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Author Topic: Ticket to Work - the Cliff Notes version.  (Read 11305 times)
jbeany
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« on: January 28, 2013, 04:45:04 PM »

Got this from my EN - Employment Network - that I assigned my ticket to.  You find one and select it from the SS website.  Mine emailed me this simplified version of what using Ticket to Work means - above and beyond the "they will help you find a job" that my social worker told me.

The guidelines for working on SSDI with a Ticket to Work are as follows:


When you first return to work you enter into your Trial Work Period. During your 9 month TWP, you are actually allowed to work and earn as much money as you can, and your benefits will not be affected.


The only months that count as one of these TWP months would be months that you have earned over $750. However long it takes you accumulate 9 of those months over $750 will be the length of your Trial Work Period.


After your TWP is over, the first month that you earn over $1040(SGA) in gross wages, this starts your 3 month Grace Period.

During your Grace Period, you are able to earn over $1040 and be guaranteed your SSDI check for that month and the next 2.

If you continue after your Grace Period to earn over $1040 a month, that is when you will lose your benefit check.


This is when your Extended Period of Eligibility starts. This is an additional 36 months after your TWP+Grace Period.

During your Extended Period of Eligibility, if you do lose your SSDI check because you are earning over $1040 for a month, any month that your earnings drop under $1040 again, you will automatically receive your SSDI.



It is also important to know that during all of this, if you are receiving Medicare, you will be protected from losing this for 93 months after your TWP ends. (You are protected from losing your medical during your TWP as well.) This is almost 8 years of protection from losing your medical benefits. http://www.ssa.gov/redbook/eng/The%20Red%20Book%202012.%28F%29.pdf (page 29).


Medicaid: You will continue to receive your Medicaid until your annual income exceeds your state's Threshold limit. http://www.socialsecurity.gov/disabilityresearch/wi/1619b.htm


**** Our incentives we offer are considered employment supports, and is non-countable income. This means that if you are eligible for a bonus from us, it is not counted towards your $1040 per month.

Okay, and a note about these incentives....
They may vary between Employment Networks, but mine offers a $500 non-taxable bonus for the first 3 non-consecutive months I earn over $750.  I can do that for 12 months worth, or $2000.  After the first 12 months, the incentives change to $200 non-taxable per month for 12 months.

Also, for the first 3 years after you lose your benefits, they have an easy restart option, so you don't have to go through the whole approval process if you get too sick to work and have to stop again.

And, just to make it easier for you to get a job, there is the Worker Opportunity Tax Credit.  Private Employers or non-profit agencies who hire people using Ticket to Work are eligible for a tax credit of up to $9000.  (The highest credits are for veterans and those who have been on welfare long term.  I think anyone who employs me gets back about $2400.  They have it all worked out on a chart.)


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« Reply #1 on: January 28, 2013, 05:55:00 PM »

Interesting, thanks jbeany. So you have to report your monthly income to the EN?
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jbeany
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« Reply #2 on: January 28, 2013, 05:58:36 PM »

Yes, you email them pay stubs.  They track it and send it to SS, as well as use it to calculate the bonuses.
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« Reply #3 on: January 28, 2013, 06:07:26 PM »

Great info!!  Any idea about owning your own business??  Does it work the same??  I guess my real question is this; if I earn say $2000 a month but only pay myself $750 is that ok??  The rest would stay in my business account for expenses taxes and kind of a back up savings if I need it. The lines seem to get blurry about self employment. There is the addition expense of filing you business with my state (articles of incorporation), business liability insurance a d the biggest issue is if you work on your own no group health insurance would be available unless you bought yourself a policy for big bucks and paid premiums out of the business account. Of course that all assumes that one would be able to operate a business that would bring in enough billing to even afford the set up costs let alone paying yourself. Anyone have any experience??  I had my own company years ago but dissolved it so I can re-register the same name but would still involve a substantial initial output of money to get up and running. Love to know if anyone has had success with self employment and how or if it falls in the guidelines of the ticket to work program. I was in the information technology field, my last position was IT Director for the city of Palmetto. I was laid off due to economy in 2007. THX G.
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Geoffrey Campbell
Diagnosed with ESRD at 26
Transplanted in 1999 rejected 2001
In center hemodialysis since late 2001 3X a week 4 hours late evening 3rd shift
jbeany
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« Reply #4 on: January 28, 2013, 06:24:23 PM »

