Benefits Training and Consulting

P.O. Box 40, Oxford, PA  19363

Telephone: (610) 696-1551   Fax: (610) 932-0428   E-mail: wallinginc@aol.com

 

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        Our Publications are on SALE during December

 

                                      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. 

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                               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 person’s 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 individual’s 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 person’s 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 person’s benefits

and work history, as it is stored in SSA’s 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 SSA’s

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

person’s file; and 3) have past errors in the person’s 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 organization’s 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

with disability.

 

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

licensed counselors."

 

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.


If you wish to report Medicare or Medicaid fraud, contact the Department of Health and Human

Services, Office of Inspector General at 1-800-447-8477, or visit their website at

http://oig.hhs.gov/hotline.html.

 

 

                      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.

 

                         

 

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