Individual receiving SSDI or long-term disability benefits following illness or injury. Reduced income, Medicare eligibility, return-to-work considerations.
HC-02 is the disability-income archetype: SSDI or employer LTD recipients managing benefit offsets, the 24-month Medicare waiting period, the Trial Work Period under 42 USC §422(c), and SGA-threshold tests that can terminate benefits mid-month.
HC-02 exists because disability-benefit administration sits at an intersection of regulators (SSA, IRS, ERISA plan sponsors, state Medicaid agencies) that almost no other archetype encounters. SSDI eligibility under 42 USC §423 requires the claimant to be fully and currently insured (the 20-of-40-quarter recent-work test), and approval triggers a 24-month Medicare waiting period after which the claimant is auto-enrolled in Part A. The Trial Work Period (§422(c)) allows 9 months of work above the TWP earnings threshold without losing benefits, after which a 36-month Extended Period of Eligibility applies, and the Substantial Gainful Activity (SGA) threshold (indexed annually, with a separate higher threshold for blindness) is the trip-wire. Employer LTD plans almost universally offset against SSDI dollar-for-dollar — a successful SSDI award reduces the LTD check by the same amount, often with retroactive recoupment of overpayments. ABLE Act §529A accounts for disabled beneficiaries (disability onset before age 26 under current law, expanding to age 46) and SSI resource limits ($2,000 individual / $3,000 couple) create planning surfaces no other corpus exercises.
The structural story is a household with reduced income and partially-replaced wages. Median income is $58k against median net worth $198k, with median liquid net worth of just $74k — runway is thin. Half of households still carry a mortgage, half a car loan; credit-card balances appear in every household. The cash-flow picture is a fixed monthly benefit (SSDI plus LTD net of offset) against largely fixed expenses, with healthcare costs partially socialized through Medicare or Medicaid post-waiting-period. Return-to-work consideration is rational but mechanically painful — the SGA cliff plus the LTD-recapture provision make incremental work decisions non-monotonic in net household income.
HC-02 differs from S-03 (medical debt crisis) by being post-stabilization on a chronic-disability path rather than mid-acute-event; from X-04 (neurodiverse/disability household) by the active SSDI/LTD claim posture rather than the broader disability-household profile; and from HC-03 (benefits gap) by having ongoing if reduced coverage rather than a coverage gap. The diagnostic is the SSDI/LTD income mix and the regulatory cliffs that surround it.
Aggregated across the 12 HC-02 households in the shipped v3 corpus corpus. Numbers describe the corpus, not population claims.
James is the high-stress HC-02 file — a single-parent claimant at age 33 with $59k of disability income against $244k of liabilities and only $16k of liquid runway. The retirement goal sits at $1.32M (off track because contributions stopped at the disability onset) and the education-funding goal at $1.35M is essentially aspirational. This is the file that breaks ABLE-account-versus-special-needs-trust planning tools: the §529A account creates an asset-build option without disqualifying SSI/Medicaid resource-test thresholds, but only if the disability-onset-age requirement is met. The household also surfaces the dependent-child SSDI auxiliary benefit, which not all benefits-administration software computes correctly.
Every HC-02 household ships with — at minimum — these JSON fields populated. The full schema is documented in the data set you purchase.
Disability-insurance carriers and ERISA-plan administrators use HC-02 to test SSDI-offset computation, retroactive-overpayment recoupment, and the Trial Work Period / SGA-threshold workflow that drives claim-termination decisions. Benefits-counseling and Work Incentives Planning and Assistance (WIPA) products use it for net-benefit projections across the TWP and EPE periods. Wealth and special-needs-planning platforms use it for ABLE Act §529A account modeling, including the disability-onset-age eligibility test, the SSI $2,000 resource limit interaction, and the SNT (special needs trust) versus ABLE-account choice. Tax-software teams use HC-02 for the partial taxability of SSDI under IRC §86 (the 50%/85% inclusion brackets) and for the IRS Notice 2015-57 / Publication 915 lump-sum-election worksheet when SSDI back-pay is received.
HC-02 is the active SSDI / LTD claimant with stable benefit status. Workers in the application phase awaiting an ALJ hearing (the 18–24 month SSA backlog) are not specifically modeled here — that population has zero benefit income and depleting assets, which makes it closer to S-03 than HC-02. SSI-only recipients (Title XVI, means-tested, no SSDI work-history qualifier) are a related but distinct population not represented in this corpus; the SSI $2,000 resource limit applies but the household profile differs sharply. Veteran Service-Connected Disability (VA disability ratings, separate compensation) belongs in MV-03 (Disabled Veteran). Workers' Compensation claimants overlap but operate under state-specific statutory schemes outside the SSA/ERISA framework. Households where mental-health or substance-use disability creates Representative Payee management requirements are present but not over-sampled.
Income and benefit-mix bands during v3 synthesis were anchored to SSA Annual Statistical Report on the Disability Insurance Program and Council for Disability Awareness LTD-industry benchmarks for SSDI-offset and replacement-rate patterns. Median age (49) and the single-parent concentration reflect SSA disability-population demographics. State concentration in TX / FL / NY is a sampling choice; SSDI itself is federal but state Medicaid eligibility post-Medicare layering varies materially. Per CLAUDE.md §9 the corpus is FROZEN — priors above describe synthesis intent rather than auditable distribution fits. SGA threshold values reflect SSA cost-of-living indexing as enacted but year-specific snapshots are not asserted.
MV-03 is the Disabled Veteran with VA service-connected disability rating and the separate VA compensation regime. Use MV-03 when the diagnostic surface is VA rather than SSA/ERISA.
X-04 is the broader neurodiverse / disability household — may include non-claimant family members and supported-decision-making arrangements rather than active SSDI/LTD claims.
S-03 is medical-debt crisis at the acute event point. Reach for S-03 when the household is mid-event and pre-stabilization rather than on a chronic-disability path.
RL-01 is the RMD-stage retiree. Use RL-01 when the household has aged into traditional retirement and SSA disability has converted to Social Security retirement under §202(a).
HC-02 — Disability Claimant (SSDI / LTD) represents households receiving Social Security Disability Insurance under Title II of the Social Security Act and/or employer-sponsored long-term disability, with the LTD-SSDI offset pattern, 24-month Medicare waiting period, and SGA-threshold work-incentive cliffs as the diagnostic surfaces.
The 12 shipped HC-02 households have a combined gross income median of $58,013 (25th–75th: $51,921–$67,387) — reflecting the 60–70% replacement rate typical of SSDI plus LTD net of offset. Median net worth is $197,809 but median liquid net worth is only $73,636, leaving thin runway against benefit interruption.
Yes — the household profiles support modeling of TWP (9 months over rolling 60-month window), the 36-month Extended Period of Eligibility, and SGA-threshold work-incentive failures. Specific TWP-month accruals are downstream computations against the household work history rather than pre-baked attributes.
MV-03 households receive VA service-connected disability compensation under a separate regulatory regime (38 CFR, VA rating schedules) that does not offset against SSDI and is generally not taxable. HC-02 is the SSA/ERISA regime with LTD offset and partial IRC §86 taxability of SSDI.
The corpus supports ABLE-account-eligibility testing — disability-onset-age test, $100k SSI-resource-exclusion ceiling, qualified-disability-expense list. Specific ABLE contributions and balances are downstream attributes against the household profile rather than pre-baked corpus fields.
No. The shipped v3 corpus is frozen and not regenerable from current code (drift confirmed 2026-05-09). Improvements land in a future v4 release with per-archetype golden fixtures in CI.
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