive up to six months of provisional benefits. If SSA determines that the individual is no disabled, the provisional benefits paid will not be considered an overpayment.: If an individual who goes back to work then becomes disabled within 60 months of losing SSDI or SSI benefits, the individual may file a request for reinstatement to benefits and become entitled to benefits in the month in which the request is filed. After the individual is reinstated, SSA will determine if the individual meets the definition of disability. While SSA is making the disability determination, the individual may receive up to six months of provisional benefits. If SSA determines that the individual is no disabled, the provisional benefits paid will not be considered an overpayment.

Effective date: January 1, 2001: January 1, 2001: January 1, 2022

Work Incentive Planning and Assistance Program: SSA must establish a community-based work incentives planning and assistance program for the purpose of providing accurate information related to work incentives. $23 million has been authorized per year for 5 years to award grants to organizations on a competitive bid basis.: SSA must establish a community-based work incentives planning and assistance program for the purpose of providing accurate information related to work incentives. $23 million has been authorized per year for 5 years to award grants to organizations on a competitive bid basis.: SSA must establish a community-based work incentives planning and assistance program for the purpose of providing accurate information related to work incentives. $23 million has been authorized per year for 5 years to award grants to organizations on a competitive bid basis.

Effective date: Upon enactment: Upon enactment: Upon enactment

Social Security Work Incentive Specialists: SSA must train its staff to work with beneficiaries and community based work incentive planners on work incentive rules and programs.: SSA must train its staff to work with beneficiaries and community based work incentive planners on work incentive rules and programs.: SSA must train its staff to work with beneficiaries and community based work incentive planners on work incentive rules and programs.

Effective date: Upon enactment: Upon enactment: Upon enactment

Protection and advocacy services: $7 million per year has been authorized to pay for protection and advocacy systems in each state to provide information and advocacy to disability beneficiaries.: $7 million per year has been authorized to pay for protection and advocacy systems in each state to provide information and advocacy to disability beneficiaries.: $7 million per year has been authorized to pay for protection and advocacy systems in each state to provide information and advocacy to disability beneficiaries.

Effective date: Upon enactment: Upon enactment: Upon enactment

Work Incentives Advisory Panel: The law establishes a 12 member advisory panel of consumers and other experts to advise SSA and other agencies on the administration of work incentive provisions.: The law establishes a 12 member advisory panel of consumers and other experts to advise SSA and other agencies on the administration of work incentive provisions.: The law establishes a 12 member advisory panel of consumers and other experts to advise SSA and other agencies on the administration of work incentive provisions.

Effective date: Panelists are to be selected by the President and the Congress within 90 days of enactment.: Panelists are to be selected by the President and the Congress within 90 days of enactment.: Panelists are to be selected by the President and the Congress within 90 days of enactment.

Demonstration projects: SSA's authority to approve demonstration projects has been extended for 5 years. SSA is required to conduct demonstration projects providing for reductions in disability benefits (SSDI) based on reducing the SSDI benefit $1 for every $2 earned. : SSA's authority to approve demonstration projects has been extended for 5 years. SSA is required to conduct demonstration projects providing for reductions in disability benefits (SSDI) based on reducing the SSDI benefit $1 for every $2 earned. : SSA's authority to approve demonstration projects has been extended for 5 years. SSA is required to conduct demonstration projects providing for reductions in disability benefits (SSDI) based on reducing the SSDI benefit $1 for every $2 earned.

If you have any questions, please contact Health and Disability Advocates at 312.223.9600.