http://www.socialsecurity.gov/redbook/2010/ssdi-only-employment-supports.htm
This website has explained it plain and simple.... I hope this helps you too.
Trial Work Period (TWP) (SSDI eligible)
How does the TWP help you?
The TWP allows you to test your ability to work for at least 9 months. During your TWP, you will receive full SSDI benefits regardless of how high your earnings might be as long as your work activity has been reported and you have a disabling impairment.
When does the TWP start?
Your TWP starts the first month you are entitled to SSDI benefits or the month in which you file for benefits, whichever is later.
How long does
the TWP last?
The TWP continues until you accumulate 9 months (not necessarily consecutive) in which you perform what we call "services" within a rolling 60-month period. We use this "services" rule only to count TWP months.
In 2010, we consider your work to be "services" if your gross earnings are more than $720 a month, or if you work more than 80 hours in self-employment in a month.
What happens when you complete your TWP? After you complete your TWP, you begin your Extended Period of Eligibility (EPE), unless we conduct a continuing disability review and find your impairment has medically improved. After the TWP ends, we take into account your work and earnings to decide if you can work at the SGA level (see the section on SGA).
When your TWP is complete, you become eligible for other employment supports and we consider whether any of them apply to your situation.
What else do you need to know about the TWP?
* You are not eligible for disability benefits or a TWP if you work at the SGA level within 12 months of the start of your impairment(s) and before we approve your claim for disability benefits. This is because your impairment does not meet our definition of disability (see the section on How Do We Define Disability?).
* We can consider medical evidence that might demonstrate your medical recovery at any time. Therefore, it is possible for your benefits to stop due to your medical recovery before the end of your TWP.
* We will not conduct a continuing disability review if you are participating in the Ticket to Work program and you are using your ticket (see the section on Ticket to Work ).
* Unsuccessful Work Attempts (UWA) do not apply during the TWP (see the section on UWA).
* The dollar amount of TWP "services" can be adjusted each year based on the national average wage.
Does the TWP apply to SSI? No. A TWP does not apply to the SSI program.
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Extended Period of Eligibility (EPE) (SSDI eligible)
What is the EPE?
The EPE begins the month after the TWP ends, even if you are not working that month. The first 36 months of the EPE is the re-entitlement period. The EPE allows you to resume receiving benefits if you are not working during the re-entitlement period.
How does the EPE help you? During the 36 month re-entitlement period, benefits are paid for months your earnings (or work activities) are below the substantial gainful activity (SGA) level as long as you continue to have a disabling impairment. Benefits are suspended for months your earnings are over the SGA level. We will restart your benefits within the re-entitlement period if your earnings fall below the SGA level. A new application and/or disability determination is not required to start your benefits again. (This is a different rule than Expedited Reinstatement (EXR) that is described in a separate section on Expedited Reinstatement.)
What happens the first time you work above SGA?
If we find you worked above SGA in the EPE for the first time and are continuing to engage in SGA, we will pay for the first month your benefits stop due to SGA and the following 2 months. This is referred to as the grace period. If your earnings fall below SGA and are you are still in the 36-month re-entitlement period, we can reinstate your benefits without a new application.
Can you continue to receive benefits after the re-entitlement period ends?
If you are not working above SGA and are eligible for a benefit payment for the 37th month, you will continue to be eligible for benefits until you:
* Work a month at the SGA level, or
* Medically recover.
What happens if
you work after the re-entitlement period ends? Your benefits will end if you work above SGA after the 36-month re-entitlement period. However you may be able to start your benefits again if you stop work within the next 5 years (see the section on Expedited Reinstatement.)
Do you get an EPE under SSI? No. The EPE applies only to individuals who receive SSDI cash benefits
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Unincurred Business Expenses (Self-Employment) (SSDI eligible)
What are they?
"Unincurred Business Expenses" are contributions made by others to your self-employment business effort. For example, if the state VR agency gives you a computer for your business, or a friend works for your business as unpaid help, these are "unincurred business expenses".
SSA generally follows the Internal Revenue Service (IRS) rules to figure your net earnings from self-employment. The IRS only allows you to deduct expenses for which you actually paid or incurred debt. When we make an SGA decision, we also deduct unincurred business expenses from your net earnings because we want an accurate measure of the value of your work.
