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Once you have a job, there are some things that you should know, so that you can keep your job and stay employed. This section describes some common situations that many people face in their jobs.
After you start working, you may find that you need to take time off from work because of your disability or if you become sick. It’s important to understand whether you are eligible for different programs that will protect your income during the time that you need to be away from work.
You can remain insured on your parents’ private health insurance, if it is available and if it is cost effective for you, up until you are 26. Your employer may also provide health insurance coverage as a benefit of your employment. However, every policy is different and you will have to do a careful review to see which option is best for you.
Before you face a medical or disability-related issue, make sure to:
If you have health insurance from a job (or a family member’s job), you are considered covered and will not have to pay the fee that uninsured people must pay. If you have medical assistance, like Medicaid, you are also considered covered and do not have to pay the penalty. For more information, visit https://www.healthcare.gov/what-if-i-have-job-based-health-insurance/
If you do not have health insurance from your job, you must purchase a policy (unless you qualify for medical assistance like Medicaid, in which case you are considered to have sufficient health insurance). Under the new law, every health insurance plan will cover a core set of benefits called “essential health benefits.” Generous subsidies in the form of tax credits are available for many people to offset the costs of premiums and co-insurance. To learn more about buying health insurance under the new law, visit https://www.healthcare.gov/what-is-the-health-insurance-marketplace/.
For more information on the Affordable Care Act in general and what it means to you, call 1-800-318-2596 (TTY: 1-855-889-4325) or visit: http://www.delawareinsurance.gov/health-reform/ACA.shtml or healthcare.gov.
If your healthcare insurance is provided by your employer, there are certain protections under another federal law, the Employee Retirement Income Security Act (ERISA)[2]. Under this law, health insurance companies are required to give you important information about the plan. They also must have a fair process for handling benefit claims.
For more information on your rights and responsibilities under ERISA, call 1-866-444-EBSA (3272) or visit www.dol.gov/ebsa.
The Delaware Insurance Commission is another important source of information about health insurance in Delaware. If you have questions about insurance or complaints about an insurance company or insurance agent, contact the Commissioner’s Consumer Services division:
1-800-282-8611 toll-free in Delaware or (302) 674-7310
Email: consumer@state.de.us
Website: delawareinsurance.gov
Or review their “A Guide To Insurance and Health Care Programs For People
with Disabilities,” http://delawareinsurance.gov/Guides/DisabilitiesGuide.pdf.
You may be surprised to learn that in Delaware, employers are not required to provide employees with sick leave, either paid or unpaid.[3] Employers must follow their own policies, so it is always a good idea to get a copy of your employer’s leave policy and make sure it is being followed.
You also should know that Social Security does not provide any short-term disability coverage.
There are a few ways that you may either continue to receive your income or your health insurance coverage, even while you are away from work due to illness or as related to your disability:
Your employer may offer this insurance as a benefit for employees. If your employer doesn’t offer this insurance, you may wish to purchase a policy on your own.
This type of insurance provides some compensation when an employee needs to take time off work due to injury, illness, or disability.
The terms of the policy will determine what disabilities are covered, how much the employee will receive, and for how long. This means that every employee’s situation will be different.
FMLA is a federal law that requires companies to provide employees with up to twelve weeks of unpaid leave per year (“year” may not necessarily mean calendar year) to deal with one’s own medical issues or to take care of a sick member of one’s immediate family.
FMLA applies to only certain companies and only certain employees.[5] If you need to take leave for medical reasons, you should first find out whether FMLA applies to your employer. If it does not apply to your employer, you cannot take leave under FMLA.
FMLA is an important form of job protection for employees with disabilities, because your employer cannot fire you while you are on FMLA leave. However, there are some important things that you should know about taking leave under FMLA:
If you believe that your rights under the FMLA have been violated, you may file a complaint with the U.S. Department of Labor’s Wage and Hour Division. Here is more information on how to file a FMLA complaint: http://www.dol.gov/wecanhelp/howtofilecomplaint.htm
If you have more questions, call 1-866-487-9243 or visit www.wagehour.dol.gov. You will be directed to the Wage and Hour Division office that is closest to you.
You should find out how working will impact your eligibility for public benefits that you already receive, such as Medicaid or social security benefits. This section gives an overview of resources to contact. You can also contact a Benefits Specialist at the Division of Vocational Rehabilitation (302-761-8275 or http://dvr.delawareworks.com/benefits-counseling.php).
