LACONIA — Brenda Martel, owner of Cafe Déjà Vu, said she would like to employ Clyde Trask, a dishwasher who has a disability, more than two to three days a week. He used to work full-time, but increases in the minimum wage have meant Trask more quickly meets the earnings ceiling beyond which his government benefits evaporate.

Because of his disability, Trask relies on Medicaid, Social Security payments to help with food and rent, and assistance through Lakes Region Community Services to live independently.

“It’s one of the things I’ve struggled with over the years,” Martel said. “When they raise the minimum wage, they don’t raise the amount of money he’s able to make. I have to cut back his hours, or he’ll lose his benefits.”

One of the biggest barriers for workers with disabilities is the limit on what they can earn, which translates to how much they can work before losing their Social Security Insurance, Medicaid, and other government benefits, including subsidized housing and food stamps. The income-versus-benefits balance can hamstring employers, and leave workers with disabilities hovering at near-poverty levels, according to economists and advocates for people with disabilities.

The federal Social Security Administration governs federal income supplements that they can receive, such as Social Security Disability Income, or SSDI, which is based on how much a worker earned before becoming disabled (or a parent’s or spouse’s benefits); and Social Security Income, or SSI, a standard monthly payment for people with serious disabilities, including intellectual and developmental disabilities and chronic mental or physical illness that interferes with their ability to work. SSI payments (around $750 per month in New Hampshire; slightly more in Vermont) are intended to cover rent and food, but that amount is seldom enough to pay rent in New Hampshire. Both SSDI and SSI have caps on earnings, meaning if you work too much and exceed the income threshold, those those benefits shrink or stop, leaving workers in a damned-if-you-do, damned-if-you-don't position.

Medicaid, which provides health insurance, also ends when a disabled person’s income rises above a maximum level, which can be right around poverty level. It’s Medicaid — not private health insurance through an employer — that enables people with disabilities to receive support for independent living, including personal assistants who help them shop, cook, clean, dress, and find a job, and who drive them to work each day.

For people with disabilities, it’s a serious conundrum, experts say: What’s more important, making more money and working toward full independence, or keeping benefits that are life-sustaining and act as safety nets?

In New Hampshire, benefit specialists can explain to clients what will happen as their income increases. “It’s like putting a puzzle together, explaining what jobs will do to benefits, which are individualized,” said Ashley Palma, a work incentive counselor at Granite State Independent Living.

Income-based benefits include government-subsidized housing and food stamps. Your rent grows with your income, and can cancel out the benefit of working more.

Although government programs allow (and encourage) people with disabilities to work toward self-sufficiency, and public benefits can be quickly reinstated within five years of going off, the fear of losing public health insurance and a monthly income check discourages many from attempting independence — especially if they have lifelong disabilities or health conditions that interfere with their ability to function, said Andrew Houtenville, research director of the Institute on Disability and a professor of economics at University of New Hampshire.

“The fear of losing benefits is very powerful,” said Kimberly Phillips, research associate professor at the Institute on Disability.

Living on benefits alone can be nearly impossible, considering the cost of rent, scarcity of affordable housing, and the long wait — as much as 10 years — for an apartment in government-subsidized housing, according to authorities on housing and homelessness in New Hampshire.

SSI and limits on earnings “has it’s purpose,” said Houtenville, “but it ends up being a trap — a poverty trap because it doesn’t put you above the poverty level. You can’t work too much. You spend one to two years getting your benefits,” negotiating a complicated and slow-moving application process and benefits administration system. “Are you automatically going to jump?”

The Sunshine Project is underwritten by grants from the Endowment for Health, New Hampshire’s largest health foundation, and the New Hampshire Charitable Foundation. Contact Roberta Baker at

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(1) comment


"High DI" people such as myself have taken a pass on this work "opportunity." After paying for gas, clothing, higher Mediicaid cost-sharing (Mass, CT, formerly VT), at the TWP level, so little net gain to not be worth it. Here is my world: restricted to living in just four states with a Working Disabled Program I can even get on due to the size of my benefit alone. Graduated from college in a STEM career, both a blessing and a curse, very much a curse at first, until Vermont changed the rule on unearned income in late 2005. Last employment on the Ticket was in 2001, and my employer got a great deal, 75% off the going rate. When my job moved, I could not see paying for gas and for commuter car insurance as worth it. Got into a tangle with Social Security over hours too, and they wanted to take a check that was worth more than twice my gross TWP earnings. I can count, they cheated, went to court and won. I had to give up going to grad school because of the who work activity issue, and the last thing I needed was more unearned income (to fail Medicaid test in Vermont). The latest no-no was playing the stock market. I swear I still have Medicaid today over that only because it timed out for 30 days. But how does one save for retirement? Oh, the Social Security is my retirement, right? So stuck this way forever, I guess. I did learn I might qualify for an ABLE account, if the records from a quarter century ago exist at SSA or the hospital. I was in, until I read about the lien. NO ONE has been able to answer my question about whether I can save a bit with investments in the ABLE to get a better house and whether the house bought with ABLE funds becomes Medicaid-attachable. Having to play low-income games in order to get my $100K annual drug bill paid for is a loss for all--any new discovery or publishing I could have done, income from a job, social life because regular people do not date those without a job. While I have access to more tools (education, high benefits), I have been robbed of the life I was promised by doing well in school--a top math student. Oh, to stay under, voc rehab keeps offering me home health aid jobs, low-wage, go nowhere, ready employment. Why would I do that? If there is a path from zero to getting new or updated work credentials, in a relevant field, math-heavy for me, without losing my prime benefits right off, and without giving some employer and exploitive discount, it is inobvious. Let's say, MBA or actuary or bioinformatics, fields I have not worked in previously but woud have been reasonable steps when I took the GRE in 1998. How do I take aged college credits to make the leap? Who pays for my education, since I have already had all the Pell I can get?

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