Employment After Spinal Cord Injury (Part 2)
Work vs. benefits: finding a balance
Sometimes people are reluctant to start working because they don’t want to lose their medical benefits under Social Security Disability Insurance (SSDI), Supplementary Security Income (SSI), or private or state long-term disability insurance (LTD). They may also be concerned about the extra costs of getting to or staying at work.
Federal work incentive programs under SSDI or SSI allow people with disabilities to receive benefits and federal health care (Medicare and/or Medicaid) while still keeping some of their earnings from employment. This can be a powerful incentive for someone with a high-level SCI who has a strong desire to work but needs personal care assistance on the job, must pay for a van, and needs other services in order to work. Some LTD policies include vocational rehabilitation benefits or incentives to return to work.
Work-incentive programs are complicated. and you may want to consult your vocational rehabilitation counselor, a resource specialist with an independent living center, or a social worker familiar with benefits systems. (Also see “Resources,” below.)
If employment is not possible
Sometimes it is not possible for a person to obtain any kind of work after SCI. This includes people who cannot earn enough by working to pay for their own personal care assistance and other disability costs. People who live in rural areas may not have access to transportation or employment. Older workers may not be able to transfer their pre-injury skills to a new occupation. In these cases, the individual can apply for disability benefits with the help of the rehabilitation counselor or other health provider.
A person is eligible to receive disability payments from the Social Security Administration (SSA) if he or she is unable to perform any kind of work at a level of “substantial and gainful” activity and the disability is expected to last at least a year.
The SSA pays disability benefits under two programs:
- Social Security Disability Insurance (SSDI) is a long-term disability insurance program funded by payroll taxes. Eligibility is based on your past work history and income.
- Supplemental Security Income (SSI) is a federal welfare program for people with disabilities who are unable to work and are low income.
Newly injured individuals with SCI should apply for SSA benefits immediately if it seems likely that they will not return to work for at least a year. Sometimes there is a waiting period before starting to receive benefits. Once enrolled, a person is immediately eligible for either state Medicaid benefits or, after a waiting period, for federal Medicare benefits.
The case for volunteering
If paid employment is not possible, consider getting involved in a volunteer activity. Not only can volunteering provide enjoyment and a sense of accomplishment, it can give you the skills, confidence and professional contacts that might eventually lead to paid employment some day.
Resources
- Benefits for People with Disabilities, Social Security Administration: http://www.ssa.gov/disability/
- Find your local Vocational Rehabilitation Agency, Job Accommodation Network, U.S. Department of Labor: http://askjan.org/cgi-win/TypeQuery.exe?902
- The Red Book: A Guide to Work Incentives, Social Security Administration: http://www.socialsecurity.gov/redbook/
- Social Security Area Work Incentive Coordinators (AWIC) provide information about work incentive programs. You can find the AWIC in your area at http://www.ssa.gov/work//awiccontacts.html.
Reference: http://www.msktc.org/sci/factsheets/Employment-After-Spinal-Cord-Injury
