Employment and Disability: Glossary of Terms
(The following information is drawn from The Red Book from the Social Security Administration.)
Blind Work Expenses. If you are blind, the SSA does not count any earned income that you use to meet expenses in earning that income when it decides your SSI eligibility and payment amount.
Break-Even Point. The dollar amount of total income that will (after applicable deductions are applied) reduce the SSI payment to zero in a given set of case facts. Your break-even point depends on your earned and unearned income, living arrangements, applicable income exclusions, and state supplement, if any. (SSI)
Continuing Disability Review. The SSA’s process of obtaining complete current information about your condition to decide if your SSDI and/or SSI benefits should continue. (SSDI and SSI)
Continuation of Medicare Coverage. You can receive at least 93 consecutive months of hospital and supplemental medical insurance after the trial work period. This provision allows health insurance to continue when you go to work and are engaging in SGA. (SSDI)
Countable Income. The amount of money left after the SSA has subtracted all available deductions from your total income. We use this amount to decide your SSI eligibility and payment amounts. (SSI)
Countable Income Test. One of the tests the SSA may use to evaluate self-employment income if the individual has received SSDI benefits for 24 months. (SSDI)
Expedited Reinstatement. Qualified individuals may request reinstatement of benefits, within 5 years of benefits having stopped, without having to file a new application. Up to 6 months of provisional benefits are available while the SSA makes a decision on the request. (SSDI and SSI)
Extended Period of Eligibility. During the 36 consecutive months following the trial work period, if you qualify, the SSA may restart your SSDI benefits without a new application, disability determination, or waiting period. (SSDI)
Impairment-Related Work Expenses. The SSA deducts the cost of items and services that you need to work because of your impairment; for example, attendant care services and medical devices, when it decides if you are engaging in SGA. It does not matter if you also need the items for normal daily activities. The SSA can usually deduct the cost of these same items from earned income to figure your SSI payment. (SSDI and SSI)
Income. SSI income is:
• Earned income – money received from wages, including from a sheltered workshop or work activity center, self-employment earnings, and some royalties and honoraria; and
• Unearned income – money received from all other sources; for example, gifts, interest, Social Security, veteran’s benefits, and pensions. Unearned income also includes “in-kind income” (free food, clothing, or shelter) and “deemed income” (some of the income of a spouse, parent, or sponsor of an alien).
Medicaid. Medical coverage provided to a person by the state Title XIX program. Also known as MediCal in California, AHCCS in Arizona. (SSI)
Medicaid Protection for Individuals with Disabilities Who Work. A state may provide Medicaid coverage for individuals with disabilities who:
• have earnings that are too high to qualify under current rules;
• are at least 16, but less than 65 years of age; and
• meet state resource and income limits.
A state may also provide Medicaid coverage to these individuals when they lose coverage due to medical improvement, but still have a medically determinable severe impairment.
Medical Improvement Expected. When the SSA decides you have a disabling impairment, and it also decides that the disabling impairment(s) may improve; it documents that your case will need a future review. (SSDI and SSI)
Medicare. Two-part health insurance program for eligible disabled individuals and individuals age 65 or older:
- Hospital Insurance under Medicare (Part A); and
- Supplementary Medical Insurance under Medicare (Part B). (SSDI)
Medicare for Individuals with Disabilities Who Work. Some individuals with disabilities who have returned to work can buy continued Medicare coverage when their premium-free Medicare ends due to work activity. States are required to help pay the hospital insurance premiums for some working individuals with disabilities. (SSDI)
Plan to Achieve Self-Support (PASS). Under an approved PASS, you may set aside income and/or resources over a reasonable time period that will enable you to reach a work goal to become financially self-supporting. You then can use the income and resources that you set aside to obtain occupational training or education, purchase occupational equipment, establish a business, etc. The SSA does not count the income and resources that you set aside under a PASS when it decides SSI eligibility and payment amount. (SSI)
Property Essential to Self-Support. The SSA does not count some or all of certain property necessary for self-support when it applies the SSI resources test. (SSI)
Resources. Resources are anything you own; for example, a bank account, stocks, business assets, real property, or personal property thatt you can use for your support and maintenance. The SSA does not count all your resources when it decides your SSI eligibility. (SSI)
Substantial Gainful Activity (SGA). The SSA evaluates the work activity of individuals claiming or receiving disability benefits under SSDI, and/or claiming benefits because of a disability (other than blindness) under SSI. Under both programs, the SSA uses earnings guidelines to evaluate your work activity to decide whether the work activity is substantial gainful activity, and whether it may consider you disabled under the law. While this is only one of the tests used to decide if you are disabled, it is a critical first step in the disability evaluation. (SSDI and SSI)
SSDI. Social Security Disability Insurance, authorized under Title II of the Social Security Act.
SSI. Supplemental Security Income program authorized under Title XVI of the Social Security Act.
Subsidy and Special Conditions. Supports you receive on the job that may result in more pay than the actual value of the work you perform. The SSA uses only the actual value of the work you perform when it makes a SGA decision. (SSDI and SSI)
The Three Tests. One of the tests the SSA may use to evaluate self-employment income when an individual initially applies for SSDI and prior to the individual’s receiving SSDI benefits for 24 months. The three tests are also used when evaluating work activity in the reentitlement period after benefits have ended due to SGA. (SSDI)
Trial Work Period. The trial work period is an incentive for the personal rehabilitation efforts of SSDI beneficiaries who work. The trial work period lets you test your ability to work or run a business for at least 9 months and receive full SSDI benefits, if you report your work activity and your impairment does not improve. (SSDI)
Unincurred Business Expenses. Support contributed to your self-employment effort by someone else. If you are self-employed, the SSA deducts unincurred business expenses from earnings when it makes an SGA decision.
Unsuccessful Work Attempt. An effort to do substantial work (in employment or self-employment) that you stopped or reduced to below the SGA level after a short time (6 months or less). This change must have resulted because of your impairment, or the removal of special conditions related to your impairment that was essential to the further performance of your work. The SGA does not count earnings during an unsuccessful work attempt when it makes an SGA decision.
