Mental Health Disabilities and Employment: An Interview with the Social Security Administration

An Interview with the U.S. Social Security Administration

The Social Security Administration (SSA) provides retirement, survivorship, and disability benefits to 64 million Americans.

An anti-poverty program in operation for more than 80 years, the SSA was created to support the wellbeing and protection of beneficiaries that span all ages. Two benefits programs that may be available to individuals with disabilities—including those caused by mental health conditions—are Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). While SSDI is based on the amount a person worked/contributed to social security taxes prior to becoming disabled, SSI is determined by financial need.

In the following interview, a spokesperson from the Social Security Administration graciously offered expertise on the benefits programs available to individuals with mental health disabilities in need of financial support.

CounselingSchools.com: How does the SSA determine eligibility for SSDI and SSI?

Social Security Administration Spokesperson: Social Security (SSA) determines eligibility to Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) benefits based on both medical and non-medical requirements.

Medically, both programs provide benefits based on disability or blindness. The applicant must meet SSA’s definition of disability:

However, there is a separate definition of disability for children (under age 18) who are applying for the Supplemental Security Income (SSI) program. See the definition and the non-medical requirements for SSI here.

Social Security Disability Insurance (SSDI) benefits replace part of the earnings from work that a person loses due to disability. For SSDI, to ensure the relationship between benefits and a loss of earnings, the worker must have credit for a specific amount of work over a certain period. See the non-medical requirements for SSDI here.

CounselingSchools.com: What challenges may individuals with mental health conditions face when trying to qualify for these benefits programs?

SSA Spokesperson: Mental health conditions vary widely and affect individuals differently. Severe impairments affect cognitive functioning in many ways, and applicants with severe mental illnesses may find the application processes confusing, difficult, or stressful.

SSA makes every effort to ensure that applicants understand their rights and responsibilities with consideration of the particular benefits involved and conditions alleged. Especially when assisting people who have potential mental health issues, we reduce distractions in the interview environment as much as possible; speak simply, slowly, clearly, and calmly; and listen to the person in an accepting manner.

We also provide claimants with information about other government programs, offering potentially more immediate assistance based on financial need, such as the Supplemental Nutrition Assistance Program (SNAP) and Medicaid.

CounselingSchools.com: What limitations are placed on SSDI and SSI beneficiaries with regard to employment?

SSA Spokesperson: As a recipient of SSI benefits or a beneficiary of SSDI benefits, the individual or his or her representative must promptly report any changes in work activity, such as:

• Return to or stop work
• Changes in duties, hours, or pay
• The start of payments for expenses that he or she needs for work due to their disability

For SSI, the more countable income the recipient has, the less his or her SSI benefit will be. If their countable income is over the allowable limit, he or she cannot receive SSI benefits.

For 2021, the monthly Federal benefit rate (FBR) for the SSI program will be $794 for an individual and $1,191 for a couple. In 2021, the allowable limit (or break-even point) for earned income (employment), will be $1,673 for an individual and $2,467 for a couple. For more information on earned and unearned income break-even points (i.e., the income thresholds above which SSI would not be payable), see SI 00810.350.

Due to special exclusions and work incentives for the SSI program, the earned income has less of an impact on payment amounts than any unearned income the recipients have. As evidenced by the breakeven points, SSA counts less than half of the earned income in determining payments. Specifically, we do not count the first $65 of the earnings the recipient receives in a month, plus one-half of the remaining earnings.

Their countable earnings are reduced further if other work incentives apply (e.g., certain impairment-related expenses that recipient must pay to be able to work). See SI 00820.500 for more information about earned income exclusions. Even if the SSI payments stop because of their earnings, their Medicaid coverage may continue if he or she earns less than their annual state thresholds.

For SSDI, SSA uses information about their work activity and earnings to decide if their eligibility for disability benefits should continue based on whether he or she is able to engage in Substantial Gainful Activity (SGA). We generally use earnings guidelines to evaluate whether their work activity is SGA.

For 2021, average earnings from work activity of over $1,310 per month generally indicate SGA. For blind individuals, the monthly SGA amount is $2,190. SSA has several work incentive programs to help beneficiaries in obtaining and maintaining gainful employment.

For instance, the trial work period (TWP) allows the beneficiary to test his or her ability to work for at least nine months. During their TWP, he or she will receive full SSDI benefits regardless of how high their earnings might be as long as he or she reports their work activity and have a disabling impairment. Following the completion of the TWP, SSDI benefits are not paid for months in which earnings exceed SGA.

You can find more information about the limitations placed on SSI and SSDI beneficiaries with regard to employment, as well as the work incentives referenced above in our publication The Red Book.

CounselingSchools.com: What challenges may SSDI and SSI recipients with mental health conditions experience when returning to work and what support/resources are available?

SSA Spokesperson: One of Social Security’s highest priorities is to support the efforts of beneficiaries with disabilities who want to work by developing policies and services to help them reach their employment goals.

The SSDI and SSI programs include a number of employment support provisions commonly referred to as work incentives. Employment supports help you to enter, re-enter, or stay in the workforce by protecting your eligibility for cash payments and/or health care until you achieve this goal. You can find more information about these employment supports in The Red Book.

SSA’s Ticket to Work program offers SSDI beneficiaries and SSI recipients creative options for employment support. To provide these services, Social Security has agreements with service providers, called Employment Networks (ENs). ENs provide a wide variety of services, from employing beneficiaries directly, to providing job placement, training, resume development, benefits counseling, or supported employment job coaches.

Work Incentives Planning and Assistance (WIPA) projects are organizations that provide free benefits counseling to Social Security disability beneficiaries, to help them make informed choices about work.

Protection and Advocacy for Beneficiaries of Social Security (PABSS) organizations represent eligible beneficiaries to remove barriers to successful employment and help them to understand their rights regarding conditions of employment. While these employment support programs are not limited to beneficiaries with mental health conditions, they are effective resources made available to eligible beneficiaries who wish to return to work.

CounselingSchools.com: What advice do you have for individuals with mental health disabilities in need of financial support?

SSA Spokesperson: Eligibility for disability benefits is based on any type of medical disability, including mental impairments. If mental limitations prevent the person from working and engaging in SGA, he or she may be eligible for monthly disability benefits from either the SSDI and/or SSI programs. Once he or she starts receiving monthly benefits, several employment-support and work incentive programs are available to SSDI beneficiaries and SSI recipients. These programs help them maintain eligibility for cash payments and/or healthcare while they attempt to enter, re-enter, or stay in the workforce and earn additional income.

As one example, beneficiaries may be able to deduct certain impairment-related work expenses from their countable income to maximize their benefit payment or their overall eligibility for benefits as they attempt to work. For those with mental health disabilities, expenses could include the cost of medications and/or co-pays for therapy and counseling appointments.

More information about these and other employment supports for individuals with mental health disabilities can be found in The Red Book.