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Wisconsin Disability Benefits Network Newsletter For Your Benefits

Vol. 5, Issue 19, June 2007

Introduction

For Your Benefit is sporting a new look – We hope you approve! Our aim is to provide the best information, news, and professional forum to benefits specialists and others who have an interest in understanding and promoting benefits counseling services. Current and accurate information is critical when it comes to helping others access and maintain needed benefits, learn about the use of work incentives, or weigh options when considering work. Future issues may be shorter but come more often, as we strive to keep readers up to date. Please share this newsletter with others and send us your feedback – and perhaps a tip, story or article to include in the next issue. Contact Theresa Kulow at kulow@eri-wi.org with your comments or suggestions.

Small steps, united effort toward quality assurance – We are pleased to say that a grass roots task force has been formed to work on developing a credentialing system for the overall profession of benefits counseling in Wisconsin. A group of Work Incentive Benefits Specialists (WIBS), Elderly Benefits Specialists (EBS) and Disability Benefits Specialists (DBS) have formed the Benefits Specialist Quality Assurance Task Force. The group's first step was to develop a summary paper that states a goal, lists ideas for moving forward, and asks for feedback to determine the level to which benefits specialists actually want credentialing to happen. Let us know your thoughts – complete the survey and we'll be sure to keep you posted as to the progress of the Task Force.

Tammy Liddicoat, ERI Executive Director

What's New


Assuring Quality in Wisconsin Benefits Counseling

Recently, a Wisconsin Benefits Specialist Quality Assurance Task Force was created to prepare for a structured statewide system and/or body that will facilitate credentialing of Wisconsin Benefits Specialists to include testing for the award of credentials, monitoring of continuing education requirements and enforcement of provisions.

Reasons:

Summary of activities and request for support for the profession of benefits counseling EBS - Elderly Benefit Specialists • DBS - Disability Benefit Specialists • WIBS Work Incentive Benefit Specialists

Through the Wisconsin Disability Benefits Network (WDBN), this task force has been assembled to work through the steps and make recommendations toward the development of a system to assure quality for the overall profession of benefits counseling. The task force is comprised primarily of benefits counselors representing the three categories of Wisconsin benefits specialists: Work Incentives, Elderly, and Disability Benefits Specialists.

Proposed Work Plan:

  1. Outline a core base of knowledge required that addresses the commonalities that exist in DBS, EBS, and WIBS. First develop a list of common competencies; later develop sub-specialty areas.
  2. Acquire funding sources and partnerships to focus on implementation of common training concepts and requirements for credentialing.
  3. Assemble a board of peers responsible for various tasks.
  4. Develop testing materials, continuing education requirements, and monitoring procedures.

Support is key:

While this information generalizes the initial work and goals necessary for developing a credentialing system, gaining the overall support of those working within the profession of benefits counseling is key. Candidates for credentialing must see a benefit to this effort and be willing to support it.

Tell Us What You Think! Link to short survey.Tell us what YOU think...take our short credentialing survey.

ABSTRACT developed by: Tammy Liddicoat, WDBN; Renee Burkel, DBS; Candace Corbett, EBS; Karin Zuleger, WIBS

Now Open for Your Membership:


National Association of Benefits and Work Incentives Specialists

The National Association of Benefits and Work Incentives Specialists is now accepting applications for membership. The goal of the organization is to serve as a medium for deliberation, exchange of ideas, knowledge, skills and experiences, and for compilation and dissemination of information.

NABWIS members will include individuals, governmental agencies and non-governmental organizations, including voluntary and private organizations, public and private not-for-profit rehabilitation providers, disability advocacy organizations, consumer organizations, self-help groups and individuals. Categories of membership are:

Membership Levels:

Find out more at http://www.nabwis.org.

National Association of Disability Specialists (NADBS)

The National Association of Disability Specialists (NADBS) is a Division of the National Rehabilitation Association (NRA).

Our MISSION: To increase public understanding of the social and economic gain to individuals and communities through empowerment of persons with disabilities to become self-sufficient, self-supporting, and contributing members of the community. NADBS will also:

Approved by the NRA Board in November 2006, the NADBS is now accepting members!

