Disability Terms and Definitions

Substantial Gainful Activity (SGA) The level of work activity used to establish disability. A finding of disability requires that a person be unable to engage in SGA. Benefit Percentage The benefit payable is usually determined as a percentage of the insured's pre-disability income up to an overall maximum benefit amount. Elimination Period This is the period of time between the date the disability commences and the beginning of the benefit payment period. It is the period during which an employee must be disabled before payment of benefits begins. It is sometimes referred to as the Qualifying Period. Medicare (SSDI) Two-part health insurance program for eligible disabled individuals and people age 65 or older Windfall Offset A provision to prevent a person from receiving monthly SSI and OASDI benefits in excess of the total amount which would have been paid if the OASDI benefits had been paid when they were due rather than retroactively. Ticket to Work program The Ticket to Work program provides disabled beneficiaries with expanded options for access to employment services, vocational rehabilitation services, or other support services. Outcome Payment System The system providing a payments under the Ticket to Work program to an employment network for each month, up to a total of 60 months, during which Social Security disability benefits and Federal SSI cash benefits are not payable to a beneficiary because of the performance of substantial gainful activity (SGA) or by reason of earnings from work. Reasonable Accommodation Any change in the job application process, work environment or work process, or modification to the benefits or privileges of employment, that results in equal employment opportunity for an individual with a disability. Section 1619(b) Status The special SSI recipient status for Medicaid purposes provided to working disabled or blind individuals when their earnings make them ineligible for regular or special cash payments. Medicaid provider A professional or medical facility who is enrolled as a provider for the Medicaid Program by entering into a contract with the Medicaid Program to provide medical services to Medicaid eligible recipients. By entering into this contract the professional has agreed to abide by all rules and regulations governing the Medicaid Program.

Are you currently seeking legal information regarding Toledo disability laws or Toledo social security laws? If so, contact one of our experienced Toledo disability attorneys or Toledo social security attorneys today!

	Did You Know?
	SHMO means Social Health Maintenance Organization A managed system of health and long-term care services geared toward an elderly client population. Under this model, a single provider entity assumes responsibility for a full range of acute inpatient, ambulatory, rehabilitative, extended home health and personal care services under a fixed budget which is determined prospectively. Elderly people who reside in the target service area are voluntarily enrolled. Once enrolled, individuals are obligated to receive all SHMO covered services through SHMO providers, similar to the operation of a medical model health maintenance organization (HMO).