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LARRY'S STORY
Larry receives a
monthly Social
Security Disability
Insurance (SSDI)
check. He began
receiving this check
about five years ago
when he was
diagnosed with a
severe mental
illness. After
receiving SSDI for
24 months, he became
eligible for
Medicare (this is a
health insurance
available to Social
Security
beneficiaries). He
also applied for
Medicaid and was
approved because of
his disability. With
his Medicaid, he
paid a monthly
spend-down each
month. Through a
spend-down he
had to pay for some
of his medical
expenses each month,
and then Medicaid
would pay the rest.
At times, it was
hard for Larry to
meet the spend-down
and keep up with his
other bills.
Larry tried to work
several times, but
had difficulty
keeping a job for
more than two to
three months at a
time because of his
disability. Even
though he was not
able to keep his
jobs, he was using
one important work
incentive timeframe
associated with his
Social Security
Disability Insurance
(SSDI) check. This
work incentive is
called the Trial
Work Period.
While he was working
at previous jobs, he
used all nine months
of his Trial Work
Period. Larry
received a letter
from the
Social Security
Administration
to let him know he
had used his Trial
Work Period, and was
entering into
another work
incentive timeframe
called the 36-month
Extended Period
of Eligibility.
After reading the
letter, he was
confused. It was
difficult to
understand what
these work incentive
timelines meant. He
thought he was being
cut off of his
Social Security
Disability Insurance
benefits all
together. Because of
this, he was
wondered if he
should try to work.
In the summer of
2007, Larry did
begin looking for
work again. He saw a
Help Wanted sign at
a factory not far
from his home, so he
stopped in and
filled out an
application. He was
thrilled when he was
hired to work.
Today, Larry works
on the first shift,
at least 40 hours
per week. His gross
monthly earnings are
over $1,500 which is
above
Substantial
Gainful Activity (SGA).
He is still in his
36 month Extended
Period of
Eligibility
timeframe. If Larry
earns more than SGA
in any months during
the Extended Period
of Eligibility, he
is not entitled to
his SSDI check for
that month. If his
gross monthly
earnings are less
than SGA he is
eligible for his
benefit check for
that month. The
Extended Period of
Eligibility provides
Larry with a safety
net in trying to
work full-time
without totally
losing eligibility
for his benefits.
Larry talked to his
Social Security
Claims
Representative and
an
Indiana Works
Community Work
Incentives
Coordinator
to help him
understand the
Extended Period of
Eligibility and what
will happen to his
benefits check. They
informed him about
another work
incentive available
to him during the
Extended Period of
Eligibility called
Impairment-Related
Work Expenses (IRWE).
With an IRWE, he can
deduct the costs of
certain work related
expenses from the
amount that he
earns, and it will
keep his earnings
counted by Social
Security under SGA.
Larry, his Indiana
Works Community Work
Incentives
Coordinator and the
Social Security
Claims
Representative were
able to identify
IRWE expenses that
he had. Because his
doctor told him he
must refrain from
driving due to his
disability, and
because there was no
other public
transportation that
he could access, he
needed to hire
someone to drive him
to and from work.
Paying for a driver
to help him get to
and from work
qualified as an IRWE.
Through the IRWE
work incentive, he
was able to try to
work full-time, earn
more money, keep his
SSDI longer as he
tried to become
self-sufficient, and
stay healthy.
Because Larry also
had Medicaid, and
had a spend-down to
keep this Medicaid
coverage, he was
worried about what
his work income
would do to his
Medicaid. When he
called his
Division of Family
Resource
caseworker to let
her know that he had
started the job at
the factory, he
dreaded finding out
how much his
spend-down would
increase. But, his
Medicaid caseworker
had good news for
him. He was eligible
for a Medicaid
program for working
employees with
disabilities, called
MED Works.
With MED Works,
monthly premiums
take the place of a
spend-down. Larry
now pays a monthly
premium for his
Medicaid health
insurance that is
much less than the
spend-down. He not
only has his
earnings from his
job, he also has
more money because
he doesn’t have to
worry about paying
for some of his
medical expenses out
of his own pocket
each month to meet
the spend-down.
Larry enjoys his job
and the
self-sufficiency of
earning an income
that offers him and
his family a higher
standard of living.
Because of work, he
is feeling better
too. Over time Larry
hopes to save enough
money to buy a car,
and when his doctor
releases him from
driving
restrictions, he
hopes to drive
himself to work. He
is proud of his
efforts at his job,
and proud that he
has been able to
keep his job for so
long. With the help
of Social Security
work incentives
and
MED Works,
he says; “I am well
enough to work and I
want to work.
Getting a paycheck
every week makes me
feel really good.”
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The Disability Benefits and Work website was
funded by the Medicaid Infrastructure Grant (CFDA # 93.768)
This site is intended for informational purposes only.
Individual situations vary widely and must be evaluated on
an individual basis by Division of Family Resources
eligibility caseworkers, or Social Security Claims
Representatives and/or Indiana Works-Community Works
Incentive Coordinators. Links from this site are provided to
help people research various topics and do not constitute
endorsements by the State of Indiana or its partners. |