Developing Written

Benefits Analysis Summaries

VCU YTD Technical Assistance Office

October 17, 2005

What is Benefits Analysis?

An intensive benefits counseling service that entails :

gathering benefit and other information specific to a YTD participant

analyzing the various options or paths available providing advise regarding the impact of these

options

Benefits Analysis Summary…

is the written report which documents the information gathered, analysis results, and advice provided to the individual.

The centerpiece of the summary is individualized, case-specific information and advice on current benefits status, the effect of earnings on benefits, and the use of relevant work incentives.

Why have a written analysis?

To document:

– What the beneficiary told you – What you told the beneficiary – What you uncovered through verification– What changes will affect benefits– What the beneficiary must do to report

changes

Analysis serves to…

Take a snapshot of current situation

Help build understanding of benefits issues

Provide a resource for beneficiaries, their families, and the support team

Keep the communication clean and clear

When is it Necessary to Develop a Written Benefits Analysis Report?

Information and Referral Services

Providing general information on all Federal, State, and Local benefit programs.

– Initial and continuing eligibility

– Impact of employment & other changes

– Work incentive provisions

Information & Referral

Can you tell me what the current SGA amount is?

How does a PASS work?

What is this ticket & will I get in trouble if I don’t use it?

I have a disability and would like to work. Do you know of anyone who can help me?

Problem Solving

Answer questions specific to the beneficiary/recipient, but relevant to only a small piece of their situation.

Gather, verify and analyze information to solve the particular issue at hand.

Advise on options, but not a complete analysis.

Problem Solving

I didn’t get my SSI check. Can you help me figure out why?

I reported my earnings, but my check wasn’t adjusted.

I’ve just found out that my benefits are going to stop.. . Can you help me with Section 301?

Benefits Analysis & Advisement

Research and provide verification of complete benefits picture.

Inform beneficiary of options/outcomes.

Provide advise to support informed choice.

Benefits Analysis & Advisement

Jill is 20 and has never worked. She is considering work when she leaves school next year and wants to understand what would happen to her benefits.

As a General Rule…

…a written benefits analysis report is needed whenever individualized, case specific benefit information and advice is given

This means anything beyond basic information and referral services!

When to write the analysis…

As a base point, when the youth enters the project

After major life changes, such as change in employment status residence change graduation Marriage

Within a year of reaching the 17th Birthday

When to Write the Analysis

Within a year of reaching the 17th Birthday

For SSI Beneficiaries:

– Age 18 Redetermination Process– Parental Deeming Stops at 18– Inkind Support & Maintenance Starts at 18– Potential Changes in unearned income– Access to new resources– Continued Access to Medicaid– Work and Work Incentives– Marriage – Couple FBR

When to Write the Analysis

Within a year of reaching the 17th Birthday

For Title II Beneficiaries:

– Potential loss of Child’s Benefit– Potential eligibility for Childhood Disability Benefit– Special Medicaid Beneficiary Status for CDBs– Impact of Marriage on CDB– Work and SSDI eligibility on own record– Title II disability work incentives (TWP, EPE)– Other Work Incentives – IRWE, PASS

When to Write the Analysis

Within a year of reaching the 17th Birthday

Not Previously Eligible for Disability Benefits

Representative Payee-ship

Post-Secondary education

Asset Development

When to Write the Analysis

As a periodic update when other changes have been gradual

When the person leaves the project

What Should a Written

Benefits Analysis Report

Look Like???

Suggested format

– Introduction– Current benefits– Priorities and intentions– Impact of work– Outstanding issues– Reminders– Disclaimer

I. Introduction

Person’s status in project

Purpose of analysis

Where you gathered information

Introduction example

Dear Sam,

This is a letter for you to use for your records. It gives information about your benefits, and how work will affect them. We met on October 5th…

II. Current benefits

Types and amounts of benefits received

Can be chart, list or paragraph

Current benefits example

According to the Social Security Administration, you receive SSI in the amount of $579.00. You also have Medicaid…

III. Priorities and Intentions

This section should outline:

What the youth plans to do

and

What benefits are most essential in the youth’s life

Priorities example

You told me that you plan to take a part-time job as soon as you find one.

You also said that you were very concerned about losing your Medicaid.

IV. Impact of Work

Impact of employment goal and earnings on various benefits received

Outline applicable work incentives

Use examples specific to the individual

Refer to supplemental material rather than rewriting existing basic material

Remember the waivers!

Impact example

If you go to work next month and bring home $425.00 in gross wages, you will receive less money in your SSI.

