Benefits Analysis

If you are receiving disability benefits and are thinking about returning to work you need to know how earning money will affect your benefits. The Kenai Peninsula Independent Living Center can help you understand how earned income will change your benefits. Trained benefits analysts can help you map strategies that will allow you to work with the Social Security system to maximize your earnings and keep benefits in place for as long as possible.

Benefits Analysis services include:

Initial Benefits Assessment

Identification of appropriate work incentives offered by Social Security and;

Counseling and follow-up services

If you have questions about your benefits and how they will be affected when you begin earning wages, please fill out and submit the form below.

All information will be kept in the strictest confidence.

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone 1

Phone 2

e-mail

Are you a Vocational Rehabilitation Client? Yes No
What benefits/amounts are you currently receiving? Please check all that apply and include monthly or in the case of Native Corporation benefits quarterly amounts. Round amounts down to next whole dollar amount. Social Security Disability Insurance SSDI, Social Security Aid to Disabled Adult Child SSDAC, Supplemental Security Income SSI, Adult Public Assistance APA, Temporary Assistance Program ATAP,Veterans Administration VA

SSDI Amount

SSDAC Amount

SSI Amount

APA Amount

ATAP Amount

VA Amount

Child Support Amount

Native Corporation Amount 1 2 3

Rental Income Amount

Interest Amount

Wages Amount

Rental Subsidy Amount

Other Amount

? Medicare

Medicaid

1619b

Medicaid Buy-In

Other (specify)

Please type your questions in the box below. Please be as specific as possible so we may fully answer you questions. Click the submit button to send this form. Use the reset button to reset all fields.

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