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Wisconsin Disability Benefits Network Newsletter For Your Benefits

Vol. 6, Issue 25, April, 2008

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For Your Benefit – Introduction

The Wisconsin Disability Benefits Network (WDBN) is a statewide system that provides direct assistance to benefits counseling practitioners and seeks ways to reach out to and better serve people with disabilities, their supporters, and professional service providers in Wisconsin. This newsletter provides current program news, important notices and updates, and upcoming training and educational opportunities. Check out past editions of this newsletter!

2008 WDBN Calendar:

• May 13 - 15, 20 - 22, and 28 - 29 WDBN Benefits Specialist Initial Training. REGISTER for this training.
• June 10th HEC Quarterly Meeting in Wisconsin Dells. RSVP your attendance to Stephanie Drum.
• June 11th WDBN Quarterly Meeting in Wisconsin Dells. REGISTER ONLINE | Download an agenda: WORD version | PDF version.
• Oct 13, 14, and 15 Benefits Specialist Conference (In collaboration with Annual ADRC conference)

What's New


MAPP/HEC Specialists Contact Information

Some of you may know that as part of the 2008-2012 WDBN project, the Health and Employment Counseling (HEC) Program has been in the process of being re-designed. The program will place more of an emphasis on outreach and education regarding the Medical Assistance Purchase Plan (MAPP) as well as provide consumer assistance regarding HEC enrollment and participation. Effective March 1, there will be MAPP/HEC Specialists (formerly called HEC Screeners) that will correspond to the DHFS Pathways Regions. Find more information about the MAPP / HEC Program or check out the revised contact information for the MAPP/HEC Specialists.

Quality, Referrals and SGA…DVR/WDBN Work Group Update

A work group of representatives from the Department of Workforce Development, Division of Vocational Rehabilitation (DVR) and Wisconsin Disability Benefits Network (WDBN) have been meeting recently to gain a mutual understanding of the issues surrounding the provision of benefits counseling services to DVR customers. The goal the work group is to develop ideas for assuring that the most effective and highest quality products are delivered and that more consistency exists in how services are acquired. During the first meeting held February 27 the following needs were identified:

• The need to clarify the intent of the service for DVR customers
• The need to build purchaser awareness regarding service quality and effectiveness
• The need to implement workable quality assurance measures for the product
• The need to develop consistency for benefits specialist service referrals

DVR has since developed new directives for the purchase of Work Incentives Benefits Specialist Services, stating that they will pay for a benefits analysis to assist consumers in their work efforts so they may go off cash benefits. If consumers wish to have a benefits analysis to determine how to continue benefits or who plan to use work incentives as long term employment supports, DVR staff will refer them to programs that provide that service at no cost to DVR.

In a recent letter to DVR, the WDBN made the request that we work together:

The WDBN/DVR Work Group met again on April 1 and a response from Charlene Dwyer, DVR administrator was shared regarding these requests. The response indicated:

  1. that it would be helpful to discuss with the WDBN appropriate methods of inquiry regarding consumer intent for their benefit income relative to their earned income;
  2. involvement of DVR staff in the benefits analysis process is strongly supported;
  3. DVR invited WDBN representatives to meet and discuss recommended methods for achieving referral consistency statewide and;
  4. DVR is willing to assist with the development of a quality indicator checklist for benefits analysis/reporting and also willing to implement a review process for DVR purchased benefits analysis products.

Many ideas were discussed at the April 1 meeting that included all of the above and the possibility for developing training for DVR management and counselors statewide during 2008. The Work Group will continue to meet and we will keep everyone updated as work progresses.

Wisconsin Benefits Specialists Credentialing & Quality Assurance Process

During the past few months, there has been much planning going on regarding the development of a credential for benefits specialists in Wisconsin. The Benefits Specialist Quality Assurance Task Force met several times so far in 2008. The group further developed the goal of having a professional credential and unified quality assurance system implemented for Wisconsin benefits specialists who serve seniors and people with disabilities by December of 2009. For more information, download a copy of the Project Summary (pdf).