Geoff, I don't think the source of income would make any difference, but I wasn't looking for self-employment info, so I'm not sure.  They don't find the jobs for you, and they do offer plenty of work from home options that they have researched to make sure they are legit.  It seems to me that self-employment would fit right in.
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« Reply #5 on: January 28, 2013, 07:11:57 PM »

I need to get off my a$$ and research this. I've had offers for work but have turned down some because I wasn't up for and others for fear of losing benefits. I think I will make it my #1 priority next week. This week is full already!!!  But I sure need some way of finding additional income SSDI is a blessing (not that I didn't work for it!) but I need to get back to working on a regular basis. It make me feel better health wise and lifts self esteem. I'll post what I find and what I end up doing. THX. G.
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Geoffrey Campbell
Diagnosed with ESRD at 26
Transplanted in 1999 rejected 2001
In center hemodialysis since late 2001 3X a week 4 hours late evening 3rd shift
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« Reply #6 on: January 29, 2013, 05:39:10 PM »

I did some searching and found some  great info. I need to put it all together and meet with social security to verify. SBA has classes and help organizing your plans and putting them into writing as vell as advise on how to do it properly. More to come. G.
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Geoffrey Campbell
Diagnosed with ESRD at 26
Transplanted in 1999 rejected 2001
In center hemodialysis since late 2001 3X a week 4 hours late evening 3rd shift
jbeany
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« Reply #7 on: January 29, 2013, 06:25:09 PM »

I was really interested in the Medicare protection.  As a transplant recipient, there's no way I could pay for meds without insurance.  It's also hard to find a full time job with benefits without some experience.  The only way to get the experience is to work part time with no benefits - at least in the legal field at a clerical/legal assistant level.  Ticket to Work is insurance protection for over 8 years.  By then, I'll have plenty of experience.

Not that I'm going to turn down the tax free cash bonuses though!
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"Asbestos Gelos"  (As-bes-tos yay-lohs) Greek. Literally, "fireproof laughter".  A term used by Homer for invincible laughter in the face of death and mortality.

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« Reply #8 on: January 29, 2013, 08:49:35 PM »

jbeany - the information you posted is *mostly* accurate. I just want to clarify a few things (I work for that awful SSA and doing the work reviews is my specialty)

The guidelines for working on SSDI with a Ticket to Work are as follows:


When you first return to work you enter into your Trial Work Period. During your 9 month TWP, you are actually allowed to work and earn as much money as you can, and your benefits will not be affected.


The only months that count as one of these TWP months would be months that you have earned over $750. However long it takes you accumulate 9 of those months over $750 will be the length of your Trial Work Period.

You have to use all of your 9 trial work months within a 5 year period - it's a "rolling" period so if you use 1 TWP month per year, you'd never use all 9. Months 1 through 9 must all be within 60 months of each other, otherwise the earliest months (more than 5 years ago) drop off and the number used adjusts because any that were more than 5 years ago no longer count.

Or, think of it like a roll of toilet paper rolled out 60 sheets across a table, all 9 months have to appear on the table. If you go to sheet (month) 61 lets say and that is the 9th time you've earned over the TWP amount, and sheet (month) 1 was your first TWP month, that first month is going to fall off the table because it's not within 60 sheets of the final one. Does that make any sense? That is the part I hate explaining the most.

After your TWP is over, the first month that you earn over $1040(SGA) in gross wages, this starts your 3 month Grace Period.

During your Grace Period, you are able to earn over $1040 and be guaranteed your SSDI check for that month and the next 2.

If you continue after your Grace Period to earn over $1040 a month, that is when you will lose your benefit check.


This is when your Extended Period of Eligibility starts. This is an additional 36 months after your TWP+Grace Period.

This is very misleading. Once your TWP is over, the next month starts the 36 month extended period of eligibility (EPE). It doesn't matter if you're working or not. If you're working and earning under the substantial limit (currently $1040) then you would just continue working and collecting benefits.

