How Ticket to Work Impacts Benefits

How Will Using a Ticket Affect Your Benefits?

People with disabilities who get benefits like Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Medi-Cal, and Medicare often worry that if they try to get a job, they’ll lose their benefits.

However, the Ticket to Work program was designed so that you don’t have to worry. While you are doing the Ticket program:

  • If you begin working, you will not automatically lose your disability benefits
  • You will not get a medical Continuing Disability Review CDR)
  • You can continue to get public health care benefits
  • You can easily return to benefits if you stop working

The Ticket program is one of several rules called "work incentives" that can help you keep your SSI, SSDI, Medicare, or Medi-Cal coverage while you transition to work. Here we are going to describe some of these work incentives.

Delay of Continuing Disability Reviews

Part of the adult definition of disability used by Social Security is that you have to be unable to work. Many people worry that if they try to get a job, Social Security will decide that they are able to work and will take away their benefits. One of the biggest advantages of the Ticket program is that as long as you are in it, Social Security will not decide you aren’t disabled.

That’s because Social Security won’t make you do a medical Continuing Disability Review (CDR) while you’re participating in the Ticket program.

Here’s how it works:

  • If you are on SSI or SSDI and not doing the Ticket program, Social Security will review your medical disability status on a regular basis to see if you still meet their medical eligibility rules for disability benefits. During these Continuing Disability Reviews, if they decide that you are not disabled according to the rules, you could lose your benefits.
  • If you are doing the Ticket to Work program, Social Security will stop your medical disability reviews for as long as you are working towards your employment goal. You can even get a job and start earning money and they still won’t review your disability status.

The great thing about the Ticket program is that it means that if you don’t get a job or if your job doesn’t go well, you won’t lose your eligibility for disability benefits such as SSI, SSDI, Medi-Cal coverage, or Medicare.

SSDI Work Incentives

SSDI’s work incentives function like a 3-stage process that begins when you get a job:

  1. The Trial Work Period lets you work and get benefits at the same time no matter how much money you make. This period continues until you’ve made more than the Trial Work Month limit in 9 different months during a 5-year period. The exact limit changes each year; in 2019, the limit is $880.
  2. When the Trial Work Period ends, the 3-year Extended Period of Eligibility (EPE) lets you work and get benefits for every month that you earn less than Substantial Gainful Activity (SGA) ($1,220 in 2019, $2,040 if you’re blind).
  3. For the first 5 years after your EPE ends, Expedited Reinstatement means that if your income drops below SGA, you can quickly get back on SSDI without having to completely re-apply.

These 3 incentives mean that you can get a job and see how it goes. If it goes well, you’ll be in a better financial situation than before. If it doesn’t go well, you will be able to get SSDI and be in the same situation as you were before you tried out working.

These 3 rules, combined with the fact that you will not have to do a Continuing Disability Review (CDR) while you’re in the Ticket program , mean that you can safely try out working without risking losing your SSDI benefits.

To learn more about SSDI, read DB101’s SSDI article.

SSI Work Incentives

Most people on SSI who go to work end up better off financially. Even though their SSI benefits may be less, their total income from SSI and wages will almost always be higher.

When you earn income, only part of the money you earn will be counted when SSI adjusts your monthly cash benefits. The SSI program does not count the first $65 you earn each month, and they only count about 50% of the rest. This means that a little less than half of your earnings will be counted when Social Security figures out your SSI payment.

Even if you earn enough money for your SSI benefits amount to drop down to zero, you’re not “out” of the SSI program. People who no longer get SSI cash benefits often can keep their health coverage through Medi-Cal thanks to rules like SSI 1619(b) and programs like the Working Disabled Program (WDP).

If you lose your job or your income drops for another reason, you can have your SSI benefits restarted easily thanks to the Expedited Reinstatement (EXR) rule, as long as it is within 5 years of the last time you got an SSI check.

There are also various other rules that can help you if you’re on SSI and get a job:

  • Social Security will recognize money you spend on some things you need for your job as “Impairment Related Work Expenses” (IRWEs) or “Blind Work Expenses” (BWEs). That means your SSI benefits will be less when you get a job.
  • Plans to Achieve Self-Support (PASS) let you save up money you make at your job. With a PASS, you can save more than the usual SSI asset limit ($2,000 if you’re single, $3,000 for couples). Any money you save in a PASS also won’t be counted by Social Security as income, so your SSI benefits won’t be lowered.
  • The Student Earned Income Exclusion (SEIE) lets students under the age of 22 make more money without having their SSI benefits lowered.

These rules, combined with the fact that you will not have to do a Continuing Disability Review (CDR) while you’re in the Ticket program, mean that you can safely try out working without risking losing your benefits if you need them.

To learn more about SSI, read DB101’s SSI article.

Health Care

Medicare

If you’re on SSDI and Medicare, you will keep getting Medicare while you complete the full 9 months of your Trial Work Period (TWP). Assuming you still have a medical disability after your Trial Work Period ends, you then get at least 93 additional months (almost 8 years) of free Medicare Part A coverage. Since the Ticket program means you won’t have to do a Continuing Disability Review, you won’t lose your medical disability status and will be able to keep Medicare coverage that entire time.

When you can no longer get free Medicare Part A, you can choose to pay to keep getting it until you reach age 65, as long as you continue to meet the Social Security medical rules for disability.

To learn more about Medicare, read DB101’s Medicare article.

Medi-Cal

If you’ve been on Supplemental Security Income (SSI) and Medi-Cal and you work your way off SSI, you may become eligible for SSI's 1619(b) provision.

1619(b) means that if your monthly SSI cash benefits ends because your wages are too high, you can still get your Medi-Cal health coverage as long as you don’t earn more than $37,706 ($39,062 if you’re blind).

In order to get Medi-Cal coverage through 1619(b), your assets must also remain below SSI’s asset limit, which is $2,000 for an individual or $3,000 for a couple.

To learn more about Medi-Cal, read DB101’s Medi-Cal article.

Working Disabled Program (WDP)

If you don’t qualify for 1619(b), you may be able to qualify for the Working Disabled Program (WDP).

To qualify, you must be:

  • A California resident
  • Age 16 to 64
  • Certified disabled by Social Security
  • Employed and making less than 250% of the Federal Poverty Level ($2,602 per month for individuals, $3,523 for couples)

People in the program pay a monthly premium for their coverage. The premium is based on their income and household size. The maximum monthly premium is $250.

To see if you might qualify for the WDP program and what your estimated premium would be, use the DB101 Medi-Cal for the Working Disabled Calculator. For more details on the program, read DB101’s comparison of different Medi-Cal programs.