HWD designated staff responsibilities

For an individual receiving HWD benefits who appears to no longer meet the disability requirements for the BCG, use the following procedures.

Example #1

An HWD individual receives a letter from SSA that states he/she no longer meets the disability requirement to receive SSDI cash after completing his/her Trial Work Period (TWP) and has earnings at or above the substantial gainful activity (SGA) level for one subsequent month.

He/she will be eligible for and receive the SSDI benefit for that one month and the following two months. However, during any month in which earnings fall below the SGA level, the individual remains eligible for his/her SSDI cash benefit during the Extended Period of Eligibility (EPE). The EPE begins the month after the TWP ends. The individual should contact the Social Security Administration (SSA) to confirm when their TWP ended once their SSA cash benefit ends because of earning at or above the SGA level. To receive SSDI for a month in which earnings fall below SGA, the client must call SSA and document for them the amount of earnings; no application is necessary.

When an individual receives this letter from SSA, it might appear he/she does not continue to meet disability requirements for coverage under the HWD Basic Coverage Group (BCG). This is not true, since the client remains eligible for coverage under the BCG during the EPE. Staff need to recalculate the monthly premium amount and send proper notification. Staff should email the HWD program manager in Olympia, if they have questions about the client's coverage during the EPE.

For more information about this SSDI work incentives , see the SSA Red Book Extended Period of Eligibility .

Example: #2

An individual completes the EPE and remains enrolled in HWD. If medical improvement has occurred, the client's coverage continues until the completion of a disability determination for the Medically Improved Group (MIG) is completed. Email the HWD program manager to request a determination of eligibility under MIG and continue coverage until one is completed. .

To approve HWD coverage for a member of the MIG, use the new "Disability Source" (CD) code to indicate the client has a medically improved disability as determined by the HWD program manager.

For an individual receiving HWD benefits that no longer meets the eligibility requirements for BCG or MIG, continue HWD coverage until you redetermine eligibility for other medical programs.