Professional Membership is $30 (requires NRA membership)
Student Membership is $15 (requires NRA membership)

For more information about this exciting new Division, contact the NRA office at 888-258-4295 or download a copy of the National Association of Disability Specialists Membership Flyer (pdf).

Benefits News Roundup


SeniorCare Continues

Are you wondering about SeniorCare? When it was originally decided that SeniorCare would not be continued, the State of Wisconsin developed an alternative program called WisconsinCare. Instead, a provision to keep the SeniorCare program running until December of 2009 was approved last month. At this time, it does not appear that WisconsinCare will take effect.

Blind Diagnosis after Entitlement to Disability

A person who is receiving Supplemental Security Income (SSI) disability or Social Security Disability Insurance (SSDI) based on a diagnosis of a medical condition other than blindness may become blind. In such cases, it is usually in that beneficiary's best interest to request that the Social Security Administration (SSA) make a revised determination for a diagnosis of statutory blindness. To do this a beneficiary or someone on his/her behalf should make a written request to SSA for a reopening and revision and then submit the appropriate medical related information for the state Disability Determination Bureau (DDB) to make the medical determination.

The SSA statutory definition of blindness is either: 1) central visual acuity of 20/200 or less in the better eye with the use of a correcting lens, or 2) a limitation in the field of vision so that the widest diameter of the visual field is an angle of 20 degrees or less (tunnel vision).

The advantages of having a diagnosis of blindness for a beneficiary include a higher Substantial Gainful Activity amount, special blind work expenses under SSI, and other special provisions.

Ask Ben Speck: Debonair Benefits Specialist About Town

Ask Ben Speck: Debonair Benefits Specialist About Town.

Dear Ben,

I am a single woman receiving Supplemental Security Income (SSI) disability payments (federal and the state supplement), working earning $1,000 per month, and turning 62 soon.

I am divorced but was married for 15 years to a man who is now receiving regular Social Security retirement benefits. The people at Social Security say that although I haven't worked enough to get regular Social Security retirement on my own record at 62, I will be entitled to benefits of around $350 every month from my ex's record - how can that be since we're divorced? And do I have to file for them? I'm afraid that if I start getting the SSA benefits, those along with my work earnings will make me lose my Medicaid, which I need.

Rita

Dear Rita,

You will be entitled to retirement benefits on your ex-spouse's record because you were married to him at least 10 years, will be age 62, and are unmarried. And you do have to file for these benefits because under the SSI program, a recipient must apply for all other available benefits.

Your SSI payments (both federal and state) will stop because your work earnings of $1,000 per month plus a regular Social Security benefit of $350 per month will exceed the income limit for SSI. However, you can still be eligible for Medicaid under the 1619(b) provision for SSI: disabled or blind SSI recipients whose earned income make them ineligible for payment can continue to receive Medicaid. For 1619(b), you also must still be disabled and otherwise eligible for SSI (like be under the $2,000 resource limit), and you must meet the Medicaid Use Test (you depend on Medicaid) and the Threshold Test (your total earned income is below a $31,323 in 2007.)

So, in your case, even though your SSI payments stop, your total income will be higher and you'll still get Medicaid.

Ben

Stymied by 1619-b? Befuddled by Blind Work Incentives? Ben Speck, Debonair Benefits Specialist About Town, is here for you. He can be reached at benbow@eri-wi.org. Not all questions submitted can be personally answered. Opinions expressed by Mr. Speck are not necessarily those of ERI, the editors, or our underwriters.

Emergency Advance & Immediate Payments from SSA

Local Social Security Administration (SSA) field offices can make special direct payments to beneficiaries in certain situations.

Under the Supplemental Security Income (SSI) program, SSA can make Emergency Advance Payments (EAPs) and Immediate Payments (IPs) directly to recipients who are due payment and have a financial emergency. The local SSA office writes out a paper check to the person. Direct Field Office Payments (POMS SI 02004.000)

Both the EAP and IP are advances against future SSI payments which SSA will recover; they are not additional money for the SSI recipient. Normally the recipient’s next regular check will be reduced accordingly.