So for example, you are earning $900/month. You do this consistently and use up your 9 TWP months, and let's say your trial work period ended this month, 1/2013. Your first month of the EPE would be 2/2013 regardless of how much you are earning, even if it is under the $1040 limit. And you could keep working making that $900/month through the 36 month EPE and beyond and never see an interruption in your benefits because you are under the $1040 limit. Now lets say you keep this job for 5 years, so you'd be 2 years out of your EPE. If your checks have never been ceased, and you decide to take a full time job at that point, then you would get your cessation and grace period months, and the benefits would terminate once those are over. The suspension of benefits can only occur during the 36 month EPE.

There are also things that can be applied and deducted from how much you earn. Obviously transplant drugs are expensive. And if you are paying for them each month, the out of pocket costs can be deducted from the amount you earned, which can bring you below the $1040 limit. These are called impairment related work expenses or IRWEs. If your benefits have never been ceased and you earn over the $1040 in just a few months (less than 6), but all the other months of the year you are well below, this can sometimes be written off as an unsuccessful wok attempt (UWA) if the reason you had to reduce or stop working was because of your condition. Sometimes the earnings can be averaged over a few months or the year if you earn over the $1040 amount in a few months, but are regularly below. I see this the most when there is a 5 week month. If you work the same days each month and are below, on those months where the month ends and begins at the beginning/end of the week and you work those days, then you could accidentally and unintentionally go over. As long as you've never used any cessation or grace period months, those earnings can be averaged in if you're under the rest of the time.

Also, with the cessation and grace period months, if you don't use both grace period months you lose them. So if you are earning $2000/month at the end of your trial work period, and a month after your TWP ends you have to stop working, you've only used 1 of the grace period months. Your check would be considered "reinstated" because you're under the limit, and the other 2 grace months you didn't use because you had to stop working are lost. I always tell people if you are going to go back to work F/T in your TWP and are planning on quitting at the end (and don't ask me why people do this...) I tell them to go big and do it for a full 12 months to ensure they get their 9 TWP months and the cessation and 2 grace months. No sense giving them up!

I just wanted to clarify those things. Is this something the EN provided in writing? If so, I can give you the policy references and you should let them know they are not very clear on those things. I hate when people get misleading information and then have their benefits affected.

Oh! Also after your benefits terminate, if you become sick again with the same or a related condition within 5 years, you can file an Expedited Reinstatement to get back on benefits. That's in the Red Book too, I am not sure which page though.
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Caregiver to Husband with ESRD.

1995 - Diagnosed with vesicoureteral reflux and had surgery to repair at age 11. Post surgery left side still had Stage I VUR, right side was okay. Both sides were underdeveloped.
2005 - Discovered renal function was declining, causing HBP. Regular monitoring began.

March 2008 - Started transplant evaluation for preemptive transplant due to declining function.

September 16, 2008 - Transplanted with my kidney.
September 18, 2008 - Kidney was removed due to thrombosis in the vessels in and leading to the kidney.

October 2008 - Listed in Region I

May 2009 - Started in Center Hemo
January 2010 - Started CCPD on Liberty Cycler

June 15, 2012 - Kidney transplant from a 43 year old deceased donor
June 22, 2012 - Major acute rejection episode and hospitalization began
June 27, 2012 - Nephrectomy to remove kidney after complete HLA antibody rejection. Possibly not eligible for another transplant, ever again.

Now what?
Rerun
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« Reply #9 on: January 30, 2013, 01:38:59 PM »

I watch this guys email for him and he pays me so I had to report it.  I made $670 last year from this job. I will report it to IRS and had to report to SSDI.  Do you think I'll get kicked off for $75 a month?  I just wanted some mad money and I can do it from home.

      :waiting;
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jbeany
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« Reply #10 on: January 30, 2013, 02:11:37 PM »

Rerun, are you using Ticket to Work?  (There's a lot of paperwork to fill out, but it's not complicated.)  I'm not sure what the difference is between earning money without using it.  And I'll let smcd23 answer that, cause I have no idea!

jbeany - the information you posted is *mostly* accurate. I just want to clarify a few things (I work for that awful SSA and doing the work reviews is my specialty)

I just wanted to clarify those things. Is this something the EN provided in writing? If so, I can give you the policy references and you should let them know they are not very clear on those things. I hate when people get misleading information and then have their benefits affected.


