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Section 1619


Section 1619 of the Social Security Act provides that if you are already on Supplemental Security Income (SSI), and then you go to work in spite of your medical condition, and the Medicaid you get from being on SSI provides you the help you need to work, then the income limit rule will be waived.

This can continue indefinitely if earnings are low enough and the worker continues to have the impairment which qualified him or her for SSI disability in the first place.

You must always get advance permission from Social Security to take advantage of Section 1619.

In those states where Medicaid doesn't come automatically from being on SSI, you'll need to bring SSA paperwork verifying your 1619 status to the welfare office too. 

Section 1619 only applies to SSI. It does not apply to income from Supplemental Security Disability Insurance (SSDI). Section 1619 won't preserve SSDI benefits if your SSDI is so low that you're on both SSI and SSDI. You'll lose your SSDI (after the 9 month Trial Work Period and the 3-month Grace Period) but the Medicaid that comes from being on SSI will continue.

Section 1619 will not enable you to earn large sums of money and yet stay on Medicaid.

You May Lose SSI, But Retain Medicaid

Social Security looks at your countable income (income after any impairment-related work expenses and the $85 and half the rest of earned income is disregarded). If your resulting countable work income is greater than the permitted SSI income level, you still lose the actual SSI check. However, Social Security will pretend you were still on SSI so that you would continue to get a Medicaid card. Since Medicaid is one of the most valuable health coverages you can get with an expensive illness, Section 1619 can be a tremendous benefit. Unfortunately, it is little-known and little-used.

Section 1619 Has An Income Limit

The law says that once your gross earnings are high enough for you to pay your own SSI and Medicaid costs yourself, Section 1619 eligibility stops - and so does your Medicaid. For income eligibility levels in your state, click here offsite link.

If your earnings exceed the specified "threshold" level in your state, you're presumed to be no longer eligible for Section 1619. However, you are permitted to ask for an "individualized" Section 1619(b) determination to show that your own personal, actual medical and related expenses are higher. In that case, the higher, individually-computed level would become the Section 1619 limit for you. The individualized level consists of twice the state's current SSI eligibility level + $85 + the amount of your medical care Medicaid pays for. To help you with this "individualized" determination, 20 Code of Federal Regulations 416.269 and Section SI02302.050D of Social Security's own POMS Manual tells Social Security workers to assemble these figures for you. If necessary, the workers are directed to get from the state Medicaid agency the amounts it spent on you.

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