Eligibility Criteria

To be eligible for the 250% WDP, an individual must:

  • Meet the federal definition of disability as defined by federal law for Social Security disability programs, without regard to the ability to perform Substantial Gainful Activity (SGA), even if the individual has earned income over the current SGA amount.
  • Be otherwise eligible for SSI/SSP benefits, if earnings are disregarded.
  • Have net non-exempt family income less than 250% of the Federal Poverty Level (FPL).

    • Note: Disability income is exempt income. Earnings placed in a separate identifiable account are exempt income in the month received and the account is exempt property.

  • Meet all other non-financial MC eligibility program requirements (i.e., California residency).

    • Reminder: Disabled individuals who do not qualify for Aged, Blind and Disabled-Medically Needy (ABD-MN) programs due to SGA may be eligible for the 250% WDP.

Family Income

Net non-exempt Family Income is used in the 250% FPL test including:

  • The client’s own income, except for disability based income and earnings retained in a separate account.
  • The spouse’s income, if the spouse has income above a certain SSI threshold.
  • The parent’s income, if the applicant is a child.

Family Income does NOT include the income of a child in the home, unless the child is the applicant of the 250% WDP. A child must meet the same work requirements as an adult to be eligible for the 250% WDP, the child would be in a separate MFBU.

Disability Determination

An individual must meet the federal definition of disability to qualify for the 250% WDP. However, SGA does not apply to determine disability for the 250% WDP.

A Disability Determination Service Division (DDSD) referral packet is required to determine disability unless disability has already been verified; for example client receives Social Security benefits based on disability.

To clearly identify the referral packet as a 250% WDP, the “Disability Determination and Transmittal form” (MC 221) must include:

  • Section 8 - Check the “Other” box and enter “250% WDP”
  • Section 10 - Write “250% Working Disabled Program - NO SGA Determination Required”
  • Indicate the client’s working hours for contact purposes only.

    • Note: Confirmation of disability determination from DDSD is required before granting eligibility for the 250% WDP.

Immigration Status

Individuals requesting the 250% WDP must meet the immigration status requirements of the SSI/SSP Program.

The following individuals are not eligible for the 250% WDP:

  • Undocumented individuals,
  • Foreign visitors in the United States (U.S.) on a temporary visa,
  • Other non-citizens who would qualify only for restricted MC.

    • Note: All children under age 19 receive full-scope MC under SB75. SB75 does not apply to the 250% WDP.

  • Non-citizens with the following statuses are NOT eligible for 250% WDP UNLESS they are lawfully living in the United States and were receiving SSI on or before August 22, 1996:
    • Voluntary Departure INS Section 242(b)
    • Order of Supervision (INA Section 242)
    • Registry Alien (INA Section 249)
    • Indefinite Stay of Deportation
    • Suspension of Deportation (INA Section 244)
    • In United States with Permission of INS
    • Deferred Action Status
    • Indefinite Voluntary Departure
    • Extended Voluntary Departure
    • Stay of Deportation (INA Section 106)
    • Immediate Relative Petition
    • Application for Adjustment Status
    • Lawful Temporary Resident.

Property Determination

Non-MAGI MC property regulations apply, with several exceptions as described below. Individuals requesting the 250% WDP must have net non-exempt property at or below the property limit. For the 250% WDP the property limit does not increase if there are additional family members in the home.

The following individual retirement accounts are EXEMPT:

  • Individual Retirement Accounts (IRAs)
  • Work related pension funds administered by an employer or union including deferred compensation and thrift plans, and
  • Plans for self-employed persons such as KEOGH plans.

    • Note: The above-mentioned retirement plans will continue to be exempt when an individual is no longer participating in 250% WDP, and is receiving MC program based on age, blindness or disability (ABD-MN). This exemption applies as long as the client is in an ABD-MN aid code. EWs must document that the specific retirement plan continues to be exempt.

  • Retained Earned Income is also EXEMPT if it is kept in a separately identifiable account.

Net Non-Exempt Property Test/SSI Property Test

The net non-exempt property must meet the SSI/SSP property test. To complete the SSI Property Test, the EW must:

  1. Use the “SSI/SSP Property Test Work Sheet for the 250% Working Disabled Program - Adult and Children Applicants” (MC 338 C) to determine the net non-exempt property for the individual.
  2. Determine the SSI/SSP property limit. Use the property limit of:
    1. $130,000, if the applicant is a child or a single adult.
    2. $195,000, if the applicant has an eligible/ineligible spouse.

      1. Note: The property limit does not increase if there are additional family members in the home.

  3. Compare the net non-exempt property from Step 1 to the SSI/SSP property limit from Step 2.
    1. If the net non-exempt property is less than or equal to the SSI/SSP property limit, the individual passes the SSI Property Test.
      1. Continue to determine eligibility.
    2. If the net non-exempt property is more than the SSI/SSP property limit, the individual does NOT pass the SSI Property Test and is not potentially eligible for the 250% WDP.
      1. Evaluate the applicant for other types of MC (i.e., Pickle, A&D FPL and ABD-MN).

