By Kevin Nickerson, Co-Director, American Dream Employment Network
For individuals receiving Supplemental Security Income (SSI) or Social Security 
Disability Insurance (SSDI), returning to work, or exploring the world of work for the first time, can be confusing, especially when trying to determine how earned income will impact cash benefits.
This blog will address some of the most frequently asked questions about Social Security benefits, work and Medicaid, and how they can help beneficiaries on the road to financial stability.
Supplemental Security Income
SSI is a program administered by the Social Security Administration (SSA) for individuals with a disability or aged or blind individuals who are experiencing a financial need. SSI can provide a minimum level of income and health care coverage through Medicaid. Once eligible, an individual can work and continue to receive SSI.
In fact, there are Work Incentives in place to provide for a successful and equitable transition back to work. In general, these incentives allow for a reduction of the amount of earnings SSA looks at when calculating benefits each month. To learn more about the Work Incentives available for SSI and SSDI beneficiaries, please review the Social Security Red Book – A Guide to Work Incentives.
What about my Medicaid benefits?
One of the biggest fears faced by beneficiaries is the thought of losing medical coverage if they work.
Section 1619(b) of the Social Security Act protects Medicaid when SSI recipients return to work. Based on this SSA policy, even after an SSI recipient exceeds the break-even point due to earnings (no longer eligible for any cash benefits), Medicaid coverage can be retained up to state-specific income thresholds.
While thresholds vary, in most states, an individual who is in a non-pay benefits status due to earned income can remain eligible for Medicaid with income up to $30,000-$40,000/year in most states. Some states have a threshold as high as $82,000/year! Additionally, for SSI beneficiaries who work, Social Security only counts $1.00 for every $2.00 earned when calculating monthly checks.
In short, SSI Work Incentives allow beneficiaries to remain connected to health care while earning a monthly income. To examine state threshold amounts, visit the Social Security Administration’s Continued Medicaid Eligibility webpage.
Social Security Disability Insurance
SSI and Social Security Disability Insurance are similar, but eligibility requirements differ. Both require beneficiaries to have a significant qualifying disability. The primary difference between the two benefit programs is that SSDI is an entitlement that is earned by paying Federal Insurance Contributions Act (FICA) taxes.
For SSDI eligibility, an individual must have “insured status as a former worker.” Insured status is based on working and paying FICA taxes long enough to have the appropriate number of “quarters of coverage.” SSA will generally look at earnings during the last 10 years to determine this.
The Work Incentives available to individuals receiving SSDI benefits are also different than for those receiving SSI. A total of nine Trial Work Period (TWP) months are available to SSDI beneficiaries who choose to work, during which time any amount of money can be earned while health insurance and benefit checks continue. After the TWP is completed, a 36-month Extended Period of Eligibility (EPE) is available. The EPE begins after the conclusion of the ninth TWP month. During this EPE, payment of cash benefits is based on amount of earnings and whether earnings are over the “Substantial Gainful Activity (SGA)” level.
In 2022, the SGA level for most SSDI beneficiaries is $1,350/month in “countable wages.” For months where earnings are more than the SGA level, cash benefits may not be paid. However, if work ends for any reason during this period, benefits are paid again without the need for a new application. This gives beneficiaries plenty of opportunity and time to adjust to work again, and to evaluate whether long-term work, leading to self-sufficiency, is possible.
For SSDI beneficiaries, SSA has policies that also protect Medicare. In fact, SSDI beneficiaries can be assured that they will continue to receive Medicare for at least 93 months after the ninth TWP month has been used. These incentives allow beneficiaries to evaluate their ability to continue working long-term, while assuring much needed health care coverage is still in place.
To learn more about the Work Incentives available for SSI and SSDI beneficiaries, please review the Social Security Red Book – A Guide to Work Incentives.
The Ticket to Work program
The purpose of the Ticket to Work program is to assist beneficiaries who have a goal of returning to a self-sufficient lifestyle if they are able. The Ticket to Work program is free and voluntary for SSA beneficiaries.
If the information provided in this blog sounds like good news to you, and you’d like support getting back to work, there is an option for assistance through the American Dream Employment Network (ADEN). ADEN is an approved SSA Ticket to Work provider and National Employment Network with providers in more than 30 states, and growing. ADEN offers its participants guidance on SSA Work Incentives, as well as providing career counseling, job search assistance and long-term follow-up supports. To learn more about ADEN and the Ticket to Work program, visit: www.AmericanDreamEN.org.
This blog was written by Kevin Nickerson, Co-Director at the American Dream Employment Network
Kevin Nickerson is Co-Director of the American Dream Employment Network, a division of National Disability Institute (NDI). Kevin is a nationally recognized expert on the effective implementation of Employment Networks (EN) within the public workforce system, as well as within for-profit and non-profit organizations that serve individuals with disabilities. Kevin has over 20 years of experience helping SSA disability beneficiaries, is a certified community work incentive coordinator (CWIC), and has worked under SSA’s former Benefits Planning Assistance & Outreach (BPAO) project, as well as the Work Incentive Planning Assistance (WIPA) project. A graduate of Cortland State University, Kevin holds a Bachelor of Science Degree in Psychology.
