Easter Seals Nebraska employs benefits specialists to help job seekers reach self-sufficiency through full use of state and federal work incentive programs. Those benefiting from Easter Seals Nebraska's services include Social Security Disability Insurance (SSDI) beneficiaries, Supplemental Security Income (SSI) recipients, Nebraskans served by the state vocational rehabilitation program, and young adults with disabilities who are transitioning from school to the workforce. For more information, go to ne.easterseals.com.
PAS services are designed to increase the individual's control in life and the individual's ability to perform activities on and off the job. PAS is consumer-directed and is intended to supplement the individual's own personal abilities and resources. PAS can be used at home, the worksite, and in some educational settings.
What are Personal Assistance Services (PAS) in the Workplace?
Personal Assistance Services are offered statewide to the extent necessary to enable an individual to be engaged in competitive employment. PAS are provided to help an employee in the workplace perform specific personal tasks that includes specialized procedures or health maintenance activities. This does not include job tasks required to perform the job. The employer's responsibility for providing reasonable accommodations begins when the employee reaches the job site and concludes when the work day ends.The determination of need for PAS at the worksite is made by the local DHHS Medicaid Eligibility Worker on an individual basis as documented in a plan of care for that individual. PAS is intended to provide the needed support to live, get to and from work, and perform at the worksite.
Must my employer allow me to have Personal Assistance Services (PAS) in the workplace if I need them?
Yes. The employer must allow a Personal Assistant at the worksite but they do not have to provide them. Regulations say the services have to be related to the basic personal needs of the person and not a work duty.What if I need more than 40 hours of PAS per week?
Nebraska Health & Human Services has policies in place to review individual requests from qualified, employed individuals with disabilities who believe they require more services than determined at their individual assessment, or a different type of physical or cognitive assistance than that which has been made available. You may explore your options with a local Medicaid Eligibility Worker.Are Personal Assistance Services (PAS) allowed in college or career school settings?
Yes. PAS is allowable for qualified individuals in educational settings based on individual need and documented in a plan of care for that individual. All sources of services and programs used by the individual and their specific responsibilities need to be considered in determining the appropriateness of the PAS program.What is the funding for the Personal Assistance (PAS) Service?
Nebraska Medical Assistance Program (Medicaid) or a Home and Community-Based Waiver (for persons who meet eligibility requirements). A person must remain eligible for Medicaid to receive PAS.What is a home environment?
The home environment is the individual's primary residence which is not a hospital, nursing, or intermediate care facility.
Social Security Disability Insurance (SSDI)
Social Security Disability Insurance (SSDI) provides benefits to disabled or blind individuals who are "insured" by workers' contributions to the Social Security trust fund. These contributions are required by the Federal Insurance Contributions Act (FICA), which created Social Security taxes which are paid based on an individual's earnings or those of a spouse or parents.Supplemental Security Income (SSI)
The Supplemental Security Income (SSI) program makes cash assistance payments to aged, blind and disabled individuals (including children under age 18) who have limited income and resources. The Federal Government funds SSI from general tax revenues. Most states pay a supplemental benefit to individuals in addition to their Federal benefits.SSDI and SSI share many concepts and terms. However, there are also many, very important differences in the rules affecting eligibility and benefit payments. Many individuals may apply or be eligible for benefits under both programs at the same time.
Childhood Disability Benefits (CDB)
Eligibility criteria include individuals 18 years of age or older who are disabled by SSA's definition before age 22; and are the child of an insured worker who is disabled and receiving SSDI benefits, retired and receiving Retirement benefits or is deceased.1619A
1619A is a special cash benefit for individuals who are working and earning over the Substantial Gainful Activity Level up to the break even point when an SSI check is no longer due.Substantial Gainful Activity Level is defined as working and earning more ($ see Red Book) in gross wages per month.