Project Timeline:

National Association of Disability Benefit Specialists (NADBS)

The first edition of the National Association of Disability Benefit Specialists (NADBS), a Division of the National Rehabilitation Association (NRA), Newsletter is now available! Download a copy of the newsletter: WORD version | PDF version.

The mission of the NADBS Association is 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).

Get Your Red Books!

Now updated: 2008 Red Book. One of the Social Security Administration's (SSA) highest priorities is to support the efforts of disabled beneficiaries who want to work by developing policies and services to help them reach their employment goal. To that end, the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs include a number of employment support provisions commonly referred to as work incentives.

The Red Book is a general reference tool designed to provide a working knowledge of these provisions. The Red Book is written primarily for educators, advocates, rehabilitation professionals, and counselors who serve individuals with disabilities. We also expect that applicants and beneficiaries will use it as a self-help guide.

Benefits News Roundup

Benefits News Roundup

Disability Rights Wisconsin Update March 2008:

Disability Benefit Specialists...The following topics are covered in the Disability Rights Wisconsin (DRW) updates Medical listing revisions, phase-out of Family Care Non-MA eligibility, changes in Levels Of Care (LOC), and other updates and resources. Also check out the following resources.

Quick Disability Determination

The Social Security Administration (SSA) has implemented nationwide the Quick Disability Determination (QDD) process for initial disability claims. Under QDD the SSA expedites the processing of certain disability applications by using predictive computer models to identify disability claims where there is a high potential that the claimant is disabled and where evidence of the person's allegations can be quickly and easily obtained.

SSA will use this process for disability claims identified and selected by the computer system; no staff members are involved in the selection. The Supplemental Security Income (SSI) Presumptive Decision (PD) process and the Terminal Illness Case (TERI) process for disability applications are still in place and not affected by the QQD.

QDD has been tested in New England where 97 percent of the cases identified as QDD claims had disability decisions made within 21 days of application with the average decision time being 11 days. SSA is also planning to expand the number of cases that can be identified by the computer models.

SSA Benefit Debit Cards

The Social Security Administration (SSA) will soon make payments available to SSA beneficiaries via pre-paid debit cards. The purpose of the cards is to give SSA beneficiaries faster and safer access to their monthly payments.

The cards are targeted to the four million Social Security and Supplemental Security Income recipients who do not have bank accounts. Since debit card transactions are electronic, their use should help eliminate problems related to financial crimes, identity theft, and forged and stolen checks. In addition, the debit card should mean cost savings for those Social Security recipients who use check-cashing services to cash their benefits checks. The debit-card accounts are protected by PIN numbers and FDIC insured.

Each month a beneficiary's payment will be automatically loaded onto the beneficiary's card account from which he/she can retrieve benefits at ATM's and make purchases at retail locations or online.

Some cardholder fees may be charged for card use. Each cardholder will have one free ATM cash withdrawal per month but will pay 90 cents for each additional withdrawal. Like other debit-card holders, users may also face surcharges at certain ATM's. Other fees will include $3 for international ATM withdrawals, 3% on international currency exchanges, 50 cents for each online bill payment, and 75 cents per month for paper statements if requested.

SSA beneficiaries in four states (Texas, Oklahoma, Arkansas, and Louisiana) will be able to obtain the cards this spring with availability to the rest of the country expected by the end of the summer. In a limited pilot study in Illinois last year, 85% of the users said they were satisfied with the cards.

In April the Treasury Department plans to send mailings to encourage beneficiaries without bank accounts to sign up for the debit card and those with bank accounts to sign up for direct deposit of their checks to their accounts.

More information and details will be available from SSA before nationwide implementation.

