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Newsletter by Michael Walling
December 1, 2009
I am changing the format of the newsletter.
In the future, items will be added to this page periodically.
Benefit Planning Query (BPQY)
A common problem, encountered by agencies assisting individuals with disability, is the lack of
accurate knowledge of which benefit the person receives and the persons current status in the
benefit program. Even agencies who are representative payee, while they may know which
benefit is received, typically do not know the individuals current status in benefit program.
There are two vital tasks to supporting an person with disability who is pursuing employment.
First, we must know the current status of the persons benefit to provide the individual correct
advise and guidance. Being able to predict how income will affect entitlement/eligibility to benefits
in the future is an employment retention strategy. Once a person is employed, we must provide
the individual with the skills and/or support to report their income routinely (monthly) to Social
Security. These tasks can assist the individual in avoiding large overpayments of cash benefits.
The SSA has developed and implemented a tool to provide a snapshot of the persons benefits
and work history, as it is stored in SSAs electronic records. This tool is called a Benefit Planning
Query - BPQY (SSA-2459). The information provided in the BPQY includes: the type of benefit
received; the current status; date of entitlement; full amount received (before deductions); net
amount received; total family cash benefit; monthly amount withheld (if overpayment exist); health
insurance eligibility; next scheduled medical review; SSDI work activity (trial work months, etc.;
SSI work exclusions (being used); and recent earning on record.
As you can see, this is all crucial information in counseling and planning with a beneficiary. To
obtain a BPQY (SSA-2459), a beneficiary can request this report from their local SSA office
or call 800-772-1213. All local SSA offices have access to the BPQY software. With a proper
written authorization, a Consent for Release of Information (SSA-3288), a BPQY can be
provided to a representative, advocate or organization. The SSA-3288 is available at SSAs
website in the "Forms" section - http://www.ssa.gov/online/ - select "search: all fields" for "3288."
Note of caution: the accuracy of the BPQY report depends on several factors: 1) has the person
been reporting income to the SSA; 2) has the local SSA office entered reported income to the
persons file; and 3) have past errors in the persons record been corrected. Local offices have
the ability to directly input earnings information. If you suspect the BPQY is incorrect, work with
personnel in the local office to resolve the suspected discrepancies.
What Does It Take To Schedule A Workshop?
Many people have called asking for more details on hosting workshop on Social Security and
medical benefits, presented by Michael Walling. To some people the offer sounds too simple
and there must be a catch.
By serving as the host organization (or agency) for a workshop, the organization has ten free
seats at the workshop. This certainly reduces staff training costs, particularly when your program
is on a tight budget.
We ask the host organization to provide meeting space, for approximately 35-40 people in a class-
room setting. The host organization is responsible for providing light refreshments (coffee, soda,
snack foods). We also ask the host organization to distribute an advertisement of the workshop
to local contacts, as they have a better mailing list of contacts in the local area.
The host organizations distribution of the advertisement is an important role in suburban and
rural areas. This usually assures a minimum registration of people to conduct the workshop. We
supply the master copy of the ad by e-mail and/or mail.
Benefits Training and Conutling will provide the trainer, the training materials, and audio-
visual equipment. All travel costs and lodging costs are covered by our company. In addition, we
take care of registration matters and the confirmation of registrations.
Host organizations have used a variety of free meeting space when their own facility was
inadequate to accommodate the workshop. The meeting site must be accessible to individuals
We maintain a list of interested organizations and contact them approximately 3 months prior
to the week Michael will be in their area. Contact us if you would like to host a workshop.
You can reach us by phone: (610) 696-1551, fax (610) 932-0428, or by e-mail.
Policy Changes to Claiming Impairment-Related Work Expenses
Impairment-related work expenses (IRWE) may be claimed by a beneficiary when the items
or services are purchased and are required in to work. The cost of these items and services
reduces how much income the SSA considers. For beneficiaries receiving title II (SSDI) the
cost of these items and services can reduce countable income below the Substantial Gainful
Activity level ($1,000 for non-blind). SSI recipients claiming IRWEs realize an adjusted cash
benefit. Their SSI cash benefit is adjusted one dollar for every two dollars spent on IRWEs.