Your SSI check will be $$$ beginning in December 2005…

If you decide to accept a full time job and your earnings increase to $$$, you will no longer receive an SSI check each month… But your Medicaid will continue…

Impact example

SSI is a benefit that is reduced when you receive other income. Not all of your wages will affect your SSI, however. In fact, because you are in the Youth Transition Demonstration…

Impact of YTD Waivers Example

SSA will look at how much money you make in a different way. You can make $65 per month without a change in your SSI benefit. For every $4 you earn over $65 per month, SSA will reduce your benefits by $1. This is different than what they usually do. This allows you to make more money without it reducing your benefit.

Impact of YTD Waivers Example

While you are in the Project, you can have a Plan for Achieving Self-Support (PASS) that has going to school after high school as a goal. You can have a PASS that says you want to look at different types of work. This is different than what is usually allowed with a PASS.

Impact of YTD Waivers Example

While you are in the Project, you may be reviewed by SSA. This is true even if you are not in the Project. SSA may find during this review that you are not eligible to continue getting benefits. If that happens, you will still get your benefits as long you don’t earn so much money that your benefits will stop.

V. Outstanding issues

Some issues take a while to resolve. If something is pending, simply write it into the summary, rather than waiting forever for it to be corrected.

Outstanding issues example

When we first met, we discussed the possibility of your applying for Food Stamps. As you know, we completed the application on September 5th. The Food Stamp office said they would notify you by…

VI. Reminders

Bulleted list that:

Gives phone numbers for contact Lets person know when to report changes Let’s person know what you are doing next,

and that you are available Reminds person of important dates, actions

Reminder example

You need to let me know as soon as you start your new job

You need to contact me when you are ready to set your earnings aside in your Individual Development Account

You may reach the Food Stamp office at 555-666-7777….

VII. Disclaimer

– Limits your liability for information contained in summary

– Indicates who has final authority for benefit determinations

Disclaimer example

The accuracy of the information provided above depends upon ….

Accuracy and completeness of info you provided about past and current benefits

Accuracy and completeness of info you provided about other relevant factors (earnings, resources…)

Current laws and regulations on effect of work… Current SSA policies and procedures Re work

incentives

Benefits Analysis Summary Pointers

Organization Tips:

– Start with on outline– Think and write sequentially– Group related concepts together– Use bolded headings or boxes, bullets…

Benefits Analysis Summary Pointers

Tips on What to Include:

– Only info on benefits, impact of earnings, and use of work incentives!

– Limit to benefits that are relevant & current– Specific solutions or options for resolving problems– Include / Attach calculation sheets, charts,

calendars lists…– Attach SSA Spotlights, pamphlets…

Benefits Analysis Summary Pointers

Writing Tips:– Individualized and Directed to YTD participant– Brief, but complete – not overwhelming!– Accessible in language and format

be organizedSimple, understandable language - avoid

acronymslimit sentences to one or two concepts

– Use templates cautiously!

Benefits Analysis Summary Pointers

The summary is for documentation, but it can be a great learning tool as well…

Use time with the participant to review and make sure they get the most out of the information you provide!

Case Records

Intake sheet with contact information Case notes Copies of any release of information forms

used to access benefits information from SSA or other agencies

Copies of BPQYs, statements of benefits

More on Case Records

Copies of any written Benefits Analyses, summaries of advisement

Copies of correspondence to or from other agencies

Copies of any work incentive information

First Steps…

Provide explanation of YTD services Obtain informed consent to gather data Gather benefits and contact information Ascertain problem & info needed to resolve Get release forms signed and submit

The Benefits Analysis Process

Benefits Analysis Next Steps…

Gather Information -- Verify all relevant benefits

Research and analyze issues

Meeting/counseling on presenting and related issues

Written Benefits Analysis

Gathering Beneficiary Information

Contact information and personal demographics

Presenting problem, issue, question, or need Future outlook – employment goals Benefits received and amounts Health insurance received and future needs Monthly income and resources

Gathering Beneficiary Information

Employment information – past and current Past use of work incentives and current work

incentives status Indicators of potential work incentives (IRWEs,

PASS, BWE, Ticket to Work) Other agency involvement Disability information

Information Gathering

Assess the presenting problem, need or question

Determine what information is needed to resolve the problem or meet the need

Do not gather information that is not necessary or relevant!

Guidelines for Gathering Disability Information

Only ask if it meets the “compelling needs” test Limit to disability “benefits assistance” related

information Provide for private setting Ensure Beneficiary’s understanding

– Why info is needed– How it will be used– Their choice

Verification

It is essential to verify directly from the benefits source whatever benefit the YTD participant receives before writing the analysis.

That means…

Contacting…

the SSA and all other benefits providers to assess impact of work on current or future benefits

Don’t guess!!!

Requesting Information from Other Sources

SSA Form 3288 SSA BPQY Request Form

Other release of information forms

– What information– From whom– Expiration date– Signed by beneficiary / payee

Use the VCU – YTD TA Office…

Help in developing customized format

Assistance in reviewing benefits analysis summaries

Benefits Analysis Summary Exercise

Enrique, 2005