Trial Work Period Issues

Social Security Disability Insurance (SSDI) beneficiaries normally have a nine (9) month Trial Work Period (TWP) in which they have the opportunity to try to work before any possible loss of benefits. During the TWP, the Social Security Administration (SSA) pays full benefits regardless of how high the beneficiary's work earnings may be, as long as the disabling impairment continues.

A month counts as one of the nine TWP service months when the work activity is valued at more than $670 in 2008 (the amount usually rises each year.) For self-employed people, work activity with monthly net earnings exceeding $670 or of more than 80 hours in a month (regardless of the actual earnings) counts as a TWP service month. The nine TWP service months do not have to be consecutive but must all be used within a rolling 60 month period.

Rolling 60 Month Period – Rolling means the period is not necessarily fixed and may change depending on how long it takes a beneficiary to accumulate the nine TWP service months.

The first month of the 60 month period is a beneficiary's first TWP service month. If at the end of the next 60 months the beneficiary has not used all nine months, that first service month is dropped from consideration, and the new first month of the rolling period becomes the month after that. As each month passes, the first month (whether or not it is a TWP service month) is dropped as one of the 60 as long as nine TWP service months have not been used.

For example: an SSDI beneficiary worked for the first time since receiving benefits January through August 2003 (using 8 TWP service months) and then stopped; the beneficiary has not worked since August, 2003. The 60 month rolling period starts with January, 2003 (first TWP service month) and ends with December, 2007 (60 months later.) As of January, 2008 that first TWP service month (January, 2003) is dropped and no longer counts toward the nine month limit; the first month of the rolling 60 month period becomes February, 2003, and the beneficiary has used only 7 TWP service months. If by August, 2008 the beneficiary has used no additional TWP service months, he/she would officially have used no TWP service months, and a new 60 month rolling period would begin his/her next TWP service month.

To determine how the rolling 60 month period is applicable to a beneficiary, count back 60 consecutive months from the beneficiary's most recent TWP service month; any TWP service month that fell before the 60 month period started is disregarded and does not count as one of the nine.

Service Month Exceptions – Even if a beneficiary's earnings are more than the $670, a month will not be counted as a TWP service month if the work activity is: 1) part of a prescribed program of medical therapy, or 2) carried out in a hospital under the supervision of medical and administrative staff, or 3) not performed in an employer-employee relationship, or 4) not normally performed for wages or gain. POMS DI 13010.050

Subsidies and IRWE – In looking at work earnings to decide what months count as being TWP service months (that is, ones with earnings above $670), SSA does not subtract subsidies or Income Related Work Expenses (IRWE) from a beneficiary's earnings. This is different from what SSA does in looking at a beneficiary's earnings once the TWP is over and deciding if the person is performing Substantial Gainful Activity (SGA) which is set at $940 per month in 2008. Once the TWP is completed, SSA will subtract from the work earnings the value of any help received or IRWE in deciding what counts for the SGA test.

Averaging – The averaging of earnings cannot apply to months in the TWP when determining countable service months for wages. However, earnings in the TWP months may be included in averaging when deciding whether or not a beneficiary's work is SGA at any time after the trial work period ends. Also SSA can average over an entire period of work, including months within, as well as after the trial work period. The example in POMS DI 10505.015D1b shows how SSA applies this rule.

Reconsiderations

The first step in appealing a Social Security Administration (SSA) decision is normally a reconsideration request, which is essentially a evidentiary case review conducted by an SSA employee other than anyone who was involved in the initial decision. The claimant has the right to representation, to present additional evidence to support the appeal, and to request SSA assistance in determining what evidence is needed and how to get the evidence.

For example, when a claimant asks for a reconsideration of a medical denial of an initial claim for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability, a disability examiner at Disability Determination Bureau (DDB) other than the one who made the initial decision conducts a review of the case including any new evidence submitted.