Previously, an IRWE may be claimed for items and services directly related to the impairment
which qualified the individual for benefits. Thus, a person who has qualified due to severe mental
illness and later developed severe high blood pressure, could not claim medications for treating
high blood pressure because it was not the listed impairment. In March, the SSA issued policy
changes which permit an individual to claim IRWEs that correlate with either the primary medical
basis of disability or any other medically established impairment being treated by a physician or
health care provider. Emphasis is placed on "being treated by a physician or health care provider."
The SSA has also defined who is a health care provider- "A health care provider must be a
licensed or registered professional. Health care providers may include, but are not limited to:
osteopaths; naturopaths; psychologists; chiropractors; audiologists; nurse practitioners; dentists;
physical, occupational, and speech therapists; registered dieticians; clinical nutritionists; and
When reviewing a claim for IRWEs, SSA personnel must address the following points:
1. Does the alleged IRWE correlate with the person's disability; and
2. Does the person need the item and/or service to work; and
3. Has the person paid for the item and/or service; and
4. When can the IRWE be deductible and how can they be distributed?
When the IRWEs do not correlate with either the medical records available to the SSA, the
individual will be asked provide medical records or a statement from physicians or health care
provider establishing the need for the item or service. Thus, it is important for the person to
prepare and/or assemble the proper documentation prior to claiming the IRWEs.
Other points clarified: 1) how IRWEs can be determined in Supportive Living Programs;
2) health and/or life insurance premiums are not IRWEs; 3) if another person is providing
the service and receiving payment for a service, the SSA may check to establish that this
income is being report under the Federal Insurance Contributions Act (FICA); and 4) the
IRS standard mileage rate in 2009 is $0.55 per mile.
When an IRWE is approved, the claim will be reviewed every twelve months (or sooner if the
IRWE is not expected to be on-going). Thus, the beneficiary must keep receipts or other proof
of payment for the periodic reviews.
Are You on the Distribution List?
If you received this newsletter from a colleague and would like to receive future editions directly,
simply send us an e-mail request. We will add you to the distribution list. You must provide your
name and position, name of your organization, business address, and a fax number. Many
organizations do not allow staff to receive attachments to e-mails, thus we will fax the newsletter
and announcements of upcoming workshops. Select "Distribution List" in the left margin menu bar.
We do not distribute, sell, or share our mailing lists.
Reporting Alleged Misuse of Funds and Fraud
When conducting training seminars, it is not uncommon for a member of the audience to express
his/her frustration in trying to report a situation of misuse or fraud to the local SSA office. With
the recent passage of the Social Security Protection Act of 2004 (see above), the issue of
reporting alleged misuse of cash benefits and/or fraud has gained renewed interest.
So who is responsible for investigating your allegation? Not the local SSA office!
The Social Security Administration (SSA), Office of the Inspector General (OIG), is the
appropriate department to contact when you wish to report fraud and/or misuse of cash benefits.
The OIG maintains a Fraud Hotline and has the necessary information and forms at their website-
Fraud Reporting Form at http://www.ssa.gov/oig/hotline/index.htm. The Fraud Hotline receives
allegations by telephone, regular mail, facsimile, and electronic mail. The information you supply
to the OIG will be kept confidential. Contact the OIG by phone between 10 AM and 4 PM at
1-800-269-0271 or by fax: (410) 597-0118.
Services, Office of Inspector General at 1-800-447-8477, or visit their website at
South Dakota Continues Benefit Training
The South Dakota Freedom to Work Project, funded in part by a Medicaid Infra-structure Grant,
will continue to provide benefit training programs throughout the state during 2010. This will be the
seventh year, this training has been available to all South Dakota residents.
One-day workshops will conducted throughout the state during the weeks of April 26-30, August 16-20 and
October 18-22, 2010. The basic workshops are divided in morning sessions on SSI and afternoon sessions
focusing on title II (SSDI) benefits. Some dates will be advanced workshops. Check the workshop schedule
by clicking "Workshops" (left hand column).
Contact the Freedom to Work Project for additional information (605) 945-2207.