Disability Terms and Definitions

Representative Payee Individual appointed by the Social Security Administration (SSA) to manage the cash benefits of a recipient of SSI or Social Security benefits, or both. 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. Social Security and Social Security Disability Insurance (SSDI) Monthly cash benefit administered by the federal Social Security Administration (SSA) to retired or disabled workers and their qualified dependents. Beneficiaries must be 62 years of age or older, or disabled, and have enough work "credits" to be qualified. Vocational Rehabilitation Services Those services identified in Rehabilitation Act of 1973, as amended, which are provided in an individualized plan for employment necessary to assist an individual with a disability in preparing for, securing, retaining, or regaining an employment outcome that is consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individual. Conversion Privilege If included, this option allows employees who are terminating employment to continue some or all of their LTD coverage at their own expense without submitting evidence of insurability. Maximum Benefit Period (Benefit Duration) This is the maximum length of time for which benefits are payable under the plan as long as the employee remains continuously disabled. Auxiliary Aids and Services Devices or services that accommodate a functional limitation of a person with a communication disability. Work Incentives/Employment Support SSA policies that help disability beneficiaries go to work and receive benefits in an attempt to become more independent. Section 1619(a) Status The special SSI cash benefits provided to disabled individuals who lose eligibility for SSI benefits under the regular rules because they have earnings at the level that is ordinarily considered to represent substantial gainful activity. 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.

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	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).