Retained Earned Income

Earned Income held in a separately identifiable account is exempt. All retained earned income is exempt property and will continue to be exempt as long as it is held in a separately identifiable account and it is not combined with other non-exempt resources. There is no maximum limitation on the amount that an individual can keep in their separately identifiable account. Proof of the exempt retained earned income and the separation from their personal checking, savings, or other non-exempt resources is required.

Interest income accrued in this retained separate account is not exempt. Accrued interest is non-exempt income in the month received and property the following month.

Income Determination

There are two income tests that need to be completed:

  • The SSI Income Test
  • The 250% Federal Poverty Level Test.

SSI Income Test

Applicants of the 250% WDP must have net non-exempt income less than the SSI/SSP payment standard. SSI income methodology is used to determine net non-exempt income, except that the applicant's earnings and disability income are exempt for this test. A determination of whether spousal deeming is appropriate is required prior to deeming an ineligible spouse's income to the 250% WDP applicant [Refer to “Supplemental Security Income Methodology Adult Income Eligibility Work Sheet” (MC 326 A (05/07)). To complete the SSI payment standard:

  1. Determine whether the net non-exempt family income of the disabled working applicant is less than 250% of FPL by using one of the following forms:
    1. For adults: Use the “SSI/SSP Income Test Work Sheet for the 250% Working Disabled Program - ADULTS” (MC 338 A), OR
    2. For children: Use the “250% and SSI/SSP Income Test Work Sheet for the 250% Working Disabled Program - CHILD Applying With or Without Ineligible Parent(s)” (MC 338 B).
  2. Use the appropriate SSI/SSP Payment Standard for:
    1. One person, if the applicant is a child, a single adult, or a married adult with an ineligible spouse when spousal deeming rules do NOT apply.
    2. Two people, if the applicants are a couple, or a married adult with an ineligible spouse when spousal deeming rules DO apply.
  3. Compare the net non-exempt income from Step 1 to the appropriate SSI/SSP payment standard from Step 2.
    1. If the net non-exempt income is less than the SSI/SSP payment standard, the individual passes the SSI Income Test.
      1. Continue to determine eligibility.
    2. If the net non-exempt income is more than or equal to the SSI/SSP payment standard, the individual does NOT pass the SSI Income Test and is not potentially eligible for the 250% WD Program.
      1. Evaluate the applicant for other types of MC (i.e., Pickle, A&D FPL and ABD-MN).

250% Federal Poverty Level Test

The family net non-exempt income of a 250% WDP applicant must be below the 250% of the FPL. SSI income methodology is used to determine the family’s net non-exempt income, except that DISABILITY INCOME of the applicant is exempt (i.e., DIB, RSDI payments based on disability, private disability payments, etc.).

To complete the 250% FPL Test, the EW must:

  1. Determine the net non-exempt Family Income based on SSI Methodology by using the following forms:
    1. For adults: Use the “250% Income Test Work Sheet for the 250% Working Disabled Program - ADULTS” (MC 338), OR
    2. For children: Use the “250% and SSI/SSP Income Test Work Sheet for the 250% Working Disabled Program - CHILD Applying With or Without Ineligible Parent(s)” (MC 338 B).
  2. Determine the appropriate family size for the 250% FPL amount. Use the 250% FPL amount for:
    1. One person, if the applicant is a child, a single adult, or a married adult when spousal deeming rules do NOT apply.
    2. Two people, if the applicants are a couple or a married adult when spousal deeming rules DO apply.

      1. Note: The FPL family size does NOT increase if there are additional family members in the home.

  3. Compare the net non-exempt family income from Step 1 to the appropriate 250% FPL amount from Step 2.
    1. If the net non-exempt family income is less than the 250% FPL amount, the individual passes the 250% FPL Test.
      1. Continue determining eligibility.
    2. If the net non-exempt family income is more than or equal to the 250% FPL amount, the individual does NOT pass the 250% FPL Test and is not potentially eligible for the 250% WDP.
      1. Evaluate the applicant for other types of MC (i.e., Pickle, A&D FPL and ABD-MN).

SSA Disability Income that Converts to Retirement Income

SSA disability income that converts to SSA retirement income when clients reach retirement age will continue to be exempt. Retirement income which converts from sources other than SSA will not be exempt. Income from SSA which is not converted from disability income, such as retirement income, when the recipient reaches retirement age will be considered unearned income.

Example Example Ms. Jackson was receiving SSA disability, when she reached retirement age the income converted to SSA retirement income. This income will remain exempt. 

Example Example Mr. Pomeroy who is receiving railroad disability income reaches retirement age. His railroad disability converts to retirement income. This income will be considered unearned income as it did not convert from SSA disability income. 

Example Example Mr. Carbondale is receiving SSA retirement income, which did not convert from SSA disability. This income will be considered unearned income as it did not convert from SSA disability income. 

Verification of the conversion is required. Verification may include the following:

  • Any written verification from the SSA office.
  • SSA award letter.
  • Verbal verification from SSA. EWs must document in Case Comments when verbal verification is received from a Social Security Administration worker.

Related Topics

250% Working Disabled Program

Eligibility Determination Procedures