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. 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. 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. SSI State Supplement A cash benefit authorized by Ch. 49.77 and 49.775, Wis. Stats. This benefit is intended to supplement the federal SSI benefit payment. Eligibility is based on current receipt of federal SSI benefits or special "grandfathered" status as a recipient of the state supplement only. 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. Benefit Year The 52 consecutive weeks for which you are eligible to receive unemployment benefits. The benefit year begins on the day that you file for unemployment benefits. 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. Optional Supplementation The payments made by States to help persons meet needs not fully covered by Federal SSI benefits. The State determines whether it will make a payment, to whom, and in what amount. IDEA Individuals with Disabilities Education Act Indexing Indexing is designed to provide some protection against inflation. After the first year of disability, a disabled employee's pre-disability earnings are usually increased (or indexed) by a certain percentage on an annual basis.

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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).