Derek Shields >> Hello and welcome to today's Ticket to Work Webinar; Debunking the Three Biggest Myths about Disability Benefits and Work. I'm excited to have you with us today. My name is Derek Shields. I'll be serving as the moderator for today's webinar. I also serve as the Senior Employment Network Development and Training Manager for the Ticket Program Manager. Before we get started with the main portion of today's session, I'd like to go over a few quick details to ensure everything works smoothly for you as an attendee. 

First, please know that all attendees will be muted throughout today's webinar. When asked, how do you want to join the meeting's audio, please select the system default option. This will enable the sound to be broadcast through your computer. Make sure your speakers are turned on or your headphones are fully plugged in to access the sound.

If you do not have sound capabilities on your computer or prefer to listen by telephone, please select the Connect with Phone Audio button on the previous slide in the dial-in option. Dial 1-800-832-0736 and then enter the access code, 4189148#. You can also use the join the meeting audio via receive a phone call as shown in the image on the screen and enter that same number and access code. 

Now let's review the Adobe Connect platform that we use. First, you will notice different boxes on your screen. We call these boxes pods. We have the presentation pod and that's where the slide deck appears. That's the largest portion. Below that is an open space. This is great for placement of the closed captioning pod. The top right corner is the Q&A pod, and below that is the Web Links pod. We will talk about these pods in more detail, but first, let's mention accessibility. Real-time captioning is available and is displayed in the captioning pod. Like I said, you can place that below the slides. You can show or hide the captioning display and can also choose the text size and text color combinations to best meet your vision preferences. To open closed captioning, please select the CC option from the top menu bar. The captioning link can also be accessed in the Web Links pod under the title, Web Captioning. You can also access captioning online in a separate viewing window. This choice is completely up to you and your preferences.

If you're fluent in American Sign Language and would like support during today's webinar, we developed a resource that provides instructions on how to connect with an interpreter through the Federal Communications Commission Video Relay Service. The ASL user guide can also be found in the Web Links pod in the bottom right corner under the title ASL User Guide. That's option number six.

We are here today to answer questions that you may have about the Ticket to Work Program. Please send your questions to us at any time throughout the webinar by typing them into the Q&A pod. We will then direct the questions to our speaker during the Q&A portions of our webinar, of which today we have two, two Q&A sessions during the presentation. So please send us your questions. We'll do our best to get to as many as possible. As a reminder, for those that have come before or if this is your first time, we are unfortunately not allowed to answer personal questions. So please keep this in mind when asking your questions. We need them to be more general. Also, please do not put any personally identifiable information into the Q&A pod. If you are listening by phone and are not logged into the webinar platform, you may also ask questions by emailing to us at ttwwebinars@ssa.gov.

Another valuable resource that we think you'll find useful is this Web Links pod that I've been mentioning. The pod, again, is in the bottom right of your screen and lists the links to the resources covered in today's webinar. To access these resources, please select the topic of interest and then access that resource to take a deeper dive and learn more. If you're listening by phone and not logged into the Adobe platform, you may email us at ttwwebinars@ssa.gov for a full list of these available resources. Or you can also reference your confirmation email for today's webinar to access those available resources too. Also, please note that the Social Security Administration cannot guarantee and is not responsible for the accessibility of external websites. We do hope that everyone has a great experience during this session. However, if you experience any technical difficulties, please use the Q&A pod to send us a message, or you can email us again at ttwwebinars@ssa.gov. Our team is standing by both in the Q&A pod and at that email address, to be able to provide you with immediate technical assistance.

Okay, as I said, I'll be serving as today's moderator. And I'm now pleased to introduce our presenter, Ray Cebula. Ray received his law degree from the University of New Hampshire's Franklin Pierce School of Law. He spent 23 years providing legal services to individuals with disabilities and their interactions with Social Security, and then became part of Cornell University's Work Incentive Support Center. In 2005, Ray joined the staff of Cornell's K. Lisa Yang and Hock E. Tan Institute on Employment and Disability. That's in the School of Industrial and Labor Relations at Cornell. He now serves as the Program Director of YTI Online. This is Cornell's Work Incentives Practitioner Credentialing Program. Welcome to today's webinar, Ray, and we look forward to learning more as we debunk the three biggest myths about disability benefits and work. Over to you.

Ray Cebula >> Okay, Derek, thank you, and I'm glad to be with you all today. This does happen to be one of my favorite webinars, because these myths that we're going to be discussing have been in existence for my entire career. And we have to dispel these myths, because returning to work while you're a recipient of SSI or SSDI is truly a safe thing to do, and we want to encourage you to destroy these myths as we talk about them today. So today we're going to help you answer questions related to debunking the myths about disability benefits and work. What is the Ticket to Work, and who can help you achieve your work goals. So debunking the three biggest myths about disability and work. What are they, and what can we do about them? 

The first myth is, I cannot work and receive Social Security disability benefits. And this myth has existed as long as these programs have existed, and it's just plain wrong. We have a notion at application for these benefits of a term called Substantial Gainful Activity. That is what Social Security considers work. This year, that number is countable income of $1,620 a month. So if you are earning $1,500 a month, and are not performing substantial gainful activity, you remain eligible for benefits. So the biggest myth is work and Social Security benefits run in tandem, and it's possible to have your foot in each one of those worlds. It's common to be worried about losing your benefits if you return to work. It's very common to be worried. People who are on benefits have pieced together their life, and it may be a stable life, and now we're asking you to take a chance and try work. Social Security has many safety nets in place to help you try working before your SSDI, your Social Security Disability Insurance, or your SSI, Supplemental Security Income, ends before you're earning, including the Ticket to Work Program and other Social Security Work Incentives. And these Work Incentives, along with the other services that the Ticket to Work bring, make this a safe thing to try. 

So what is the Ticket to Work? The Ticket to Work is a part of the Ticket to Work Act, but it's only a little tiny part of it. So it's really easy to understand. Social Security is offering you free and voluntary Social Security programs to assess and help you have success in the workplace.

Now, you don't have to do this, and the Ticket to Work providers, when we get to them, can actually help you decide what type of job you may like and whether or not work is the right step at this moment. The Ticket offers free career counseling, or career development, for people ages 18 through 64 who receive a Social Security disability benefit, either SSDI or SSI, and want to work. 