By all means, clarify, please!  Any input from someone familiar with this stuff is always welcome!  I posted this because the only thing I knew about Ticket to Work prior to starting my own research was "They can help you find a job or go back to school."  (They will help with student loans and other things, but I already had that covered, so I didn't any help with it.) 
 I didn't know about the medical coverage, the incentives, the employer tax credit, or any of the other useful things like restarting SSD easily or getting both a paycheck and a disability check in full at the beginning.  I don't think my social worker EVER discussed it, and I had a pretty decent social worker.  I figured a shorthand explanation of the service might help some other IHDer's decide if they should be looking into it or not.  It might not be entirely spot on, but it's better than the information I had previously - which was pretty much nothing!

Everything prior to my "Okay, and a note about these incentives..."  is copy/pasted directly from an email from my Employment Network.  They do send all the paperwork and brochures that go into detail as well, but this is what they sum it up as.  And they only send this after a phone interview where they do their best to explain it to you as well. 
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smcd23
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« Reply #11 on: January 30, 2013, 08:49:32 PM »

Rerun - you won't get in any trouble for that amount of money! No worries! If you haven't already, you could call your local office and just say you were doing this work, and you were only earning $75/month but you thought you should report it. Honestly, unless you're earning thousands per year it won't trigger any alerts for us to look at you. Most of the time if it comes up somehow, it just gets marked down as insignificant because it's below the TWP amount even if you earned it all in 1 month, and we just let it go - not time or cost effective for someone to go printing and mailing forms, collecting pay stubs or a printout from the employer etc for something that would have no impact on your checks.

All of those work incentives are available whether or not you enroll in the Ticket to Work, including the medicare benefit. The benefit of the Ticket to Work is that while it's assigned to an EN and in use, you cannot be medically ceased. So if someone starts using their TWP and continues working and has their checks suspended, that can prompt a medical review because if you're earning say $3,000/month that might indicate your condition has medically improved to the point where you don't meet the disability requirements. OR if you use your TWP months, complete your EPE and your benefits terminate, that can also prompt a medical review to see if we should be continuing Medicare (because if you're no longer meeting the medical requirements for disability, then the Medicare should stop since that is contingent on the disability). But again, working under the ticket with an employment network prevents medical reviews from being conducted. So it's extra protection in that regard from getting kicked off because you've "improved"
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Caregiver to Husband with ESRD.

1995 - Diagnosed with vesicoureteral reflux and had surgery to repair at age 11. Post surgery left side still had Stage I VUR, right side was okay. Both sides were underdeveloped.
2005 - Discovered renal function was declining, causing HBP. Regular monitoring began.

March 2008 - Started transplant evaluation for preemptive transplant due to declining function.

September 16, 2008 - Transplanted with my kidney.
September 18, 2008 - Kidney was removed due to thrombosis in the vessels in and leading to the kidney.

October 2008 - Listed in Region I

May 2009 - Started in Center Hemo
January 2010 - Started CCPD on Liberty Cycler

June 15, 2012 - Kidney transplant from a 43 year old deceased donor
June 22, 2012 - Major acute rejection episode and hospitalization began
June 27, 2012 - Nephrectomy to remove kidney after complete HLA antibody rejection. Possibly not eligible for another transplant, ever again.

Now what?
geoffcamp
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« Reply #12 on: January 31, 2013, 07:30:16 AM »

So here is a break down or ballpark costs associated with starting my own business. Take a look and please offer opinion and suggestions of what you think and if it is worth a try!  THX. G.


I hope you have a chance to take a look at this rough plan of the costs associated with starting my own business. Please advise if any of these costs could be figured into the ticket to work program and/or may offset the total amount I can make per month without losing current benefits until I can make enough every month not to need the SSDI check. I will need Medicare (even if i have to pay for it) and I will have to pay for a private gap insurance policy to cover the 20% Medicare does not. Please let me know if you think this is doable under my circumstances.

Here is an estimated cost break down just to start up my company before any billing or work. Just the start up costs. Please take a quick look and tell me if you think it would be worth it!!  I do have a lot of contacts and believe I could get billable work hours fairly fast.
My proposed hourly rates will be:

$50 an hour in home work for individuals.
$75-$110 an hour business to business work depending on the scope of project
I would also set minimum hours like minimums of 2 hours for individual work and 3 hours for business to business work.

