When determining whether an applicant/recipient group is eligible, the CAO will consider the total countable earned and unearned income of all the group members. The CAOwill follow these rules:
Count the income of the non-applicant spouse living with the individual and use a two-person income limit.
Count both incomes and use a two-person limit when both husband and wife apply.
Do not include the income of non-applicant children and stepchildren who are under age 21 and living in the household.
Determine countable income as described in Chapter 350, Income; Chapter 352, Self-Employment; Chapter 360, NMP Deductions; and Chapter 368, Determining Eligibility for NMP.
Keep in mind that the applicant/recipient must apply for and obtain any possible source of income.
Exception: The individual does not need to apply for benefits such as SSI and SSDI. Use Substantial Gainful Activity (SGA) as a guideline when considering a referral to the Social Security Administration (SSA) for benefits. The SSA uses SGA levels when looking at the work activity of individuals applying for or receiving disability benefits. These amounts are adjusted each year on the basis of the national average wage. For 2014, the SGA amounts are:
$1,070 a month.
$1,800 for blind individuals.
Example: Ms. Smith earns $3,000 a month as a secretary. Ms. Smith’s disability would meet the Social Security Administration’s disability criteria; however, her income would make her ineligible for SSDI.
Do not deem the income of spouse and children for the MAWD individual.
Use the income in the month of application for determining eligibility. If the income is received weekly or biweekly, determine the average weekly amount, and multiply it by four to get the monthly amount.
NOTE: Multiply the average weekly income by four even if an individual gets paid three or five times in a calendar month.
The CAO will determine the total amount of gross earned income before any deductions such as taxes, individual expenses, or dependent care are taken. The CAO will verify and record all earned income in the case record.
Earned income comes from the following sources:
Payment for services.
Wages (including tips).
NOTE: Wages received under Title V (Older Americans Act) are counted.
Salaries.
Commissions and bonuses.
Royalties earned in connection with a publication or honoraria received for services provided.
Sheltered workshop payments.
NOTE: A payment is counted when it is received or when the payment is set aside for the individual’s use.
Earnings from therapeutic activities.
Profit from self employment.
Lump sum nonrecurring payments of earned income, such as delayed wages.
NOTE: When an individual receives a lump sum payment, it must be counted as a resource in the month it was received, unless it is better for the individual to count it as income. After the first month when it is received and counted as income, any amount of the lump sum that is remaining must be counted as a resource.
Employee sick benefits, if the individual plans to return to work.
When determining eligibility for MA, the CAO will consider the gross amount of unearned income and follow these guidelines:
If the individual receives a lower benefit amount because of a deduction for an insurance premium, court-ordered support, recovery of a prior overpayment, or a similar reason, then count the original benefit amount.
If the individual receives a lower benefit amount to pay back an overpayment and the overpaid amount was already counted during the eligibility process for cash or MA, then count the actual benefit received.
The cost of living adjustment (COLA) income is not counted until the second month following the month that the federal poverty income guidelines are published.
Example: If the FPIGs are published in January, then the COLA income is counted in March.
Unearned income includes, but is not limited to, the following:
Social Security benefits, including the amount deducted for the Medicare Part B premium
Retirement benefits, private pensions, and annuities, including an amount deducted for an insurance premium
Veterans Affairs (VA) benefits
NOTE: The aid and attendance portion of the VA benefits is excluded.
Unemployment compensation.
Workers compensation.
Dividends, royalties, and interest in the calendar month posted or received.
Court-ordered or voluntary support or alimony payments.
Loans, gifts, or contributions.
Educational assistance.
Rental income.
Sales agreement income.
Lump sum.
Prizes and awards.
Inheritance.
Support payments are counted as income if the MAWD applicant is covered under the support order. When a child with special needs is the applicant, the child’s support payment is counted as income.
When determining eligibility for MAWD. the CAO will exclude income listed in Section 350.63, Excluded Income—SSI-Related.
Updated January 3,2014 Replacing January 1, 2013,