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Avoid a Benefits "Traffic Jam"

I finally, recently learned how to add the “traffic” view to my Google Maps display. This is supposed to show me, in real time, the vehicle density and consequent expect travel speed on my planned routes. Since my son’s school is quite a commute—though well worth it—and since I live in the Chicago suburbs where rush hour starts at 6 am and lasts past 6 pm except for about a three hour midday window, the traffic view should help me to assess (at any stage of my journey) which way I should move forward to get to my destination the fastest.

(Map data (c)2019 Google)

The destination for most people with disabilities is long term financial stability at a level that funds their supports and a quality life. The destination for a noticeable subset of workers with disabilities is the highest level of work earnings that will not preclude access to health and personal support benefits that cannot be covered by work earnings alone. My last week’s blog discussed form SSA-3288, aka the Benefits Planning Query or “BPQY”. The response report generated by a BPQY functions like the traffic feature of Google Maps. It tells you the density and nature of your current benefits so that you can determine the best way forward towards your financial and support destinations. This week, we are going to look what the BPQY report can tell you.

The first section of the report covers your (the beneficiary’s) cash-benefit details. Line by line, the information provided or confirmed includes:

  • Benefit Type: For Social Security Disability Insurance (SSDI), this could be “Disabled Worker”, “Disabled Adult Child”, “Disabled Widow(er)” or Disallowed or Denied Claim. For Supplemental Security Income (SSI), this might be “Disabled Individual”, “Disabled Spouse”, “Disabled Child”, “Blind Individual”, “Blind Spouse”, “Blind Child”, “Disabled Student” or “Blind Student”.

  • Benefit Status: This could be “current pay”. “suspended” or “terminated”.

  • Statutory Blindness: This will be “Yes” or “No.” This is important because individuals with blindness have higher income thresholds for eligibility purposes.

  • Date of Disability Onset: This is important because people whose disability was diagnosed before age 22 have access to Social Security benefits, based on parental work records as well as access to different Medicaid continuation programs.

  • Most Recent Date of Entitlement (SSDI) or Eligibility (SSI): This is self-explanatory.

  • Full Amount and Net Amount of Benefits Paid: “Net” amounts account for things that may lessen “take home” benefits; for example, Medicare premiums, overpayment recovery, and garnishment.

  • Others Paid on This Record: This will be “Yes” or “No.” This explains where other family members are also receiving benefits on the work record of the SSDI recipient. This is important to know, especially if the person with a disability or anyone receiving auxiliary benefits works because some payments are impacted by the primary recipient’s work income and some benefits are subject to a family maximum.

  • Total Family Cash Benefits: This figure IS the maximum that can be paid on the work record of the person with a disability to both that person and to dependent “auxiliary” family members.

  • Overpayment Balance: If Social Security has determined that they overpaid you in the past because of your error or theirs, this will tell you how much they plan to recover.

  • Monthly Amount Withheld: Just like it sounds, this is the amount the Social Security Administration is recovering monthly.

The next several sections of the BPQY report provide details of the following aspect of the person’s benefits:

  • Medical Reviews: Several lines explain the review cycle that pertains to your situation, when your next review is scheduled and whether reviews have been deferred due to participation in the Ticket-to-Work.

  • Representation: This section lists whether you have a representative payee (rep payee) or an authorize representative. Note that a representative payee receives and manages the actual payment on behalf of the beneficiary, while an authorized representative merely communicates on behalf of that person.

  • Health Insurance: This section will explain whether the beneficiary has Medicare Part A or B, when that benefit started and stopped (if applicable) and whether they are paying a premium. It also lists any Medicaid eligibility that the Social Security Administration can determine. However, this would not include, for example, Affordable Care Expanded Medicaid eligibility.

The final sections pertain to work and Work Incentives as follows:

  • SSI Work Exclusions: This is a record of what the SSA has approved and also allows the beneficiary to deduct before her/his income is “counted” for SSI eligibility purposes. Exclusions include Blind Work Expenses, Impairment- (non-blind) Related Work Expenses, the Student Earned Income Exclusion and exclusions for contributing to a Plan to Achieve Self-Support (PASS).

  • SSDI Work Activity: This is a record of work details, which are pertinent to SSDI eligibility such as how many Trial Work Months have been used up and when those started and stopped; the Cessation Month date (the first month after 9 Trial Work Months when the person earns over the Substantial Gainful Activity Threshold); the current year’s SGA threshold; and the last time the person’s work record was reviewed.

  • SSI Earnings Record: This section records the past 10 years’ annual earnings as reported to the IRS by the person’s employer(s) and also monthly earnings for the past two years as reported by the person to the SSA for SSI eligibility purposes. These will be coded “V” for “verified” or “E” for “estimated.”

  • SSDI Earnings Record: This section provides the SSA’s record of the person’s monthly gross and countable earnings over the past 5 years and whether they have been verified. Countable earnings are net of any Work Incentive deductions that were applied.

Regrettably, the BPQY data is slightly more complicated to interpret and use than the red-yellow-green codes that Google Maps uses to flag street traffic as slow-medium-fast. It is very useful data, however, and can point the best way forward for people with disabilities who want to maximize both their earnings and their benefits. Frequently, I wish I had a professional navigator to help me apply the Google Maps traffic data effectively. I would encourage people with their disabilities and their families to obtain a BPQY and then retain a qualified professional to help them make the most of it.

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