***I believe that I could hit the ground running right away with total monthly billing of 10-15 hours of billing a month as soon as I finish getting this all set up. But it depends on the rules and regulations that social security disability have in place. And ability to get the funds needed to start the company and complete website and get business cards or email lists for drumming up billable business hours. So after I get started I really believe I could be billing out approximately $750 a month upon opening my own business.

I will also put together a contract that once I leave and work is signed off any additional issues or questions will be billed. Rates will be lower for over the phone but the same if I have to travel back to the site to re-train or go over what I already did.
That being said if it is my mistake or I did something wrong I will put a guarantee in that allows customers to have me get it right at no additional cost. All this will be on the invoice and will have to be signed off by the customer. Also I will provide free estimates on an as needed basis.

Company name. TechEZ Group, inc.
I am working on a good solid business plan now on my own. I will have it looked at by SMA and anyone of my contacts with experience with business plan writing.

When to I let social security know about what I am attempting?  Before I start or after I have completed and I am ready to start working and billing out hours???

Business plan. Must write out a full plan and scope of what I am intending to do. The individuals and companies I will be targeting as well as the services I will provide. The SBA and chamber of commerce has the contacts and tools to help me with this. Usually it is free but I may have to join chamber of commerce in my area.

I am on the fence of registering as an S corp or an LLC. ADVISE????
My preference would be an S corp as it protects your private finances as well as my mothers as I want to list her as a director.

COSTS!!

Register with state. Articles of in corporation. List directors. Would like my mother to be a director for billing, collections and general clerical help (do I have to pay her??  She does not need the money and she is currently getting social security due to age not disability)
Also my sister will help (for free). She is an attorney)
The cost I figure to do all this and get my tax ID number:
Somewhere in the range of $150-$250 if I do all the work myself via sunbiz.org

$150-$250. ESTIMATE!!!!  (My accountant will be needed to help set up and do taxes every year)

The there are all the federal forms and registration of a business. After you complete the state forms they send you links on how and where to fill out all these forms. I would again be getting help from my sister and my mother for all the paperwork and set up
Estimated costs here:

$100-$200. ESTIMATE!!!!  (My accountant will be needed to help set up and do taxes every year)

Liability insurance umbrella. Usually a $million policy. Last time I did this I believe the cost for this was around $400 per year. But if I want to start providing website building for companies the insurance cost significantly more. Last time I did this it was for computer programming and networking. Web site building and maintenance is under a different category for liability insurance and was very expensive
Estimated cost:

$400-$500. ESTIMATE!!!!   (Yearly cost)

Opening a business bank account. Must have some funds to open an account. I would open a checking account with a debit card for expenses and depositing money earned.
Initial lay out of money to open an account

$500-$1000 depending on what the minimum balance must be to avoid fees (one time cost)

Marketing, advertising and networking.

Business cards
Letter head & envelopes.   (Vista print .com is best for cheap!)
Flyers or post cards to give out.   (Vista print .com is best for cheap!)
Chamber of commerce membership
Website. (Cost of domain name and building a good web presence to get customers)
Email. (Hosted email with same domain name as web site)
Server space to host website and storage for documents and back ups of work computers.
Maybe an ad in the local weekly free papers and magazines. And maybe local newspaper
**** This is the estimated cost only if I do this ALL on my own!!  No help
Costs here are hard to calculate but I'd try to put a budget of this:

$750-$1,500. (Mostly monthly costs for domain name and email rest yearly costs)

I'm sure there are other things I am not including here. So I would call this a misc.  category.

$?????  I'll have to come up with a figure of just in case things or things I have forgot.

So total on the high end without misc costs is:

$3,450.

Round to $4,000-$5,000 just to set up the company.


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Geoffrey Campbell
Diagnosed with ESRD at 26
Transplanted in 1999 rejected 2001
In center hemodialysis since late 2001 3X a week 4 hours late evening 3rd shift
Bill Peckham
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« Reply #13 on: January 31, 2013, 07:07:25 PM »

Rerun - you won't get in any trouble for that amount of money! No worries! If you haven't already, you could call your local office and just say you were doing this work, and you were only earning $75/month but you thought you should report it. Honestly, unless you're earning thousands per year it won't trigger any alerts for us to look at you. Most of the time if it comes up somehow, it just gets marked down as insignificant because it's below the TWP amount even if you earned it all in 1 month, and we just let it go - not time or cost effective for someone to go printing and mailing forms, collecting pay stubs or a printout from the employer etc for something that would have no impact on your checks.