How can the Ticket Program help? It connects you with free employment services. Again, we start at the basics, is work the right decision at this moment? We can help you prepare for work, whether that means just get your resume up to snuff, or it may mean you need a certificate program or some kind of license to do the work that you want to do. How about finding a paid work opportunity? They are really all over the place, and Derek, my buddy here, is an expert at some of those, and how these paid work experiences and internships might very well help you out. 

During those paid work opportunities, you can see how the Work Incentives perform, and realize how, exactly how much money Social Security looks at when you are working, after all of the deductions are applied to it. And then we want to help you succeed at work. Just because we may have located a paid position for you, doesn't mean we're finished. We want to make sure you have what you need by way of supports or equipment while you're getting used to working. A reasonable accommodation is a great point here. We can help you ask for a reasonable accommodation from your employer. You may not have known you needed that accommodation until after you begin working. We are going to stick with you until we think you're successful, and until you don't want us to anymore. Learn more at What is Social Security's Ticket to Work Program? A self-guided tutorial. That link is in your Web Links pod. Let me get that clicker working.

The Ticket to Work Help Line. This offers a toll-free program, Help Line, to answer your basic questions. Yeah, there is really not a wrong door when you come to returning to work. There are lots of services that are out there. And yeah, the Ticket to Work Help Line is a free Help Line that will offer you assistance in finding a team that you want to support your work effort, with no obligation. They're just giving you information and talking to you about what might happen should you return to work. You can call the Ticket to Work Help Line Monday through Friday, 8 a.m. to 8 p.m. Eastern Time. And the number is 1-866-968-7842. If you use a TTY, it is 1-866-833-2967. 

So the other Social Security Work Incentives that are out there. Social Security has many, many rules called Work Incentives that help you keep some or all of your benefits for a period of time while you try to work. Eventually, we'll be impacting your benefits and you will succeed and be financially independent of Social Security and the benefits that they're providing you. Some Work Incentives are available to all Social Security disability beneficiaries, whether you receive SSDI, SSI, or both. And some are specific to the disability benefit. SSDI has some special rules applying to that benefit. SSI has special rules that apply only to SSI. If you have questions about which Work Incentives can help you, that Ticket to Work line is a place to get some free information.

Impairment-related work expenses, or as I affectionately call them, these are a few of my favorite things. They're called IRWEs, and they are costs for items of services that you need to work because of your disability. If you are paying for them out of pocket without reimbursement, Social Security can deduct the cost of those items of services as an IRWE, from your countable income. So let's say I am working, I'm earning $1,800, but I have a $200 IRWE that I need for physical therapy over the course of each month. That means my income, countable income, is $1,600. That's below that magic $1,620 for SSDI, and I still get my payment. So these are very valuable things. They must meet the criteria that are set forth by Social Security. It's an item or a service that enables you to work. My physical therapy allows me to work. You need the item of services because of a physical or mental impairment. I need it because of a physical impairment. You pay for the item yourself and are not reimbursed by any source. So this is an out-of-pocket expense to the beneficiary, and the cost is reasonable. You're just going to have to shop, right? We all shop around for things we want, and you're going to get a reasonable product, a reasonable service. That's actually never been an issue in my career, but it is a criteria. 

An example of work-related expenses, IRWEs, some examples are prosthesis. If I have lost my lower left arm, I'm going to need a prosthesis. I'm going to have to learn how to use that. How do I type with a prosthesis? Take a class, right? We can maybe do that. Modifications to your vehicle related to your disability. That could be just adjustments made to the car that you're driving now, or it could be an accessible van. I love this last one. Expenses paid for a guide dog or service animal that enables you to work. It's much more than just the pup. This can include the purchase of the animal, the training for the animal, the equipment that you need, that little harness that that pup is wearing right now is an expensive piece of equipment. How about food? How about veterinary services? How about licensing in your city, town, or county? All of those combined together are a deduction from your gross income to see how much counts against your SSI, or whether you're doing Substantial Gainful Activity for SSDI. It's always good, the pup I love, because it's always good to go beyond what you consider the IRWE to be. It's a pup, yeah. It's going to help you at work. But what about the food and the vet? They're all very expensive items. So I always like to look behind the item or the service. 

Trial Work Period. This is the first stage of Work Incentives for SSDI, Social Security Disability Insurance. And it's a great way to test your ability to work. It's a great way to determine what type of work you might want to do. It's one of the many Work Incentives available to people who receive SSDI. So this Trial Work Period allows you to test your ability to work for at least nine months. And I think these months are precious. I think you want to save them until you're ready to just start working and see how much durational capacity you're going to have to work. It may be a long time. We can test your ability to work. The biggest benefit of this is during your trial work, you will get your full benefit, no matter how much you earn. So this year, the trial work level is set at $1,160 per month, and that's gross. There are no deductions.

So I can earn $1,160 a month, and one cent, $1,160 and one cent, I'm above the trial work level and use a month. That's good, that's okay, I can test it. But if I'm ready to try to work and start and get a really reasonable job, and I'm earning $4,000 a month, that's a better test of your ability to work. So that's just a hint. And regardless, if I earn $1,160, I'm getting my full benefit. If I'm earning $4,000, I'm going to get my full benefit during these nine months. 

How is it calculated? How's a Trial Work Period calculated? We call it the TWP, and the TWP continues until you accumulate nine service months, nine trial work months, not necessarily consecutive, but within a rolling period of 60 months. Now that sounds confusing, but I like to think about a mantelpiece, or a big windowsill. And you have 60 blocks, or one block for every month that you receive a benefit. And now you go back to work, and you use a Trial Work Period. So there's a special block on the end now, right? And you have to push, knocking off the old months. So when your shelf fills up, and you can count nine Trial Work Period months in on that shelf, your Trial Work Period will have ended. Social Security uses the amount that you earn in a month before subtracting taxes. So it is your gross wage that we look at to decide if a month counts towards your Trial Work Period. Again, in 2025, that is $1,160 a month. Or if you're starting your own business, which is a really big thing right now, you work for 80 hours in self-employment.

And that's just a different test because lots of people who start a business are not making a lot of money, but they're working really, really hard to grow that business. And if you're working really hard, Social Security is going to look, if it's more than 80 hours a month, you've used the trial work month. And these are called service months. I slipped earlier and said service months before, so now you know why we're looking at them as service months. And they are always going to count towards your TWP. 