However, in certain situations instead of the normal reconsideration case review Social Security has a face-to-face disability hearing with a DDB Disability Hearing Officer (DHO) who specializes in handling in these reviews. In this hearing the claimant has the opportunity to review the evidence, introduce new evidence, and present his/her objections to the DHO. This type of reconsideration applies to the following categories of cases:

  1. DDB disability cessation of either a SSDI beneficiary or SSI recipient
  2. DDB disability denial of SSI for a youth at 18 who has been receiving SSI as a disabled child
  3. DDB disability denial of Childhood Disability Benefits (CDB) for a youth at 18 who has been receiving Title II survivor or auxiliary child benefits and had been found disabled at age 16 (for purposes of allowing spouse's benefits for the mother or father to continue past the child's 16th birthday) POMS DI 12026.001 | DI 29001.005

A child who has been receiving Title II survivor or auxiliary benefits, had no earlier disability decision, and is denied CDB benefits based on not being disabled at age 18 can request a reconsideration of the denial, but it would be the normal case review and not the face-to-face hearing type.

If a decision on either type of reconsideration request is still a denial, a claimant may next request a normal hearing with an Administrative Law Judge (ALJ.)

The new SSA appeal process which is part of the Disability Service Initiative announced in 2006 is being piloted in certain limited areas of the country and will come into use nationwide within the next three to four years. The new system will replace the current reconsideration step with a Federal Reviewing Official at DDB who will review disability determinations upon a claimant's request.

Rental Income for SSI

A payment that a Supplemental Security Income (SSI) recipient receives for the use of his or her real or personal property counts as rental income in computing the recipient's monthly payment. SSA uses the net rental income which is the gross rent less any ordinary and necessary expenses paid in the same taxable year. The kinds of property that are often rented are land, housing, and machinery; for example, income from renting a garage would be rental income.

Net rental income is usually unearned income and so counts dollar for dollar against the SSI payment (after any monthly $20 general income exclusion if not already used.) However, SSA may treat rental income as earned (that is, self-employment) income if the SSI recipient is in the business of renting properties. For an activity to be considered a business, a recipient would have to be showing a good faith intention of making a profit, engaging in the activity on a regular basis, and presenting him/herself to others as being engaged in the selling of goods or services.

If SSA decides that rental income is earned income, the more advantageous monthly exclusion of $65 plus one-half the remainder would apply. POMS SI 00830.505



Training and Educational Opportunities:


Understanding The Ticket to Work

Please join Bob Monahan, Wisconsin's SSA's Area Work Incentives Coordinator, as he presents the following topics related to The Ticket to Work:

Event Details:

What: Ticket to Work Presentation
When: Thursday April 17th, 2008
Time: 1:00 p.m. until 4:00 p.m.
Where: Goodwill Industries of Southeastern Wisconsin
6055 N. 91st Street
Milwaukee, WI 53225
More Information: Download a copy of the event form: WORD version | PDF version.

Please RSVP by phone or e-mail by Wednesday April 9th.

Jennifer King – (414) 353-6400 ext: 144
TTY: (414) 353-6860
E-Mail: jennifer.king@goodwillsew.com
Should you require accommodations please let Jennifer know.

Light refreshments including coffee and soda will be provided.


National ADA Symposium and Expo

Date: May 12–14, 2008
Place: St. Louis, MO

The Early Bird registration to attend the National ADA Symposium ends after April 15th! If you wish to take advantage of the $75.00 savings, register by the end of April 15th. After the 15th, the registration fee will be $475.00.

For more information check out the website at: http://www.adasymposium.org

The National ADA Symposium is the most comprehensive conference available on the Americans with Disabilities Act and related disability laws. This premiere event offers a session schedule offering a wide range of topics. You can customize your schedule to meet your individual needs and interests.

Presenters at this conference are key representatives from agencies involved with the ADA and those agencies include: U.S. Dept. of Justice, EEOC, U.S. Access Board, U.S. Dept. of Labor and the U.S. Dept. of Education.

Ongoing Training:

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