The EAP is for initial claim situations only: the person must be eligible for SSI, have a financial emergency, and have received no SSI payment yet. Normally the maximum amount is the Federal Benefit Rate (FBR) which is $623 in 2007. SSA personnel have some discretion in making emergency payments. Emergency Advance Payments (POMS SI 02004.005)

The IP is usually for post-eligibility situations: the person must be eligible for SSI and have a financial emergency, and a regular SSI payment is delayed, interrupted, or not received. The maximum amount payable is the total amount of payments due or $999, whichever is less. This usually occurs in check non-receipt situations. Immediate Payments (POMS SI 02004.100)

The SSA has limits on the number of these payments: only one EAP may be made, and just one IP may be made every 30 days regardless of the amount paid.

Under the Title II programs (including SSDI payments), SSA has a Critical Payment System (CPS) that they use to make immediate payments to a beneficiary via third party paper draft. The beneficiary must be entitled, not have received a due payment, have a terminal illness or some other urgent need, and an immediate financial need for payment (i.e., a need for food, shelter, medical treatment, etc.) that cannot reasonably be met through other resources available in the community. Immediate Payment Criteria and Process (POMS RS 02801.010)

SSA Grandchild Benefits

Note that a child could become entitled on a grandparent’s record by other means. For instance, if a grandparent actually adopted the grandchild, the grandchild could qualify as an adopted child on the grandparent’s record.

It is possible for a child to receive Social Security auxiliary or survivor benefits on the record of a grandparent, however, the qualifying rules are more extensive than for regular child benefits.

To qualify, the grandchild's natural or adoptive parents must be deceased or disabled at the time the grandparent became entitled to retirement or disability insurance benefits or died insured. In addition, the grandchild must be dependent on the grandparent - which means living with the grandparent before the grandchild became 18 years old and receiving at least one-half support from the grandparent for the year before the month the grandparent became entitled to retirement or disability benefits or died.

Note that a child could become entitled on a grandparent's record by other means. For instance, if a grandparent actually adopted the grandchild, the grandchild could qualify as an adopted child on the grandparent's record. More information: Grandparent Entitlement Requirements (POMS GN 00306.235).

Family Care

The Wisconsin Family Care initiative is a new statewide plan for helping people with disabilities and people with the frailties of aging who need assistance with daily living activities and caring for their health. The care integrates a variety of existing programs and services into one flexible long-term care benefit tailored to each individual’s needs, circumstances, and preferences. The services include personal care, housekeeping, and nursing, and are provided in homes, residential care facilities, group homes, nursing facilities, and the workplace. Enrollees in Family Care become members of a care management organization (CMO) which manages and delivers the Family Care benefit. The new program is being piloted in several counties and will eventually be implemented statewide.

The intent of the new program is to eliminate the current waiting lists for community-based long-term care programs, give people better "consumer centered" choices about the services and supports available to meet their needs, improve access to services, raise the overall quality of the long-term care system by focusing on achieving people's health and social outcomes, and create a cost-effective long-term care system for the future.

Aging and Disability Resource Centers (ADRCs) are at the center of the new system. The ADRC serves as the public’s port of entry to the system, a service center that provides the public with accurate, unbiased information on all aspects of life related to aging or living with a disability. Individuals, their families or friends, or professionals can receive information specifically tailored to each person's situation. Services are provided at the center itself, via telephone, or through a home visit, whichever is more convenient to the individual seeking help. More Family Care information at http://dhfs.wisconsin.gov/LTCare/

Cobra Reminder

Under COBRA, a person can extend his/her group health coverage plan beyond the normal 18 months limitation if he/she is allowed for Social Security Disability Insurance (SSDI) by the Social Security Administration (SSA).

The extension can be up to 11 months, which in most cases will be long enough to provide medical coverage until the beneficiary is entitled to Medicare.

To get such an extension, the beneficiary must notify the group health coverage plan within 60 days of SSA’s disability determination and prior to the expiration of the initial 18 months of continuation.

Parent Eligibility for BadgerCare

One qualification for a parent to be eligible for BadgerCare is that the child receiving BadgerCare must be living with that parent. However, a parent may be eligible for coverage even when the child is not exclusively living with that parent.