The early provisions that we talked about don't apply here. Because I'm going to get paid, regardless of how much I earn. So I don't need to keep track of my IRWEs. A good hint is to keep track of things that might be IRWEs because we can use them when your Trial Work Period ends. So that you'll develop a habit to keep track of them, keep the receipts and report them. Learn more about the Trial Work Period, take a look at Trial Work Period fact sheet. There's a link in the Web Links pod to learn more about the trial work and about the other Work Incentives that are available when you complete your trial work. 

The next period is called the Extended Period of Eligibility. And the rules are a bit different. So keep looking at those fact sheets to keep up to date and keep your knowledge up regarding what stage you are in. And that brings us to a Q&A box. Derek.

Derek Shields >> This is Derek speaking. Thanks, Ray, for taking us through myth one and into the Ticket Program and some of the important Work Incentives that are available to support folks in their journeys. So we do have a lot of questions coming in. We really appreciate everyone being with us and encourage you to keep submitting them. Prior to me asking the first question, I wanted to just revisit this. Ray, you've been doing this work a long time. This first myth that we're talking about today is that people cannot work and still receive Social Security disability benefits. Why do you think this myth lasts so long when we have many environments and many service providers working to bust that myth? Any thoughts on that?

Ray Cebula >> Like I said, yeah, I usually say the street talks louder than we do. And as much as we scream, there are people living in the community who receive these benefits that just believe they can't work.

And we talk about things like totally and permanently disabled. That's not really the case. And right now, I think we're living in a different world. I don't think about a person, whether this person can work with a disability. I know they can. There are ways we can get a job just by talking to you and looking at your life and determining what you have to sell. That's what we do, right? I'm selling my knowledge to Cornell University. So we need to find out what you can sell. There's always, almost always a way that we can find you a position. 

And then the question is, what's going to happen to your benefits? Well, if I told you for the first nine months, none of your income counts. So it is really a myth, things happen. Social Security is a big agency and there are bumps in the road. There are bumps in the road if you get employed without benefits as well. And all of those bumps can be — you can receive help from the different providers we'll talk about later. So I don't think anybody in this room listening to me needs to think, can I work? I think you should start from a position of, yes, I can. The question is, how much? And how much will I be earning? That's the question. If we start with that assumption, then this myth dies.

Derek Shields >> Excellent. This is Derek again. Appreciate that mindset. And —

Ray, this is Derek.

Ray Cebula >> Okay, folks — ah, there's Derek.

Derek Shields >> Can you hear me? Yeah, I'm back. Sorry, there was an internet glitch there. All right, so let's switch. With that in mind, in this positive mindset, we have a lot of questions about somewhat the topics of how do we count? What counts? And how does that connect to Substantial Gainful Activity? So specifically, you were talking about the Impairment-Related Work Expense and countable income and kind of the strategy of reducing the countable income. So there's folks asking, explain that a little further. What's Substantial Gainful Activity? Is it the same for SSI and SSDI? And how much can I earn monthly? So could you walk through that a little bit more?

Ray Cebula >> Yeah. Yeah, sure. The first thing I have to say is Substantial Gainful Activity only applies to SSI people at application. After you've applied and received benefits, Substantial Gainful Activity has nothing to do with the program. We're just looking at a calculation mechanism to determine what counts or not. And the Work Incentives on the SSI side are very different from the SSDI, and they're incredibly valuable. I always tell people, dig a little deeper to find something like an impairment-related expense. Many people with that pup that we saw, you have a service animal. People would just say, okay, the animal costs this much and the training to get it certified for a service position is all I can deduct. But think about it. I have three dogs, and I took two of them to the vet last week to get their kennel cough vaccine. And it was $110. That's an IRWE. The food I buy for the animals, yeah, is an IRWE. So when I buy 65 pounds, a $65 bag of food, that's an IRWE, and that's deducted from my gross wage. 

Yeah, so already I've talked to you, how much is the bag of food, $85, along with $110 for the shots. I'm up to $195. And we haven't really started. We haven't really started getting into that. So let's see what another IRWE would be. I'm not thinking about them now, for Christ's sake. Now, let's take a walking stick, right? I have to have a walking stick. So what do I need? I need to buy it. A reasonable walking stick, a cane, is probably going to be $100. Okay, but you know that little rubber tip? Those rubber tips are really expensive. They're $25 to $35, and you need one every three months. So don't forget that, because the $100 is going to be one IRWE, and the $25 to $35 tip is going to be another IRWE for the rest of the year.

Let's just say I'm using a wheelchair. How comfortable am I going to work? If you're still worried, if we haven't broke those myths, and you should be worried about risking your situation that you turned into a stable situation for you, you're always going to worry about your stability. And if we start collecting the IRWEs, and I have a $300 expense, let's say I'm working at home, and because of a visual impairment, I need a big screen, a big monitor to do my job. Well, I can take that IRWE, and if it's $360, I'm trying to do the math so I can understand it, I'm looking at an IRWE that I could spread out over 12 months. So what am I going to do? I'm going to look and see what happens if I take $360 in one month, what happens if I divide it by 12, and see what makes me more comfortable. I've worked with people who had to buy a new wheelchair but they were really insecure about losing that IRWE after they have divided by 12. Well, if you're that, still that insecure, let's rent the wheelchair. And if you rent a wheelchair for two years, just like you can rent a car, we're going to use that rental expense for two years, and you can focus on going to work and becoming a worker. And we'll talk in two years, are you willing to buy and divide by 12? And then you're going to be independent of benefits, or do you need more time?

We can make all of this happen so that you can lose your benefits over a longer period of time, just because that's going to make you believe that every myth out there is wrong, and work is the right decision for you. So I hope that helps a little bit. 

Derek Shields >> Ray, thanks, this is Derek, it does. We did have a couple other kind of follow-on questions about what counts and how to use the IRWE Work Incentive. The questions are somewhat around other, what might be viewed as healthcare-related needs. So if I needed adult diapers, or if I needed perhaps counseling, like therapy, these are disability-related and accommodation-type-related expenses. Could they both be considered IRWEs?

