The past couple of years had been the worst of Deanna’s life, which was saying a lot. Her bi-polar condition had made it hard for her to maintain a job or a marriage. In her “up times” she floated through life, simultaneously bringing levity to small talk and passion to simple tasks. Deanna could turn a trip to the supermarket into a heroic tale of challenging the dogma of the 15-item express line when she was two over the limit. Her humor had always made her one of the more popular nurse’s aides wherever she worked, and she loved bringing a smile to the people she served.

	The pain from Deanna's rheumatoid arthritis sent her into a deep depression.

But then there were the downs. Her depressions crippled her and made her seem even needier than her patients. Usually, however, she could rebound after a time. But now she was getting older and her rheumatoid arthritis, mild in her younger years, was becoming severe. At age 50 the relentless pain from her arthritis sent her into a two-year spiral of depression, drugs and more depression. During that time she lost everything: her savings, her car, her third husband. Her depression was so bad she couldn’t maintain her nursing job or any other job for that matter. She had to rely on modest monthly disability-income checks from Social Security while Medi-Cal provided health coverage.

Through Medi-Cal, Deanna found a treatment for her arthritis, but more importantly she hooked up with a great therapist who helped her out of her depression. Here she was, in the autumn of her life, without children or a husband. Still, Deanna felt like she still had something to offer the world—a way she could help. Then a way to help presented itself: a $1,500-a-month job as a counselor at a woman’s shelter. If any place could use a smile it was a women’s shelter, she thought.

It sounded great, but there were a couple of hitches. Deanna feared that taking the job might force her to lose her disability income. Not only that, she worried that if she enrolled in the shelter’s health plan she’d have to give up her Medi-Cal coverage, and thus her therapist. It seemed paradoxical, but Deanna wondered if remaining unemployed and staying out on disability could actually pay better in the end than getting a job.

	Deanna wrote down her goals and found a benefits planner.

Deanna wrote down her top goals: Maintain her Medi-Cal coverage, continue seeing her therapist, and make more money working than staying out on disability. She wasn’t sure if she could accomplish all these things, but she decided if it could be done, she wanted to take the job. First, she needed an expert to answer these questions for her. She eventually found such an expert in Ruth, a “benefits planner” at the local Independent Living Center. Benefits planners are trained in benefit issues including those related to Social Security work rules. Among other things, Ruth understood how Deanna’s new job would affect her Social Security benefits.

Deanna spilled her guts to Ruth and told her the whole complicated situation over the phone. Ruth had heard similar tales many times before; people wanted to return to work but were afraid of losing their benefits. “Come by the office next week and let’s figure out all of your options,” Ruth suggested. Deanna agreed.

Deanna gathered a folder with all her important papers and met Ruth at the Independent Living Center. They retreated to a small conference room where Ruth looked over Deanna’s papers and could see why the nurse’s aide was so confused.

Deanna was enrolled in two different income programs through Social Security, so she got two checks each month from separate branches of Social Security. The $490 check she received on the first of each month was from the Supplemental Security Income (SSI) program; the second $400 payment later in the month was from the Social Security Disability Insurance (SSDI) program. Complicating things further was Deanna’s Medi-Cal health coverage, which was tied into her SSI benefit. Each benefit program she was getting money from had its own rules. Since Social Security has rules that encourage people to go back to work, Ruth believed Deanna would probably be better off taking the job after they did all the calculations.

“It sounds like we have to break the Da Vinci Code,” Deanna said, referring to the best-selling mystery novel.

“No, no, it’s not that complex,” Ruth laughed. “We’ll figure this out together.”