How will work impact benefits and health insurance?

Work Incentives Specialist Advocates (WISA)

Work Incentives Specialist Advocates (WISA’s) are individuals who have been certified to provide work incentives counseling services to DARS clients who are receiving Social Security Disability (SSDI) and/or Supplemental Security Income (SSI) benefits. Although clients working with DARS on job placement have a desire to return to work, fear surrounding what will happen to their benefits and health insurance when they return to work serves as one of the biggest barriers to achieving that goal. WISA’s have completed extensive and rigorous training through either Cornell University or Virginia Commonwealth University (VCU) surrounding the impact of work on Social Security benefits and have been certified as Work Incentives Practitioners, making them the authority on work incentive regulations that protect the client’s benefits while they test their ability to work.

Our approach to work and benefits

Although the trend has been to refer to professionals as benefits counselors, in Virginia, we refer to these individuals as Work Incentive Specialists. This is because our goal is to get people to think about this system regarding their work, not their benefits. The WISA model shifts the focus to how a client’s disposable income can go up as they work, and does not focus solely on how benefits will change. Our goal as an agency is to assist clients by creating the safety net that supports each individual’s choice to go to work. There are 13 services that can be provided by a WISA and authorized by a VR counselor on behalf of a client.

Work Incentives

  • Plan to Achieve Self-Support (PASS)
    PASS is an income and/or resource exclusion that allows a person who is disabled or blind to set aside income and/or resources for an occupational or educational objective if it leads to employment. (SSI Beneficiaries or SSD beneficiaries who can become SSI eligible using PASS).
  • Impairment Related Work Expenses (IRWE)
    IRWE’s reduce the amount of income that Social Security counts against an individual’s benefits by deducting the amount of an expense from their total countable wages. To qualify for the IRWE, the expense must be related to the individual’s disability, work, and be an expense that they couldn’t work without. It must also be paid for out of the person’s pocket. In SSI cases, the amount of the expense will be deducted from countable income every month in which the expense is incurred. In SSDI cases, IRWE’s will not be as relevant in months where the beneficiary is clearly earning less than SGA.
  • Blind Work Expense (BWE)
    SSI will not count any earned income when primary diagnosis is blindness, which is used to meet any expense reasonably attributed to earning the income, i.e. Guide dog, transportation to and from work, etc. (SSI Beneficiaries). An SSA statement received noting that the beneficiary’s Work Incentive has been approved/applied may also be used as documentation.
  • SSI 1619(b)
    One of the biggest concerns SSI beneficiaries have about going to work is the possibility of losing Medicaid coverage. Section 1619(b) of the Social Security Act provides some protection for these beneficiaries. 1619(b) provides for the continuation of Medicaid with no spend down requirements when a beneficiary loses their SSI due to earning wages above the SSI threshold or from a combination of earned and unearned income above this thresh hold. The person’s disability must continue, and they must still keep their resources under the $2,000 resource limit for a single person or $3,000 per disabled couple. In other words, they would still need to be otherwise eligible for SSI if not for their income. In the state of Virginia, income typically cannot exceed $35,118 per year for the person to be still eligible for continued Medicaid. However, certain people could qualify for an individual threshold if they meet additional conditions. (SSI beneficiaries)
  • Student Earned Income Exclusion (SEIE)
    Student earned income exclusion allows individuals under the age of 22 who regularly attend school or are involved in a vocational education program to exclude earned income up to a certain amount(as of January 1, determined each year) in a month(with a maximum per year, also determined each year). (SSI Beneficiaries). For 2016, the amount is $1,780 per month or $7,180 per year.