Ray Cebula >> Absolutely, Derek. The adult diaper situation is a month's supply. It's not just what you need on the workplace. That's clear. So the cost of that, and all of the other things, the counseling that you suggested. Counseling might be covered by Medicaid. Let's say it's an SSI recipient. If an SSI has a co-pay with that, or if you do have private insurance, and there's a co-pay with that, the co-pay is the IRWE. Yeah, so when I go to the doctors, if I go to my own doctor, I have a $30 co-pay, right? If I go to a specialist, I have a $50 co-pay. So if I'm going to see a psychiatrist or a psychiatric social worker twice a week, twice a month, I then have a $100 IRWE that's subtracted from my gross income every single month because of that medical need. Yeah, so all kinds of things like that, even if you use them every day, can be an IRWE. The wheelchair, I was using the wheelchair before I went to work, but now the expenses, because I am working, become IRWEs.

Derek Shields >> Thanks, Ray. This is Derek again. So a lot of possibilities here, but I know that it's not unlimited. So talk to us about what Social Security considers what is reasonable for an IRWE. How is that rated?

Ray Cebula >> I think it's really just a human response to what is reasonable. Now, let's say that I have a wheelchair, right? And I do purchase the wheelchair, yeah? Spread that cost because it's a big cost over 12 months, and I have a good size IRWE for 12 months. Now, the chair will be paid for, but go to the next month when you don't have that payment. What about the tires? What about the gloves you might use? What about the backpack that is made for the wheelchair? I use a briefcase to work, but if I had a wheelchair, I would have a backpack. So we have to think about all of that, the insurance on the wheelchair, the brakes, everything as a continuous IRWE. Now, the rental of that wheelchair is going to be where I want to see reasonableness. If I'm working with a client who's really unsure but willing to try work, I'm going to suggest they rent one for a two-year period. That's the lowest period you can get to rent a wheelchair. And then at the end of that two-year period, I'm going to have a long and hard discussion. Are you ready to purchase? And if someone convinces me they're not ready yet, I'm going to do another two years. Now, when it comes to the third time where I'm about to rent a wheelchair rather than buy it, I think Social Security might balk at that. They may say, wait a minute. This can't go on forever. And that might escape the reasonableness criteria. 

The other aspect that you have to look at is the cost. And I use that walking stick on purpose because if I go into CVS and I buy one of those aluminum canes, that's clearly reasonable.
Now, if I have a friend in Ireland carve me a shillelagh, it's the same walking stick, right? But it's a lot of money. Social Security will look at that cost and say, well, we're going to give you the IRWE for the cost of the CVS cane. We're not going to give you $500 for something that was hand carved. So it really isn't, I've never had an issue with this, Derek. It's never come up as some — when Social Security said, no, that's not reasonable. And I think when you tell somebody that the expense has got to be reasonable, the drawing out of the nature of using an IRWE has to be reasonable, it is just a human response. And Social Security people they buy things like we buy things. And I'm a guy that's looking for something on sale. I want my $10 call cash and I want that at a 30% discount. That's how you got to look at all of this stuff. It's just reasonable. Would you buy a $300 pair of pants or are you going to buy a pair for $60? Well, $60 sounds reasonable. And so it is a human response, I think, Derek.

Derek Shields >> Ray, thanks. This is Derek again. Appreciate that. It is a deep dive. And for those of you that are like, this is a little complicated, don't worry. We're going to talk in a little bit. Ray is going to take you through the team members that can help navigate some of this. But we want you to learn about these flexibilities that reduce countable income. We do have a couple of questions on the Trial Work Period. Let's get those and then we'll get back into the myths. So generally speaking, there was two areas around the Trial Work Period. One is, how do I know kind of if I start it and if I am in it, how do I report wages? Is that something I have to do? So kind of a two-parter there.

Ray Cebula >> Yep. I mean, how do you know you're in it? I mean, you need to be on SSDI. That's the first thing. And you need to be earning over $1,160 gross wages. If you have a job that's paying you $1,200 a month, you meet that criteria. I am in my Trial Work Period now. Social Security is not going to inform you of that, but what they're going to do is look for the end. When is the end of this Trial Work Period happening? And what they're going to do is look at your work and your income after that nine months is up. But remember, you get paid for those nine months regardless of what you did. So you know because you're keeping track of your wages.

And how can you do that? You can keep your wage stubs. I've had people who have a calendar, a wall calendar with blocks. And if they're paid hourly, every day they come back, say I worked four hours today in the Wednesday block. I worked six hours today on Thursday, in the Thursday block. And we can determine how much you worked, what your hourly rate is, and how much you earned over the cost of the month. Or I can look at Fridays if I'm paid every Friday. Okay, it's $275 I get every Friday. Does that add up to a trial work month? If it does, it's going to count. I only have eight left. So there's a lot of, I don't want to call it bookkeeping, but there's a lot of keeping track of things now that you're working. 

How do you report that to Social Security? There are several ways to report. And you can report by going to the office. That's usually the least favorite way to do it. You can report it on your cell phone. The SSI program has a cell phone app. You can get what's called a mySocialSecurity Account. And I think that you don't want to get this just because you might go to work. Everybody should have a mySocialSecurity Account. I'm at the point in my life where I'm using it to help figure my retirement income and what's going to happen. So I'm encouraging you all, once you hang up with us, to open ssa.gov, and on that cover page, you are going to see a block that you can click on for mySocialSecurity Account. Fill it out and get one. 

What will happen to me when I retire? I can find out now. If I become disabled today, how much will I get? I can find out now. There's a lot of great information in there, and it does provide you with a means to report your income. The issue we have here with people going to work is that you have to report your income every month, right? I'm going to report September's income before the 6th of October. When I report my IRWEs, I have to do that via the mail or going to the office. Of course, keeping a copy of everything for you. So your team that Derek alluded to is going to help you, give you methods as to how you can keep track of all of this information. It's going to be important. it's going to be important when they start using your IRWEs, which one did they use? They're not going to use them all at the same time. So yeah, we're going to take care of you and teach you a method, the best method for you to keep track of your hours, keep track of your salary, keep track of your IRWEs.

Derek Shields >> Ray, thanks a lot. While some of these questions that have been coming in become a little technical, they are helping get information to people that are seeking it. And we appreciate your guidance there. With that, I'm going to turn this back to you to get into our next two myths, so we can have you help debunk those, along with the final section about the employment team and all the resources that are out there that you can explain to folks how to contact. So, Ray, back to you. Everyone else, please keep your questions coming in. We'll have our second Q&A session after Ray completes this next portion.

