Frequent Pitfalls

Most of us usually rely on other people’s experiences to understand how to deal with our own situations. The problem with this is that disability and government benefits are person-centered. Benefits programs fit each person differently, based on a variety of facts and conditions, such as:

• Your work history
• How much you earn
• What you own
• What your disability is and the extent of your impairment
• How clearly you report the details of your condition to your medical provider
• How well your medical provider understands or documents these details
• What benefits an employer provides, and
• What benefits you have purchased individually.

Many people do not clearly discuss their plans to apply for benefits with their medical provider(s). Ideally, you and your medical provider should share complete information to figure out how long your disabling condition may last. If this step is not included, you may end up with a Medi-Cal (or other benefits program) application that does not support your claim. This could be because the information you provided does not clearly reflect how long the disabling condition may last or how it affects your day to day activities.

If you are enrolled in Medi-Cal's IHSS program, you need to continue to meet income and resource requirements. Working additional hours, because you are able to transfer IHSS hours to the workplace, may put you above income or resource requirements. If this occurs, you may want to consider the Working Disabled Program (WDP), which allows you to earn up to $76,320 annually and keep getting Medi-Cal and IHSS. If you enroll in WDP, you will not have to pay a share of cost for your IHSS.

You should always consider the value of In-Home Supportive Services (IHSS) when your income goes up, because providers can cost tens of thousands of dollars per year if you have to pay on your own.

One great way to keep getting your IHSS benefits is through Medi-Cal's Working Disabled Program (WDP). For WDP, your countable income must be at or below 250% of the Federal Poverty Guidelines (FPG). Depending on your situation, the way income is counted means that you could earn as much as $76,320 per year and still qualify for WDP and IHSS.

But if your countable income goes over that limit, you will lose IHSS and have to pay your care providers with your own money, and your extra money might not make up for your extra expenses. DB101's Medi-Cal for the Working Disabled Estimator is a good way for you to see how much countable income you might have if you earn more at work and can help you see if you will still qualify for Medi-Cal or WDP.