Disability Terms and Definitions

Medicare (SSDI) Two-part health insurance program for eligible disabled individuals and people age 65 or older Ticket to Work program The Ticket to Work program provides disabled beneficiaries with expanded options for access to employment services, vocational rehabilitation services, or other support services. ADA Title I: Employment Title I requires employers with 15 or more employees to provide qualified individuals with disabilities an equal opportunity to benefit from the full range of employment-related opportunities available to others. Impairment-Related Work Expenses (IRWE) The provision that permits the exclusion from earnings of the costs of items and services which are needed in order for a disabled individual to work, which are paid for by the individual, and which are necessarily incurred by that individual because of a physical or mental impairment. Maximum Benefit Period (Benefit Duration) This is the maximum length of time for which benefits are payable under the plan as long as the employee remains continuously disabled. Outcome Payment System The system providing a payments under the Ticket to Work program to an employment network for each month, up to a total of 60 months, during which Social Security disability benefits and Federal SSI cash benefits are not payable to a beneficiary because of the performance of substantial gainful activity (SGA) or by reason of earnings from work. Benefit Percentage The benefit payable is usually determined as a percentage of the insured's pre-disability income up to an overall maximum benefit amount. Section 1619(a) Status The special SSI cash benefits provided to disabled individuals who lose eligibility for SSI benefits under the regular rules because they have earnings at the level that is ordinarily considered to represent substantial gainful activity. Elimination Period This is the period of time between the date the disability commences and the beginning of the benefit payment period. It is the period during which an employee must be disabled before payment of benefits begins. It is sometimes referred to as the Qualifying Period. Unincurred Business Expenses Self-employment business support given to you by someone else without cost. If you are self-employed, we deduct unincurred business expenses from earnings when we determine SGA.

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	Did You Know?
	SHMO means Social Health Maintenance Organization A managed system of health and long-term care services geared toward an elderly client population. Under this model, a single provider entity assumes responsibility for a full range of acute inpatient, ambulatory, rehabilitative, extended home health and personal care services under a fixed budget which is determined prospectively. Elderly people who reside in the target service area are voluntarily enrolled. Once enrolled, individuals are obligated to receive all SHMO covered services through SHMO providers, similar to the operation of a medical model health maintenance organization (HMO).