Ray Cebula >> Okay, Derek, thank you. Myth two, if I go to work, I will automatically lose my Medicare or Medicaid. This can't be further from the truth. This one is just really wrong. In order to lose your health care benefits you may have to at some point pay a premium. But otherwise, if you remain disabled according to Social Security, and you are terminated from benefits because of your work activity, you will keep these benefits. The only thing on the Medicare side is that you're going to have to pay the premiums for it. Those premiums come out of your check every month. You'll see that on when we had checks, but you will see that everywhere, that $185 for Part B comes out. So if you don't have a check because you're performing SGA, you're going to need to pay that premium every month. 

On the Medicaid side, your Medicaid is going to last for years and years. Again, you have to remain disabled according to the Social Security Administration. But if your benefits are terminated, if your SSI is terminated because of earnings, you're going to keep your Medicaid. There are lots of fabulous healthcare programs out there that are going to keep a worker's benefits in place for a very long period of time. So if you receive SSDI or SSI benefits of any amount, you will keep your Medicare and Medicaid. There's a check coming in every month, then you're all set. If your benefits payments stop due to earnings or work, and you remain medically disabled, you may be able to keep your Medicare or Medicaid through the Work Incentives or through buy-in programs. So I think we're going to go talk about those next. Yeah, here we are. Two different programs, right? Medicare and Medicaid, they are remarkably different. So you need to determine which health benefit you have to start learning about what the Work Incentives are. 

Now, Medicaid, this program's fabulous. Medicaid is a good comprehensive health plan. And if you are working and your income means that you don't have any more cash coming in every month from Medicare, Medicaid, yeah, no, never mind, I said that wrong. If your income causes you to lose your cash benefit, you're going to keep your Medicaid. And the Medicaid program is 1619(b). That used to be a big block for people, but it really changed the whole game because in the past, way past, if you lost your SSI because of earnings, you lost your Medicaid. We finally accepted the fact that people need health care to work. So you lose your cash, you keep your Medicaid. Each state has what's called a threshold. That threshold can range from $25,000 up to $65,000. And you're going to keep your Medicaid until you reach that threshold. Then we can even look at you as an individual, because we're using averages to determine these thresholds. And if you have a very expensive medical program that you have to abide by, we can give you your own threshold for that. So you're doing really well, and you're making a lot of money, but you still need Medicaid to get some of those services that are helping you work. You're gone through 1619(b). If your state has a Medicaid buy-in program, and the vast majority of states do have one, I think there are only three that don't, you can pay a small premium based on your income and basically stay in the Medicaid program. And that gives you a larger SSI resource level, and it lets you make a ton of money. It lets you make a ton of money. Some of these threshold amounts, the one in New York State, they are going to increase that this year, or they're trying to, to $600,000 a year. So if you're in New York and this law passes, you could make $250,000 a year. And if you still need services that are covered by Medicaid, you're going to pay a premium for them. That's a wonderful thing.

Now when we switch over to Medicare, you have the extended period of Medicare coverage. We talked about that Trial Work Period being nine months. Once your Trial Work Period is over, the extended period of Medicare coverage lasts at least 93 months. That's seven- and three-quarter years. That's a good thing. You don't have to worry about losing your Medicaid coverage. The trick here is that if you're not receiving a cash SSDI benefit, your premiums are going to have to be paid by you. But really, this is a great program because I can talk to people about returning to work and tell them you don't have to worry about losing your Medicare for seven years, over seven years. So let's focus on work. Let's get that down. Focus on becoming a worker, working, getting to work on time, finishing up your week. Let's make adjustments to your hours because you might not be able to work 30 hours a week. So we need to reduce the 25 or just the opposite. And don't worry about your health care. It's good. 

And then Medicare for people with disabilities who work. This is going to go until you're 65. These Medicare benefits are going to be with you — or I'm sorry, the Work Incentive programs are going to be with you until you're age 65 when you become eligible for Medicare as an aged person. So we just have to protect you until you turn 65. And it's infinitely possible. The Medicare for people with disabilities, you have exceeded every limit that's put in front of you. But that's not good enough. We're not going to stop providing you with health care coverage. But you will be paying premiums.

And hopefully in that seven-and-a-half-year period, your income has increased to absorb this extra expense. At this point, you're independent of Social Security. And the question is, what do we do about Medicare? What do we need to buy? And it's going to be individualized for every person. 

Medicaid While Working or 1619(b) will give you a quick review of what we talked about. If you receive SSI and qualify for continued Medicaid coverage when your payment stops due to earnings. Remember, these are Work Incentives. If you're not working and earning, they don't pertain to you. You have had SSI in a month. Now, how does that happen? If I'm an SSI applicant and I'm awarded benefits and I get paid, I've had them for a month. What if I was on SSDI? Yeah, there's a five-month waiting period for SSDI. And many, many people collect SSI for that five-month period. You've had SSI for a month. Doesn't have to be a recent month. It just has to be a month. You continue to meet Social Security's definition of disability. The terminations, and I know that's a powerful word, but it's a real word. The terminations are coming to you because of your earnings, rather than Social Security saying you are no longer medically disabled. Still meet all of the other SSI requirements. Now, this is a bit of a bummer because we know that that SSI resource level is still $2,000 for an individual and $3,000 for a married couple. And you're working. You want to save some money. 

The ABLE account, the A Better Life Experience accounts that are available in every state will take the resources that you want to save above those resource levels, that $2,000 or $3,000 level, and put them into an account. The maximum amount that you can have in that ABLE account at any one time is $100,000. That was a shocker to me. I never thought I could tell an SSI recipient that they could save money. Now they can. It's possible. We just have to tape a couple of things together. You need Medicaid to continue to work.

There was a Medicaid use test. And the first question was, did you use Medicaid last year? If the answer was yes, you passed the test. If you didn't, do you think you're going to need to use it next year? If the answer is yes, you passed the test. If you didn't, the last question is, can you afford to replace Medicaid with private insurance? And I think the answer for everybody that's working on this webinar today and all of your listeners is no. The answer's no. So that's not really even a question at this point, but they might ask you. 