If you receive public benefits such as Medicaid, SNAP (aka food stamps), cash assistance, or Temporary Assistance for Needy Families, you will need to report changes in your income. For details, check with your Division of Social Services caseworker. We recommend that you report these changes in writing and keep a copy for yourself, such as by faxing your income changes and keeping a copy of your fax confirmation.
If you have a disability, are under age 65 and receive Medicare, you can ask about Medicare for Qualified Disabled and Working Persons. (Call 1-800-MEDICARE to get the phone number for your state Medical Assistance office.) There is also a program called Medicaid for Workers with Disabilities that provides Medicaid for workers with severe disabilities who meet the medical eligibility criteria for SSDI/SSI with incomes less than 275% of the federal poverty level. There is a sliding scale for premiums. Contact the Delaware Medicaid Program at (302) 255-9500 or 1-800-372-2022.
If you receive social security benefits (SSI or SSDI):
Social Security offers several programs designed to make it easier for you to find a job or return to work. This section has information on some of the main programs. For a list of employment supports, see “Guide to Employment Supports,” at http://www.ssa.gov/redbook/eng/employment-supports-help.htm#a0=2.
IRWEs are out-of-pocket expenses for certain items related to your disability that you need to purchase in order for you to work.
Some examples of IRWEs are: wheelchairs, specialized work-related equipment, medication, counseling services, car modifications, or attendant care services.
When calculating your SSI monthly payment amount, the Social Security Administration may exclude IRWEs from your earned income. This means that if you have IRWEs, your SSI benefits could be higher.
A PASS is a plan for individuals on SSI (or who qualify for SSI with the plan) that lets you use your income to reach a work goal. With a PASS, you can set aside money for things that will help you achieve your goal, such as skills or vocational training. The Social Security Administration must approve your PASS.
Money or resources that you set aside under an approved PASS are not counted when the Social Security Administration determines your eligibility for SSI benefits. Having a PASS can help you either qualify for SSI benefits or continue to receive SSI benefits while you are working.
You can get a copy of the PASS application Form SSA–545–BK from your local Social Security office or online at: www.socialsecurity.gov/online/ssa-545.html.
You can get a PASS Specialist’s telephone number by calling toll-free number 1-800-772-1213 between 7 a.m. and 7 p.m. Monday through Friday.
The Ticket to Work Program is a program for persons with disabilities, receiving SSI or SSDI, who want to work and participate in planning their employment. A Ticket increases your available choices when obtaining employment services, vocational rehabilitation services, and other support services you may need to get or keep a job. It is a free and voluntary service.
To search for a program in your area: http://www.chooseworkttw.net/resource/jsp/searchByState.jsp
To download program materials: http://www.chooseworkttw.net/document-library/materials-for-beneficiaries/index.html
If you are under age 22 and are regularly attending school, the Social Security Administration does not count a certain amount of earned income per month when calculating your SSI payment (with a yearly maximum; these numbers change yearly).
If you receive SSI or SSDI, the Social Security Administration may review your case periodically to evaluate whether you continue to meet the disability requirements.
If you are participating in an approved vocational rehabilitation program, or have an I.E.P. at your high school, you may continue to receive benefits, even if the Social Security Administration finds that you no longer meet the disability requirements. There are certain rules and requirement s in order for you to qualify for your benefits to continue.
For more detailed information, visit http://www.ssa.gov/redbook/eng/ssdi-and-ssi-employments-supports.htm#a0=8 or speak with an expert at SSA’s Ticket to Work Help Line at 1-866-968-7842 (V) or 1-866-833-2967 (TTY).
[1] See 124 Stat. 119 – 1025.
[2] Pub.L. 93–406, 88 Stat. 829, enacted September 2, 1974, codified in part at 29 U.S.C. ch. 18.
[3] See 19 Del. C. § 1109; Lloyd v. Wilmington Savings Fund Society, 1985 Del. Super. LEXIS 1194 (1985). Source: http://www.employmentlawhandbook.com/wage-and-hour-laws/state-wage-and-hour-laws/delaware/
[4] 29 C.F.R. § 825.100 et seq.
[5] Companies with 50 or more employees, located within 75 miles of each other. Employees must have worked a) for a total of at least one year (12 mos) for the employer, and b) for at least 1,250 hours in the preceding year.
[6] You can report changes in your work activity by phone, fax, mail or in person. We recommend reporting in writing (by fax, mail, or in person) whenever possible; keep a copy for your own records. Call toll-free 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday, or visit your local SSA office. You can find your local office by visiting www.socialsecurity.gov