All of those work incentives are available whether or not you enroll in the Ticket to Work, including the medicare benefit. The benefit of the Ticket to Work is that while it's assigned to an EN and in use, you cannot be medically ceased. So if someone starts using their TWP and continues working and has their checks suspended, that can prompt a medical review because if you're earning say $3,000/month that might indicate your condition has medically improved to the point where you don't meet the disability requirements. OR if you use your TWP months, complete your EPE and your benefits terminate, that can also prompt a medical review to see if we should be continuing Medicare (because if you're no longer meeting the medical requirements for disability, then the Medicare should stop since that is contingent on the disability). But again, working under the ticket with an employment network prevents medical reviews from being conducted. So it's extra protection in that regard from getting kicked off because you've "improved"


You're assuming the person is post transplant? If the person is using dialysis then their disability payment can be suspended/stopped but their Medicare continues no matter how much is earned right? Geoff is using dialysis, I believe.
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
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« Reply #14 on: January 31, 2013, 10:28:09 PM »

Bill,
You must be right because Ed works full time and receives medicare.
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After a hard fight to not start I started dialysis 9/13
started on PD
hoping for home hemo starting to build a fistula 1/14
cause PKD diagnosed age 14

Wife to Ed (who started dialysis 1/12 and got his kidney 10/13)
Mother to Gehlan 18, Alison 16, Jonathan 12, and Evalynn 7. All still at home.
www.donate2benefit.webs.com
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« Reply #15 on: February 01, 2013, 06:42:12 AM »

Rerun - you won't get in any trouble for that amount of money! No worries! If you haven't already, you could call your local office and just say you were doing this work, and you were only earning $75/month but you thought you should report it. Honestly, unless you're earning thousands per year it won't trigger any alerts for us to look at you. Most of the time if it comes up somehow, it just gets marked down as insignificant because it's below the TWP amount even if you earned it all in 1 month, and we just let it go - not time or cost effective for someone to go printing and mailing forms, collecting pay stubs or a printout from the employer etc for something that would have no impact on your checks.

All of those work incentives are available whether or not you enroll in the Ticket to Work, including the medicare benefit. The benefit of the Ticket to Work is that while it's assigned to an EN and in use, you cannot be medically ceased. So if someone starts using their TWP and continues working and has their checks suspended, that can prompt a medical review because if you're earning say $3,000/month that might indicate your condition has medically improved to the point where you don't meet the disability requirements. OR if you use your TWP months, complete your EPE and your benefits terminate, that can also prompt a medical review to see if we should be continuing Medicare (because if you're no longer meeting the medical requirements for disability, then the Medicare should stop since that is contingent on the disability). But again, working under the ticket with an employment network prevents medical reviews from being conducted. So it's extra protection in that regard from getting kicked off because you've "improved"