And you have gross earnings below your state's threshold. Now we told you, I told you about New York's threshold. New York is a very generous state. If you have resource — if you have an earnings level of $2,500, you might not have a higher resource level. That's up to the state to change in their 1619(b) program. But a lot of states do. So you just got to watch for those thresholds. Exceeding a threshold isn't scary. It just means you'll be in a different place in the Medicaid house, that's all. There's a link here for updated state thresholds. They change every year. So take a look and see what your state is that is in the Web Links pod. The buy-in programs, this was also a game changer for people, because if you exceeded your threshold on the 1619(b), Social Security just assumes at that point that you can access a private policy from your employer and you can afford to pay those premiums, whatever your share would be. Sometimes it works, sometimes it doesn't. So the states were able to create a Medicaid buy-in program. And you basically have an income-based premium so that if I am making — I remember when this all started because Massachusetts, which is my home state, had a waiver program from the Centers for Medicare and Medicaid Services, and it was the buy-in. 

If you need this insurance to keep going because of the Medicaid services that aren't available anywhere else, you can buy into the system. And at that point, it has to be 30 years ago, 35 years ago, the top income level was $100,000. At that point when these programs started, I could honestly talk to my clients about getting a job for 60 or $70,000. Lose your SSI cash, but keep your Medicaid, and your premium is going to be $75 a month. This was a game-changer. And I believe we're now three states short of 50. But most states have these plans. You got to look into them. It's supposed to be more continuous or more attached. But my friend Connie used to say, how lucky do you feel? So when you do exceed the income levels, you're reporting your income, right? It might happen automatically. But you should call the state Medicaid agency and make sure you're listed as a buy-in participant. That's all. 

Now, Medicare for people with disabilities who work. This applies to folks who are, again, under age 65. You continue to have a disabling impairment, and your Medicare stopped because of your earnings. We don't see this too much. We don't see this too much. But Medicare comes in four parts. Part A has no premium. Part B has $185 a month premium. And then there's part C and part D. Part D has a premium as well. So what are we going to do with this? If I'm no longer — if I'm still disabled, but I'm not getting a Title II benefit, I can continue, but I've got to pay the premiums. States have what's called Medicare savings plans that might help you pay those premiums. Different ballgame you call the state for that.

But this is a great thing. And then when you turn 65, you're a person with age, and you qualify for all of these plans. But again, you're still paying the premiums at that point. One of those team members that we've got for you can help you plan for that. 

I told you about part A, part B, and part D. You got to consider parts B and D. Yes, they're going to cost you money, but what's going to happen if you don't pay the premiums? The part D is the new kid on the block that is the drug program. Average premium is about 45 bucks a month. Much better than the cost of your drugs. Have Medicare questions? You can look online at medicare.gov. And they have a great chat line as well. And you can use that 24 hours a day, seven days a week. And it's 1-800-MEDICARE, or 1-800-663-4227. Or TTY users, 1-877-486-2048. Talk to someone, contact Medicare. Those links are in your web pod as well. 

Myth three. I'm told we got to hurry up. Yeah, I'm in a good mood, so I like to talk when I'm in a good mood. But let's, myth three. If my Social Security payments stop because I go to work, and then I have to stop working because of my disability, I'm going to have to apply all over again. No, you won't. There's a new program called Expedited Reinstatement. Now, Social Security, once they terminate you, you have to be terminated because of work. Leaves your foot in the door for another five years under Expedited Reinstatement.

There aren't any other programs out there, public benefits programs, that watch you for five years after you've been terminated. And we're going to see what happens on that one. This is a great program. If your benefit payment ends because you worked and had earnings, and you have to stop work within that five-year period, beginning with your month of termination, you may be able to have your benefits started again right away. To apply, you must have the same disability or something significantly related that qualified in order to qualify for your benefits. You must also not be working at the substantial gainful level, right? If you're working for that level, you're just not going to be eligible. But what happens if I'm working during my Extended Period of Eligibility, I'm sorry, during my Expedited Reinstatement period, and I have an exacerbation, and I have to cut myself back to half time, my income drops below that SGA level, I can request Expedited Reinstatement. 

Now, depending on the time of the month, you might get a benefit right away. Now we're at the 17th, it's probably a little too late to get one in October, but you'll get one in November. And you'll receive that benefit for six months. So we've worked, we've been terminated, and now our income drops below SGA during the five-year period after termination. We can say, my income dropped below SGA because of my impairment that I qualified for earlier. And you'll get six months' worth of payments. During that six-month period, Social Security is determining whether or not you are eligible for reinstatement. And they're using a very difficult standard, difficult for Social Security. The medical improvement standard is very hard for them to show. So the vast majority of people are successful getting this. You could also be eligible for Medicare or Medicaid again, but you got to look at those independently in this criteria and what your choices of moving forward were.

Who can help you? We're going to go through this too. Lots of people can help you. You are able to build an employment team that's specific to you. So as you think about returning to work and possibly changing careers, you may have questions and need support. If these people are Ticket Program providers, they can help you at no cost to develop achievable goals and establish steps to find and maintain employment in a new career, in a new job, or just doing your job a little differently than you did it before your disability occurred. Ticket to Work service providers can even help you identify the type of career that you might enjoy. Notice we use the word career. We do that on purpose because we don't want just a job for you. We want something that you can consider a career that you might want to do forever. 

The Ticket to Work service providers, there are Employment Networks, they're called ENs, and your State Vocational Rehabilitation agencies, or VR agencies. These are big players here. An EN, an Employment Network, is a private or public organization that has an agreement with Social Security to provide free employment support services to people who are eligible for the program. And remember those eligibility criteria, 18 through 64, and receiving a cash benefit. Many state public workforce systems, such as the American Job Centers, they used to be called one-stop centers, are Workforce ENs, and they can help you to do that too. That's a great place to start because you can get a hold of a computer and update your resume, search for jobs, apply for unemployment if you need to. It's a great place to start.

Now, how can working with an EN help? Services and supports is designed to help you on your path to financial independence through work. All of these plans are individual to your situation. Identify your work goals. Well, at this point, I might be able to work 25 hours a week, but I'd like to eventually go back to work full-time. Good plan. Let's see how we need to help you get to full-time. Write and review your resume. I keep telling people when I'm doing these sessions that my resume is 25 years old. If I want to change jobs now, I'm going to definitely need assistance getting my resume up to date and put into a format that's used today and not 25 years ago. 

