CESP Benefits Counseling 3 — Questions and Answers
Question 1: Which federal program provides health insurance to workers with disabilities who lose SSDI due to earnings, allowing them to purchase Medicare at reduced cost for up to 93 months?
- Medicaid Buy-In
- Extended Period of Medicare Coverage (EPMC) (Correct answer)
- Medicare Savings Program
- Consolidated Omnibus Budget Reconciliation Act (COBRA)
Correct answer: Extended Period of Medicare Coverage (EPMC)
The Extended Period of Medicare Coverage allows former SSDI beneficiaries who lose benefits due to SGA earnings to purchase Medicare Parts A and B for up to 93 months after the Trial Work Period.
Question 2: Under SSI rules, which of the following is considered an 'in-kind support and maintenance' (ISM) that could reduce SSI benefits?
- A gift card for clothing
- Free room and board provided by a family member (Correct answer)
- A small birthday cash gift under $20
- Employer-provided health insurance
Correct answer: Free room and board provided by a family member
In-Kind Support and Maintenance (ISM) refers to food or shelter provided to an SSI recipient for free or below market value, which can reduce the SSI payment by up to one-third of the FBR plus $20.
Question 3: A client with a disability who is self-employed wants to know how SSA evaluates their earnings for SSDI purposes. What measure does SSA use?
- Gross business revenue
- Net Earnings from Self-Employment (NESE) (Correct answer)
- W-2 reported wages only
- Adjusted Gross Income from tax returns
Correct answer: Net Earnings from Self-Employment (NESE)
SSA uses Net Earnings from Self-Employment (NESE), which is calculated as 92.35% of net profit, to evaluate whether a self-employed SSDI beneficiary is engaging in Substantial Gainful Activity.
Question 4: What is 'Expedited Reinstatement' (EXR) and who is eligible for it?
- A fast-track application for new SSDI claims processed in under 30 days
- A provision allowing former SSDI/SSI recipients whose benefits ended due to SGA to request reinstatement within 5 years without a new application (Correct answer)
- An SSA program that reinstates benefits immediately upon request without medical review
- A state program for reinstating Medicaid benefits after work
Correct answer: A provision allowing former SSDI/SSI recipients whose benefits ended due to SGA to request reinstatement within 5 years without a new application
Expedited Reinstatement allows former SSDI or SSI recipients whose benefits terminated due to SGA earnings to request reinstatement within 5 years of termination, receiving provisional benefits during review.
Question 5: Which of the following expenses can be deducted as an Impairment-Related Work Expense (IRWE) for both SSI and SSDI purposes?
- General commuting costs such as gas and tolls
- The cost of a power wheelchair used exclusively for getting to and from work (Correct answer)
- Mortgage payments on a home adapted for disability
- Childcare expenses while at work
Correct answer: The cost of a power wheelchair used exclusively for getting to and from work
IRWEs are costs for items or services that a person needs because of their disability in order to work, such as specialized transportation, prosthetics, or adaptive equipment used for employment.
Question 6: A benefits counselor must report changes to SSA. Which change MUST be reported when a client is receiving SSI?
- A change in the client's favorite hobbies
- Any change in earned or unearned income, resources, or living situation (Correct answer)
- The client obtaining a library card
- The client's employer changing managers
Correct answer: Any change in earned or unearned income, resources, or living situation
SSI recipients must report any changes in income, resources, household composition, living arrangements, or other factors that could affect their benefit amount, typically within 10 days of the end of the month in which the change occurred.
Question 7: The Ticket to Work program was created by which legislation, and what is its primary purpose?
- The Rehabilitation Act of 1973; to fund vocational rehabilitation services
- The Ticket to Work and Work Incentives Improvement Act of 1999; to help Social Security beneficiaries with disabilities obtain employment services and supports (Correct answer)
- The Americans with Disabilities Act; to mandate reasonable accommodations for disabled workers
- The Workforce Innovation and Opportunity Act; to create individualized employment plans
Correct answer: The Ticket to Work and Work Incentives Improvement Act of 1999; to help Social Security beneficiaries with disabilities obtain employment services and supports
The Ticket to Work program was established by the Ticket to Work and Work Incentives Improvement Act of 1999 to give Social Security disability beneficiaries access to employment services through Employment Networks (ENs) or State VR agencies.
CESP Benefits Counseling 3
Which federal program provides health insurance to workers with disabilities who lose SSDI due to earnings, allowing them to purchase Medicare at reduced cost for up to 93 months?