Normally a child is under the care of the relative who is living with and has legal custody of the child. When the natural or adoptive parents of a child do not live together and have joint custody, either parent can apply for BadgerCare, but only one at a time can be eligible. The servicing agency has to identify who is the court designated primary caretaker of the child. If neither parent is so designated, the parents can decide which of them will apply. Otherwise the agency worker has to identify who is the primary caretaker based on the parents' activities and responsibilities in relation to the child. For more information go to Medicaid Eligibility Handbook 3.5.3.2 and 5.7.3.2

Period of Disability and Later Benefits

For those Social Security Disability Insurance Beneficiaries (DIB) who work their way off benefits or who are no longer determined to be disabled, the period during which the person received DIB can be excluded from the computation of his or her later retirement, disability, or survivor benefits.

Normally, excluding a period of disability from a Social Security Title II benefit computation results in a higher benefit because years when the worker was unable to work are not used to determine the worker's average earnings. The excludable period includes the five-month waiting period and any months of entitlement to Disability Insurance Benefits (DIB). Any periods where a person is disabled only for auxiliary or survivor benefits are not considered part of a period of disability.

In determining Social Security credits (Quarters of Coverage or QCs) needed for insured status for later benefits, SSA excludes months in a period of disability unless the person needs credits earned within that period to establish entitlement to later benefits. More Information: Effects of a Period of Disability (POMS RS 00605.215)

Garnishment

Garnishment is the collection of a specified sum of money from a beneficiary's Social Security benefits to satisfy a debt. Although such direct collection is not allowed in most debt situations, the Social Security Act does allow garnishment from Title II benefits (which includes SSDI) in order to collect unpaid child support and/or alimony.

Supplemental Security Income (SSI) payments are not subject to garnishment.

Although the effect is the same, garnishment is different from the requirement that federal agencies such as the SSA offset benefit payments to collect delinquent non-tax debts owed to the federal government (such as outstanding student loans) under the Benefit Payment Offset (BPO) system. More Information: Garnishment (POMS GN 02410.200)

Training and Educational Opportunities:

Augmentative and Alternative Communication – Enhancing Independence and Employment

There will be a full day training entitled "Augmentative and Alternative Communication – Enhancing Independence and Employment" presented August 2 in Stevens Point and August 16 in Waukesha. This program is FREE of charge and is funded by the Medicaid Infrastructure Grant.

Complete information, registration, agenda and conference brochure is available at the UW Stevens Point Continuing Education website (www.uwsp.edu/conted/conferences/aac/) or download a copy of the Enhancing Independence and Employment brochure (pdf)

The program is available for credit, and is approved for Continuing Education by the American Speech-Language-Hearing Association (ASHA). CEUs can be applied to RESNA for ATP Credit. Application is also being made for CRC credit.

Contact with Questions:
Ralph Pelkey
Assistive Technology Specialist
Division of Disability and Elder Services
1 West Wilson Street, Room 1151
PO Box 7851
Madison, WI 53707-7851
pelkerj@dhfs.state.wi.us
(608) 267-9091

Contact Us:

Name Job Title Extension Email
Benbow, John Researcher/Curriculum Developer 247 benbow@eri-wi.org
Fowler, Megan CWIC Benefits Specialist
HEC Regional Screener		 230
Toll Free WIPA line
(877) 242-1357
Toll Free HEC line
(800) 391-2950 		fowler@eri-wi.org
Fuller, John Director of Employment & Benefits Counseling Services 223 fuller@eri-wi.org
Goodman, Phil Assistive Technology Consultant 234 goodman@eri-wi.org
Hurst, Maria Office Manager 0 hurst@eri-wi.org
Kulow, Theresa Marketing & Communications Director 224 kulow@eri.org
Larson, Meredith Benefits Specialist 227 larson@eri-wi.org
Liddicoat, Tammy Executive Director 222 liddicoat@eri-wi.org
Line, Stephanie Learning Services Program Lead 229 drum@eri-wi.org
Schramm, Randy Financial Manager 237 schramm@eri-wi.org
Wanek, Jolene Benefits Counseling Project Lead
HEC Regional Screener 		231
(toll free #) (877) 826-1752
wanek@eri-wi.org


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