Disability Benefits: New Law will Help Disabled Return to Work

An important new law will help disabled persons return to work without losing medical benefits, and correct some other disincentives to returning to work after being disabled. However, this complex law is not effective yet; different parts will be phased in over the next few years, and some provisions will depend on decisions by each state.

We asked benefits expert Tom McCormack of T2CANN (Title II Community AIDS National Network) to outline some of the provisions of this legislation, the Ticket to Work and Work Incentives Improvement Act of 1999 (a bipartisan law which was signed by President Clinton on December 17, 1999).

He noted that the most important changes will need approval by each state. But three which will apply to all states are:

Easing but not eliminating the risk of losing benefits due to being determined to be no longer disabled. For example, the fact that somebody is working will not be used as evidence that they are no longer disabled. (This provision becomes effective on January 1, 2002.)

For disabled persons who return to work from SSDI, Medicare Part A will be free for 99 months, vs. 45 months under current law. (This change becomes effective October 1, 2000.) [After the free period ends, still-disabled persons can continue their Medicare indefinitely, but must pay the $166 monthly Part A premiums themselves. If they cannot afford that, the welfare department's QWDI program can pay for them if they earn under $2832 monthly; welfare's SLIMB/QI program can also pay the $45.50 monthly Part B premiums (which come due after only 12 months back at work) for those earning under $1939. For an explanation of the unusual rules on how to use these programs, see "Keep Your Medicare in Force As You Go Back to Work--What to Do and How to Do It" by Thomas P. McCormack, AIDS Treatment News #313, February 19, 1999.]

"Ticket to Work" vouchers will enable disabled persons to obtain vocational rehabilitation, job training, return-to-work counseling and benefits guidance from nonprofit organizations or businesses which meet certain requirements; these organizations will be paid for this service by the federal government. Previously, persons usually had to get these services from their state vocational rehabilitation department. (Service organizations can benefit from this new program and can subcontract out specialized job-training activities.)

A very important provision will require a decision to participate by each state. Alaska, California, Iowa, Massachusetts, Minnesota, Nebraska, Oregon, South Carolina, Vermont, and Wisconsin already give Medicaid to working, still-fully-disabled persons earning up to about $43,000, under the old law (all states could do so if they chose to). The new law will allow all states to cover them but also cover the formerly disabled (those who were disabled under Social Security, but then were ruled no longer disabled during a review--but who are still likely to have special medical needs) and some but not all states can also cover the pre-disabled (those who have medical conditions which could later result in disability, such as those who are "only" HIV+). Also, the new law will allow states to have even higher income and asset levels for these programs.

[Note: Unfortunately the new law does not affect private disability insurance. With private insurance, it can be difficult to return to work without permanently losing disability insurance--a serious problem if it turns out that one is unable to continue working. "Almost all cases involving private disability insurance must be individually pre-negotiated," according to McCormack, "building on whatever rudimentary provisions the policy might have on return-to-work and vocational rehabilitation issues--to develop a workable work-return plan that includes protection for continued benefits, or the reinstatement of benefits, should the work effort collapse because of medical problems. This can only be done case-by-case for each individual by expert attorneys or other skilled benefits advocates, because policy provisions are so different."]

For more in-depth information, request a summary of the new law, an advocacy kit for getting your state to add Medicaid coverage of the disabled (including the "pre-disabled" and the "ex-disabled"), and a copy of "Returning to Work and Keeping Medicare and Medicaid" from Tom McCormack, tomxix@ix.netcom.com.

Also, attorneys and other benefits advocates can subscribe to a free non-profit email discussion group on benefits and other legal issues. To subscribe, send a message to:
HIV-Law-Approval@Web-Depot.COM; you will receive a brief questionnaire which must be returned for your subscription to be approved.