Well said when I was working I was making about $4,500 a month. I lost my disability checks because it was automatically deemed my ESRD medical condition had improved. But I was able to keep Medicare but I had to pay for it. And I had access to a group health insurance policy so there was something like the group policy was primary but I'm a little fuzzy on that. I can't remember exactly how that was done but there was some change in who was paying my medical bills and what doctors and providers I was allowed to see, I believe it was called "in area" or something. After working for about 6 years on dialysis MWF evenings (night shift stated at a little after 5pm and I got out around 10pm usually) I was laid off and I had to go to the social security office and start over again. I have to say I was very surprised how easy they made it to restart disability checks. It took very little time and two meetings at the SS office and forms my doctors filled out. My caution to people is to keep yor disease a secret until you get thru your probationary period. You can do this even if like in my case they required a medical exam to hire me. By HIPPARCHUS laws the doctors are only allowed to say if I am medically able to do the job as detailed in the job description. Things like being able to lift 20lbs were in my job description. I was directly told by the risk management manager that had they know of my ESRD or someone with a heart condition they would advise people like me or with other chronic issue NOT BE HIRED. I was amazed he told me that!!  But my heathcare made their group policy rates go up. I know because I was on the board that reviewed our health care insurance and was looking for how we could provide the best policy for employees at the least possible out of pocket payment for the plan. We even shopped rates and every time we did my file was the first one theybalwaysvhad questions about, they were not aware usually I was right there in the meeting!!  But when the economy went bad I was in the first round of layoffs I believe and I was told directly that my health insurance costs along with time away from work for doctors appointment, leaving a little early MWF and a few hospital stays of a week or so each time was the main reason I was chosen. They praised me for the job I did and even that I saved my department money every budget year!!  It hurt really bad. But in Florida we have a law that the state is what they call an at will employment state (I think that is the term). It basically says that I can quit at anytime I want and my employer can terminate me anytime they wish with no reason. That is unless you have an employment contract. Some people in at my level working for the city I worked for had contracts but they had been with the city for many years, when I was hired they no longer offered the security of an employment contract. All this was a huge bummer for me. To this day I really wish I still had that job. It put me in a depression I am still struggling with. I hope to figure out a way to get back to work or in my case start my own company. But my big piece of advise is NEVER EVER let your employer know during the hiring process or the probationary period about your chronic illness. They WILL let you go ASAP without reason. Because I was told the reasons I was 1st to be laid off I had to sign a release to get the severance package which was generous and it basically said I can't sue them. Oh I just remembered the term. It's called a "right to work state". So some states may not have this law. I'm in Florida and they do, I looked it up. Here you can be terminated without cause. Horrible law but like I said if possible try to get an employment contract with significant penalties or say 2 years salary if they decide to terminate you. Any lawyer can put together an employment contract and its worth a try to ask your HR director to look at maybe make some changes and sign. Usually this would be attempted a few months after your probationary period is completed successfully. That's my story, man I still really miss that job!!  G.
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Geoffrey Campbell
Diagnosed with ESRD at 26
Transplanted in 1999 rejected 2001
In center hemodialysis since late 2001 3X a week 4 hours late evening 3rd shift
Rerun
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Going through life tied to a chair!

« Reply #16 on: February 01, 2013, 11:32:37 PM »

SMCD23 Thank you for your answers.

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smcd23
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The patient, the baby and the donor - October 2010

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« Reply #17 on: February 06, 2013, 08:58:55 PM »

You're assuming the person is post transplant? If the person is using dialysis then their disability payment can be suspended/stopped but their Medicare continues no matter how much is earned right? Geoff is using dialysis, I believe.

Yes, you are correct. That is a whole separate provision called Medicare for the Working Disabled. If your checks stop and you are out of the 7 year period that Medicare continues automatically and still working thus not qualifying for monthly payments, you can pay your Medicare Part A and B premiums so long as you are still deemed to be medically disabled. In 10 years I've had one person do this, so I am not 100% familiar with the process (had to look it up the last time, and that was at least 4 years ago!) but you still have to have a medical condition that is considered disabling despite earnings, you can pay for Medicare as long as you meet that requirement. Here is the quote from the little book I hand out to people who want to know about working

"Continuation of Medicare—If your Social Security disability benefits stop because of your earnings, but you are still disabled, your free Medicare Part A coverage will continue for at least 93 months after the nine-month trial work period. After that, you can buy Medicare Part A coverage by paying a monthly premium. If you have Medicare Part B coverage, you must continue to pay the premium. If you want to end your Part B coverage, you must request it in writing."

So if I recall from the time I did this for a gentleman, he had a medical review, still was found to be disabled, and was paying $300+/month for part A and whatever the B premium was at the time (around $90) but if you have no other insurance, or your employer offers crumby insurance, it's definitely an option!
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Caregiver to Husband with ESRD.

1995 - Diagnosed with vesicoureteral reflux and had surgery to repair at age 11. Post surgery left side still had Stage I VUR, right side was okay. Both sides were underdeveloped.
2005 - Discovered renal function was declining, causing HBP. Regular monitoring began.

March 2008 - Started transplant evaluation for preemptive transplant due to declining function.

September 16, 2008 - Transplanted with my kidney.
September 18, 2008 - Kidney was removed due to thrombosis in the vessels in and leading to the kidney.

October 2008 - Listed in Region I

May 2009 - Started in Center Hemo
January 2010 - Started CCPD on Liberty Cycler

June 15, 2012 - Kidney transplant from a 43 year old deceased donor
June 22, 2012 - Major acute rejection episode and hospitalization began
June 27, 2012 - Nephrectomy to remove kidney after complete HLA antibody rejection. Possibly not eligible for another transplant, ever again.

Now what?
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