How about preparing for interviews? Practicing your interview and building those skills is very important. when you go to people who are about to give you a job, this is a big deal. You're preparing for those questions that you might have for your employer. Do a little research. What is this employment situation all about? What do they do? What do they make? So that you can speak with knowledge when you ask your prospective employer questions. How about reasonable accommodations? There may come a time when you need an accommodation to help you continue to work. Are you able to do that on your own? Or should your EN help you decide what accommodation you need and what the general cost is? That helps you give a lot of information to your employer when you request it. And receive benefits counseling. That's a different team member, sometimes housed right in your employment network. And that counselor is going to be able to tell you if you earn $1,000 in a month, this is what's going to happen to your benefits. And not just SSA benefits and health care. It's going to talk to you about SNAP benefits, public housing. They want to make sure you know what is occurring as you continue to earn increased income. 

State VR agencies. They're a big player here too. The State VR agency provides a wide variety of services to help people with disabilities return to work, enter new lines of work, or enter work for the first time.

A State VR agency can offer benefits counseling as well. In Massachusetts, they were housed in the VR agency. In my new state of New Mexico, they are in the VR agency. And they can help you with vocational rehabilitation, training, and education. Let's go back to my arm. If I lost my lower left arm, I'm going to need some serious rehabilitation, right? I'm going to have to use a prosthetic. That might require some training. It requires a very expensive piece of equipment. VR agencies can do that. And again, with education, if I decide I want to be a teaching assistant, and that is going to require a two-year college degree, vocational rehab can help pay for that education. If you're expensive, if your needs for your employment journey are going to be expensive, necessarily because of your disability, State VR agencies are where you're going to get the most help. Now again, they work with people with more significant, and as a result, more expensive disabilities. In some states, it includes intensive training. We did that. Rehabilitation and education. They can provide career counseling and job placement assistance, as well as counseling about the impact of your income. They're going to be with you until you have that three months at Substantial Gainful Activity levels, and then they generally transfer the case to another Employment Network who can help you with on-the-job supports. 

How do you find a service provider? This is real easy, too. You can call the Ticket to Work Help Line. Again, that number is 1-866-968-7842, or for TTY users, 1-866-833-2967, Monday through Friday, 8 a.m. to 8 p.m. Eastern Time.

To find a provider online, visit the Find Help page that's in your Web Links pod, and search by zip code. If I want someone close to me to work with, I'm not going to let the computer find everybody in the country. I want somebody in my zip code. What types of services do they offer? Do they focus on people with blindness? Do they focus on people with physical disabilities? Or how about mental disabilities? If I have a physical disability, I want to search for those employment networks, not for the others that provide services to different people. The disability type, again, we can type that in language is spoken. If I'm more comfortable working with somebody who speaks Spanish, I put that in my search, and I'll only get those Employment Networks that provide services in Spanish, and many do. How about the provider type? Do I want an EN? Do I want a workforce EN? Do I want the VR agency to help me? Or how about PABSS? That's the Protection and Advocacy Agency, and it's called Protection and Advocacy for Beneficiaries of Social Security. They can help you with any roadblock to employment that you may have. So there's even a free legal wing here to help you provide services. What if your employment says, no, that's not a reasonable combination? I'm going to deny it. Well, you can call PABSS, get some legal advice about what your next step should be. 

Okay, Derek, that was fast, but we are now ready for more questions.

Derek Shields >> This is Derek. Thanks, Ray, for going through the second and third myths, and then reviewing the employment team with a lot of great information. So we do have time for our second and final Q&A before we wrap up. Let's get right to it. Does the Ticket Program help me since I've never had a job before? Ray, what's that eligibility? Does somebody on SSI or SSDI have to have previous work experience?

Ray Cebula >> That's a great question, Derek. And we mentioned that when we were talking about VR agencies. So I'm glad you brought it up again because not ever having a job, being in a situation where you want placement for your first job, is available with state VRs, but it's available with every other Work Incentive service. If you're working with an EN, and you're on SSI or SSDI, and you want to consider work, we are here to help. So you do not need prior work expense or recent work experience.

Derek Shields >> Thanks for that. It's an important, obviously, for those of you that are asking that question, if you're on SSDI, that is previous work experience because you paid into the insurance program. But it might feel like you're starting all over if it's been a long time since you've worked. So, Ray, that leads us to the next question. We had this coming in earlier, and we've had it coming in throughout the whole session. What if I'm unsure about what type of work best suits me? Where do I get that evaluation or kind of the training? And as you mentioned, some of the certifications that might help in that pivot.

Ray Cebula >> Yeah, that training, you might be able to get from your state VR agency. They're going to talk to you. An Employment Network is also going to be able to help you. So you have a choice in providers. And if I'm not sure, when I work with people who are talking to me about wanting to go to work and don't know what to do, I talk to people about what they do all day. Just because you're in benefits doesn't mean you're doing nothing, right? You might be babysitting your grandkids, or babysitting your neighbor's children while they're working. That is a valuable skill that could be transferred into paid employment. I may be taking up knitting. This is a true story. This person took up knitting when she became disabled. And over time, she was pretty much an expert. She could make anything, but she understood all of the different kinds of fibers. Some knitting you're going to do, you need some yarn for sweaters. Some other things might not be as expensive because you're not going to have it on your body. And you can use that for a wall hanging. And when she didn't know what she could do for work, I said, well, how about working in the knitting department at Michaels? And we found her a part-time job.

And now she is the manager of that yarn center in Michaels. And she is also running classes to teach other people how to knit. It was something she loved, she was passionate about, but didn't think she could sell it. So that's what we help you look for. What do you have that you can sell? And I'm guaranteeing you, everybody here has something they can sell. We just have to find out what it is and how to sell it.

Derek Shields >> Thanks for that, Ray. This is Derek again. So this idea of career planning, we've been talking about like evaluating passions and basically creating an asset inventory and then making the plan to get from where somebody is to employment. Can you talk to us a little bit about how the employment networks use the individual work plan to help organize all this?