1619B
1619B is a continuation of Medicaid and SSI program eligibility. Countable wages are over the break even point (see Red Book) but under the state threshold amount. Case by case determination is made by the local SSA field office.Impairment-Related Work Expenses (IRWE)
SSA deducts the cost of certain impairment-related items and services an individual needs to work from gross earnings when it is determined if "countable earnings" demonstrate performance of substantial gainful employment (SGA). It does not matter if the individual uses these items and services for non-work activities.Earned Income Exclusion (EIE)
SSA does not count most of an individual's income when figuring an SSI payment amount. SSA does not count the first (see Red Book) of an individual's earnings in a month plus one-half of the remainder. This means that SSA counts less than one-half of the earnings when figuring the SSI payment amount. This exclusion applies in addition to the (see Red Book) general income exclusion (an exclusion that is first applied to any unearned income received).Student Earned Income Exclusion (SEIE)
If an individual is under age 22 and regularly attending school, SSA does not count up to (see Red Book) of earned income per month when figuring an SSI payment amount. The maximum yearly exclusion is (see Red Book). These amounts are adjusted each year based on the cost-of-living.Plan for Achieving Self Support (PASS)
An individual who is blind or disabled and receiving benefits can set aside or exclude income or resources necessary for attaining a specific occupational goal. The income or resources set aside will be excluded for determining SSI eligibility and payment. A PASS must have a realistic work goal, a specific savings plan and clear, sequential steps that lead to employment.Property Essential to Self Support
SSA does not count some resources that are essential to an individual's means of self-support when deciding initial and continuing eligibility for SSI. SSA does not count an individual's property if used in a trade or business (for example, inventory) or use for work as an employee (for example, tools or equipment), regardless of the value or rate of return. Other use of the items does not matter. SSA does not count up to ($ see Red Book) of equity value of non-business property that an individual uses to produce goods or services essential to daily activities, regardless of rate of return. SSA does not count up to ($ see Red Book) of equity value of non-business income-producing property, if the property yields an annual rate of return of at least 6 percent. However, SSA does not consider liquid resources, for example stocks, bonds, or notes as property essential to self-support, unless used as part of a trade or business.Expedited Reinstatement
If an individual's SSDI or SSI benefits ended because of work and they had earnings, the individual can request to have benefits started again without having to complete a new application. This became effective January 1, 2001.Additional reasons to request benefits start again:
- Unable to work or perform SGA because of disability.
- An individual has an impairment(s) that is the same as, or related to, the impairment(s) that allowed the individual to get benefits earlier.
- A request is made within five years from the month SSA terminated an individual's entitlement or eligibility. (The termination month is usually later than the month an individual stopped receiving cash benefits.)
Special Rules for Individuals Who Are Blind
Employment supports, in general, are special rules that help an individual return to work or work for the first time. Some of the rules apply only to individuals who are blind. Congress included language in the law to specifically to make it easier for individuals who are blind to go to work.Blind Work Expenses
SSA does not count any earned income that an individual uses to meet expenses that are needed to earn that income in deciding SSI eligibility and payment amount. The Blind Work Expenses (BWE) items do not have to be related to blindness. When figuring an SSI payment amount, items are treated as BWE instead of IRWEs. This is done this way because it always results in a higher SSI payment amount for the individual.
Many people with disabilities want to work but worry that doing so could jeopardize their vital health and long term care coverage. MIWD offers people with disabilities who are working or interested in working the opportunity to keep their Medicaid coverage while on the job. Benefits include the same as those available through Nebraska Medicaid; the opportunity to earn more without the risk of losing health care benefits and support services; higher income eligibility; increased personal and financial independence; and Personal Assistance Services (PAS) at the workplace.
Your local DHHS Medicaid Eligibility Worker can provide you with eligibility and enrollment information or you can contact a Benefits Specialist with Easter Seals Nebraska to help you with your benefits and answer questions. Contact Easter Seals Nebraska at 1-800-471-6425.
Procedures for Working Disabled Medicaid Premium Payment:
Test A - Income Steps
Test B - Income Steps
Disability Determination
Individuals currently receiving a Social Security Disability payment (SSDI) will not need an additional disability determination. All other individuals considered for this new program must have a disability determination from the State Review Team (SRT). The following procedures is for SRT determination.
Frequently Asked Questions
What does MIWD stand for?
MIWD stands for Medicaid Insurance for Workers with Disabilities.What is Medicaid?
Medicaid is an DHHS administered program designed to pay medical bills for low-income persons.What is the difference between Medicaid and Medicare?
Medicaid eligibility is based primarily on financial needs and is administered on a state-by-state basis. Medicare is not based on financial need, but is instead linked to the receiving of Social Security benefits based on being age 65 or older or having a disability. The federal government administers this program.What is the Social Security Disability Insurance (SSDI) program?
Social Security Disability Insurance is wage replacement income for individuals who have paid FICA taxes that meet Social Security's rules for disability. SSDI is financed with Social Security taxes paid by workers, employers and self-employed persons. SSDI provides a variety of benefits to family members when a primary wage earner becomes disabled or dies. SSDI benefits are payable to disabled workers, widows, widowers and children or adults disabled since childhood who are otherwise eligible.What are the Social Security disability thresholds for 2006?
For Substantial Gainful Activity (SGA), they are:
- Non-blind: $860 per month
- Blind: $1,450 per month
- For Trial Work Period (TWP), the threshold is $620 per month
Nebraska Health and Human Services System
The Health and Human Services System has offices serving each of Nebraska's 93 counties. Contact information for each office, as well as other offices that provide DHHS-related services, can be found at the Nebraska Health and Human Services System website.
Working with Disability
These documents from Mathematical Policy Research, Inc., document the earnings of Medicaid Buy-In participants in 2004 and explain how the Medicaid Buy-In Program fits into other federal efforts to expand access to health insurance and enhance employment opportunities for adults with disabilities.