DI 60075.040 Promoting Opportunity Demonstration (POD) Offset
A. Eligibility for the $1 for $2 offset
To be eligible for the $1 for $2 offset, a POD participant must:
be within the POD participation period (For a definition of POD participation period, please see DI 60075.035.);
earn above the POD monthly threshold. The POD monthly threshold is the greater of the trial work period (TWP) level or the total approved amount of the beneficiary’s monthly impairment related work expenses (IRWE); and
be entitled to Social Security Disability Insurance (SSDI) benefits.
B. Start and end date of offset
1. Offset start date
The start date of offset is the first month that a beneficiary utilizes the $1 for $2 offset. The work indication code (WIC) “Z” on the MBR HISTORY field represents this.
2. Offset end date
The offset end date is equal to the end date of participation in the POD.
C. Non-countable income
The POD determines offset using a participant’s monthly gross earnings when paid. The POD does not deduct paid time off (PTO) from the gross total.
Non-countable income (NCI) is only involved when a beneficiary enters the POD in a partial year. The POD counts the earnings paid prior to random assignment from the beneficiary and documents it as NCI in the POD Automated System (PAS). The PAS subtracts the NCI total from the yearly Master Earnings File (MEF) total when calculating the End of Year Reconciliation (EOYR) for the initial POD offset year.
D. Monthly offset calculation
A POD participant’s benefits are offset $1 for every $2 earned above the POD monthly threshold. The threshold is the greater of either the current year TWP level ($840 in 2017) or the total approved monthly amount of IRWE. The threshold cannot exceed the current year SGA/Blind SGA rate even if a beneficiary’s IRWE are higher.
POD participants are required to report their earnings and IRWE, if any, to Abt monthly. For each monthly report, we will calculate a new offset for the corresponding benefit month. Earning reports will carry forward to the next month if a beneficiary fails to report. However, IRWE will not carry forward to the following month(s). If IRWE increases the threshold in an offset calculation for a given month and the beneficiary fails to report earnings or IRWE the following month, the offset is recalculated using the last reported earnings and the TWP amount as the threshold.
Example of a monthly offset calculation
John Doe volunteered to enroll in the POD in November 2017. Abt sent John a letter informing him of his random assignment to treatment group 1 and that his offset eligibility starts in December 2017. Abt also sent John a welcome package identifying his work incentive counselor (WIC).
John contacted his WIC in early December 2017 to report his November 2017 earnings. He reported to his WIC that he earned $2000 in November 2017 and had $300 in medication co-pays. John uploaded his paystubs via the POD website. John’s monthly benefit amount (MBA) is $1200. The WIC enters the following information from him in the POD Information Data System (IDS):
Date of report: 12/05/2017;
Earnings Month: 11/2017;
Earnings Report Amount: $2000;
Impairment Related Work Expenses: $300;
Monthly Benefit Amount: $1200
We use the following chart to determine the monthly offset amount:
Monthly $1 for $2 Offset Computation
Monthly Earnings Report
TWP amount (2017)
Determine threshold used to calculate offset amount
*Greater of TWP amount or actual IRWE but IRWE amount can’t exceed yearly SGA amount
Subtract threshold determined in Step 3 from Monthly Earnings Report in Step 1.
$2000 - $840 = $1160
Divide the amount found in Step 4 by 2. The result is the offset amount.
$1160/2 = $580
Subtract the offset amount found in Step 5 from the Monthly Benefit Amount (MBA) for the report month. The result is the offset monthly benefit amount.
$1200 - $580 = $620
When applying the benefit offset, we reduced John’s monthly benefit amount by $580. His new POD offset monthly benefit amount is now $620.
E. Full offset
When the monthly offset amount exceeds the monthly benefit amount, the beneficiary is in full offset. The MBR displays a LAF code of SQ, RFD code of Q and a RFST of DMPRDP indicating demo project “DP” POD offset case.
F. Partial offset
When the monthly offset amount is less than the monthly benefit amount, the beneficiary will be in partial offset. The WIC code “Z” indicates deduction for POD offset.
G. Auxiliary payments
Any auxiliaries receiving benefits based on a POD participant’s record continue to receive full benefits until the POD participant goes into full offset. As long as the POD participant is eligible for a partial benefit amount, the auxiliaries continue to receive full monthly benefits. If the POD participant goes into full POD offset (LAF SQ.), any auxiliary benefits will also stop due to the POD participant’s work activity (LAF SQ).
H. Statutory benefit continuation payments for POD cases
POD participants are subject to regular medical CDRs. A POD participant who ceases to have a disabling impairment no longer qualifies for the POD participation period and is not eligible for the benefit offset unless he or she receives statutory benefit continuation payments based on a medical cessation appeal. In that case, the beneficiary may receive reduced benefit payments under the benefit offset during the appeal if the beneficiary:
is within the POD participation period (For a definition of POD beneficiary, please see DI 60075.035A); and
works above the POD monthly threshold amount.