Ray Cebula >> Absolutely. Individual Work Plan, that's what we're focusing on here. A plan for you, not a plan for all of you, just one of you. So if I'm looking, we have 625 Individual Work Plans that we need to build. That's going to help you, first of all, get a job. And maybe that's your goal. I just want to work part-time in Michaels in the knitting department because that's what I'm familiar with and I don't think I can work anymore than part-time. Well, that may change over time, right? So if I'm working and I'm still receiving a benefit, I could contact an EN or potentially the state agency, the State VR agency, and say, okay, let's see, what's the next step? Or maybe you've developed your first plan to get to this next step. That's turning your job into a career. And now I'm going to — I'm up working full-time now and it's okay. I do have a sick day every now and then but I still have my disability, right? And I don't have any more cash benefits. But what's the next step for me?

The next step might be the management job in that department. For all I know, you might decide you're really liking this crafting stuff and you're going to run the entire store. That's turning your job into a career. And we can start on day one. What do you think you'd like to do? Well, let's talk about your daily life. What were you doing? And we can find a good first placement for a job. But we don't want to end there. We want to end by seeing you increase into a management position. Make this more of a career. And I think that working your way up that employment ladder should be a part of every plan. Every individualized work plan that's out there should have something beyond getting you a job.

Derek Shields >> This is Derek. Excellent, thank you, Ray. This is a question we get often, but we haven't asked it today. What happens if someone is unsure what they're receiving? SSI, SSDI, or both? How can they discover that?

Ray Cebula >> One of the easiest ways is to look at the notice that Social Security sends you. It's going to say right on top, SSDI or SSI. That's a good way to do it. But one of the best ways is, again, that mySocialSecurity Account, where you can — it's going to take a couple of weeks to process, right? But no problem once you have one. I've had one for years. I can log on and see right now how much SSDI I'm going to get, how much retirement I'm going to get. What's my SSI payment? Do I have one? You'll find out exactly what your benefit is and how much benefit is being paid to you. With direct deposit now, we kind of lose track of some of that, but it's important for you when you're making your journey to work to initially find out what is your benefit? How much is it? I promise you that mySocialSecurity Account will work for you. That's why I asked you to take it home and do some homework tonight once you hang up with us and get that account set up.

Derek Shields >> Thanks, Ray. This is Derek again. And just to remind you all, if you haven't done that, it's ssa.gov/myaccount. That's the page where you can explore. Maybe you already have one, you can sign in there. If you don't, it gives you the step-by-step instructions and then you could check on what benefit or benefits you may be receiving. 

Ray, it's about that time to wrap up. We've had a really — we've covered a lot of ground. You provide a lot of information. What are your closing thoughts here? If we have some beneficiaries that are with us today that are contemplating beginning this return to work or starting their journey to work for the first time, what would you say to that person that's thinking about that return to work or starting work possibility right now?

Ray Cebula >> I would start by letting everybody know that you can do this. It is your choice, but you can do this. And you can work and not have any impact on your benefits if you're looking to eventually get into a career, you're going to have impact on your benefits. But it's a gradual process and there are people out there that you can talk to. And I think that's important. The Employment Networks, your benefits planners are all going to have the time to talk with you about what will happen if you add earned income to your current picture. And I think that's critically important because if you're considering something and you're not talking to other people who know what's going to happen if, you're missing out. Maybe you're listening to those myths. The guys on the sofa, the guy from next door who said, I went to work and it was a disaster, I'm never going to work again. That's why the Ticket to Work happened so that you can get the services that you need to consider whether work is right for you. That's the first step. And if it is the right decision for you now, let's move ahead and put a plan together so that you are aware when your benefits are going to end. You'll be aware when your benefits are going to be reduced. You'll be aware of how to continue that connection to Medicare and Medicaid. It's a ton of information. And I bet it's overwhelming for most people. But we're not a one-stop shop. If you have more questions, if your situation changes, you come back and we'll help you develop a plan based on what your earnings are now. So I think we have potentially over 600 new workers with us. And if you want to get started, don't just consider this on your own. And consider those myths that we've dispelled here. Talk to us and we'll give you the information.

Derek Shields >> Ray, that's all the time we have for your comments today. We appreciate you sharing this and helping us bust those three myths, including how you can maintain your Social Security benefits while working, how you can maintain access to your healthcare benefits while working. And of course, that if you do stop work, you can get that Expedited Reinstatement of payments if need be. So once again, thanks, Ray. And I will now move to wrap up today's session.

Ray Cebula >> Thank you, Derek.

Derek Shields >> Yep. So how to get started? As Ray has mentioned, there's kind of no wrong point of entry, but we encourage you to contact us to follow up and potentially ask the more individualized question that we couldn't get to today. And with that, we look at contacting us at the Help Line. We mentioned this before; we'll repeat that number now. If you're between the age of 18 through 64 and receiving SSDI or SSI due to a disability, call us at 1-866-968-7842 or the TTY line for callers who are deaf, hard of hearing, or have a communication disability at 1-866-833-2967. You could also visit us online. Some of you would prefer to kind of look around at choosework.ssa.gov. You can explore success stories of other people like yourselves who maybe were thinking about work and made the transition through the Ticket Program. And of course, you will encounter the Find Help tool there that Ray described that you can use to select the EN or VR or other service provider at choosework.ssa.gov/findhelp.

So really, it's your choice on how to get started. What we do is just encourage you to try one of those to learn about ENs and VRs that are out there. 

There's other ways to connect too. And we encourage you to visit the Choose Work website and go to our contact page. You can find us on social media. Subscribe to our blog and receive email updates to stay up to date with the program. Again, that's also in our Web Links pod under the Ticket to Work contact information. You're also welcome to opt in to receive text messages by texting T-I-C-K-E-T or Ticket to 1-571-489-5292. We do advise that messaging rates may apply and you may opt out of that messaging program at any time. And of course you can always email us. We welcome your emails at TicketToWork@ssa.gov. So whether you're just getting started or looking for guidance along the way, the Ticket to Work team is here and we encourage you to connect with us. And finally, we invite you to join us for our next WISE Webinar. This is scheduled for October 22 from 3:00 to 4:30 p.m. Eastern time. This will be Ticket to Work: Support on your Employment Journey. We encourage you to register online at the Choose Work website or you can contact the beneficiary support specialists at the Ticket to Work Help Line to register today. Thank you again for attending. This ends today's webinar.