SSI Budget Worksheet
SSI Budget Worksheet
(for people who receive SSI and income from working)
Name: _____________________________________ Date: ________________________
|Monthly Gross Earned Income | |
|(Weekly Gross Income x 4.3) | |
|Subtract Exclusion | |
| |- $85.00 |
|Adjusted Gross Earned Income | |
|Divide by 2 | |
|COUNTABLE EARNED INCOME | |
| | |
|Base SSI Rate | |
|Subtract COUNTABLE EARNED INCOME | |
|NEW SSI Check | |
| | |
|Monthly Income Without Working (SSI Check) | |
|Monthly Income With Working (New SSI Check + Paycheck) | |
Important Facts:
1. To be eligible for an SSI check, bank account balances must remain below $2000.
2. A person can continue to receive Medicaid, as long as their gross annual earnings are less than $33,751 (2012 threshold).
3. Changes in monthly earnings due to fluctuations in schedule or pay rate must be reported promptly and in writing to the local Social Security Office.
10/10
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