What qualifies as an unincurred business expense? For an item or service to qualify as an unincurred business expense:
* It must be an item or service that the IRS would allow as a legitimate business expense if you had paid for it; and
* Someone other than you must have paid for it.
Do they affect your SSI payments?
No. We do not deduct unincurred business expenses from earnings when we figure your SSI payment amount.
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Continuation of Medicare Coverage (SSDI eligible)
What is Continuation of Medicare Coverage?
Most persons with disabilities who work will continue to receive at least 93 consecutive months of Hospital (Part A); Supplemental Medical Insurance (Part B), if enrolled; and Prescription Drug coverage (Part D), if enrolled, after the 9-month Trial Work Period. You do not pay a premium for Part A. Although cash benefits may cease due to work, you have the assurance of continued health insurance. (93 months is 7 years and 9 months.)
When does this start? The 93 months start the month after the last month of your TWP.
How do you qualify? You must already have Medicare and be working at SGA, but not be medically improved.
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Medicare for Individuals with Disabilities Who Work
Can you buy Medicare coverage?
Yes. After premium-free Medicare coverage ends due to work, some persons who have returned to work may buy continued Medicare coverage, as long as they remain medically disabled. Some persons with low incomes and limited resources may be eligible for state assistance with these costs under various Medicare Savings Programs. Your state Health and Human Services agency makes the determination about whether you qualify for this help.
Who is eligible to buy Medicare coverage? You are eligible to buy Medicare coverage if:
* You are not yet age 65; and
* You continue to have a disabling impairment; and
* Your Medicare stopped due to work.
What kind of Medicare coverage can you buy?
Premium Hospital Insurance (Part A) is available at the same monthly cost that uninsured eligible retired beneficiaries pay. If you have less than 30 quarters of coverage, the premium is $461 in 2010. However, you may qualify for a reduction in this premium (see below).
Premium Supplemental Medical Insurance (Part B) is available at $110.50 per month; this is the same monthly cost that uninsured eligible retired beneficiaries pay in 2010.
You can buy Hospital Insurance separately without Supplemental Medical Insurance. You can buy Supplemental Medical Insurance only if you also buy Hospital Insurance. Premium Prescription Drug coverage (Part D) is also available.
Do you qualify for a reduction in your monthly Part A premium?
You may qualify for a 45% reduction in the monthly amount of your premium for Hospital Insurance (Part A). You qualify for the reduced premium of $254 in 2010 if you:
* Have 30 or more quarters of coverage on your earnings record; or
* Have been married for at least 1 year to a worker with 30 or more quarters of coverage; or
* Were married for at least 1 year to a deceased worker with 30 or more quarters of coverage; or
* Are divorced, after at least 10 years of marriage, from a worker who had 30 or more quarters of coverage at the time the divorce became final.
When can you enroll? You may enroll:
* During your initial enrollment period (the month you are notified about the end of your premium-free health insurance and the following 7 months); or
* During the annual general enrollment period (January 1 through March 31 of each year); or
* During a special enrollment period. You can enroll at any time while you are working, covered under an employer group health plan, still have a disabling impairment, or during the 8-month period that begins with the first full month after your employment or group health plan coverage ends, whichever occurs first.
For Prescription Drug coverage (Part D), you may enroll (or change plans) during the annual coordinated election period (November 15 through December 31 of each year).
How does it work with an employer's group health plan?
If you purchase Premium Hospital Insurance (Part A) and maintain your employer group health plan, Medicare will be your primary payer if you are working. Your group health plan would become a secondary payer.
When does the state pay premiums for Medicare? States are required to pay Hospital Insurance (Part A) premiums for some working individuals with disabilities. You qualify if you:
* Are eligible to enroll in Hospital Insurance for individuals with disabilities who work; and
* Meet certain income and resource standards; and
* Apply for assistance with your state Medicaid agency; and
* Are ineligible for Medicare on any other basis.
NOTE: Persons with disabilities who work should contact their state health and human services agency for information. ADDITIONAL HELP WITH HEALTH CARE FOR INDIVIDUALS WITH DISABILITIES, for more information about State help with Medicare Part A premiums.
