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A More Detailed Description of SSDI Benefits and Work

Substantial Gainful Activity (SGA)
• Is the performance of significant physical or mental activities in work for pay or profit
• SGA amounts are adjusted each year based on the national average wage
• For 2016, SGA level is set at $1,130/month

The First Step - The Trial Work Period

Have you worked in the past five years and earned over the TWP earnings level while receiving SSDI?
(TWP earnings level is set at $810/month in 2016, but varies for previous years.)

If NO
You can work for nine months within a 60 month period, earn any amount of money, and continue to receive your monthly check from SSDI! Any month in which you earn less than the TWP earnings level is not counted. TWP months do not have to be consecutive.

If YES
How many months did you earn more than the TWP earnings level? If you worked less than nine months, subtract the number of months you worked from nine. The result will be the remaining Trial Work months that you are still eligible to use.

If you want to begin a Trial Work Period tell your Social Security Administration representative, and he or she will review your case and help you to calculate the length of your Trial Work Period.

NOTE:
During the TWP, Impairment Related Work Expenses (IRWE) and subsidies CANNOT be deducted from gross earnings. After TWP, IRWE are deducted to determine SGA. For those who are self-employed and earn under $810/month, the number of hours worked in the business is used as one of the ways to determine if a month counts as a TWP month, usually 80 hrs./month.

The Second Step - Extended Period of Eligibility (EPE)

After the Trial Work Period you will enter the Extended Period of Eligibility (EPE). For at least 36 months, Medicare coverage continues and your monthly earnings level will determine whether you receive a benefit check. Social Security considers earning $1,130 a month as substantial gainful activity (SGA).

If you earn less than $1,130 a month:
• You will receive your full SSDI check
• Your Medicare coverage remains in effect
• If you are still disabled after the EPE, and continue to earn under $1,130 a month, your benefit check and Medicare coverage will continue

If you earn more than $1,130 a month:
• You will receive three more monthly checks, then your checks will stop
• Medicare continues for an additional 93 months after the TWP, as long as your disabling condition still meets SSA rules
• You don’t have to pay for Medicare Part A
• You do have to pay for Medicare Part B
• You can deduct disability related work expenses that might bring earnings below the $1,130 SGA


Impairment Related Work Expenses
Impairment Related Work Expenses (IRWEs) are items or services that are essential to you being able to work. These can be deducted from monthly earnings and if they reduce your income below $1,130, or SGA, you will continue to receive monthly SSDI cash benefits. IRWEs can be deducted only if you pay for the item or service yourself and you are not reimbursed by an agency. Some examples of deductible expenses are prescription drugs, deductibles and co payments not covered by Medicare, a wheelchair, etc. Check with your SSA representative for a complete list of IRWEs.

IRWEs can lower your countable income:
Gross Monthly Earned Income$1,150
Deduction for IRWE- 250
Adjusted Amount of Earned or Countable Income= $900
$900 is under the SGA of $1,130, so you would receive your check!

What If I Get Sick Again or Lose My Job? Expedited Reinstatement of Benefits.

If you are unable to work because of your medical condition, you would be able to request reinstatement of benefits. You must file the request for reinstatement with Social Security within 60 months from the month of their termination. While Social Security is making a new determination, you may receive up to six months of provisional benefits, including Medicare and Medicaid, as appropriate. If Social Security decides that the medical condition no longer prevents you from working, the provisional benefits would not be considered an overpayment.

Continuing Eligibility Review

Social Security reviews cases of people who receive SSDI to determine if they are still medically disabled or if they can perform SGA. It is important to keep accurate and up to date documentation of your disability, because if SSA determines you are no longer disabled, your SSDI benefits will stop. Benefits do not cease if you are in a vocational rehabilitation program or can prove that you are entitled to continue receiving SSDI.

Vocational Rehabilitation: The Ticket to Work and Work Incentives Act of 1999

This law establishes the Ticket to Work and Self sufficiency program. Social Security beneficiaries will receive a “Ticket” to obtain vocational rehabilitation (VR) or other support services from an approved provider. Those services are designed to provide you with training or other assistance you need to update your job skills, start a new line of work, or go to work for the first time. SSA does not provide those services but will pay for them when certain conditions are met. If you enter a vocational rehabilitation program, your monthly benefit check would continue until the end of the program. The Ticket program is voluntary. Once you begin using the Ticket, Social Security cannot initiate a continuing disability medical review.

Important Points about SSDI and Work:

• Report your earnings in writing to Social Security (sample letter link).
• For people who are self employed, Social Security looks at how many hours you've worked not just your earned income. Usually 80 hours/month of work is considered to be substantial gainful activity. This can also apply to volunteer time. Contact your Social Security representative to discuss your work plan.
• If you are attending school or a training program, any grants or scholarships that you use for tuition, books and supplies do not count toward your SGA level.

Further resources:

Social Security Administration
Phone: (800) 772 1213
www.ssa.gov

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