SSDI and SSI employment Supports

Subsidy and Special Conditions (SSDI and SSI eligible)

When do we consider Subsidies and Special conditions?

We consider the existence of subsidies and/or special conditions when we make an substantial gainful activity (SGA) decision. We use only earnings that represent the real value of the work you perform to decide if your work is at the SGA level.

What is a subsidy?

A “subsidy” is support provided by your employer that may result in your receiving more pay than the actual value of the services you perform.

What are special conditions?

“Special conditions” refers to support and on the job assistance provided by your employer, or by someone other than your employer, for example, a vocational rehabilitation agency. Because of this support, you may receive more pay than the actual value of the services you perform.

How can you tell if a subsidy or a special condition applies to you?

A subsidy or special condition may exist if:

  • You receive more supervision than other workers doing the same or a similar job for the same pay; or

  • You have fewer or simpler tasks to complete than other workers doing the same job for the same pay; or

  • You are given additional or longer paid breaks than other workers doing the same job for the same pay; or

  • You have a job coach or mentor who helps you perform some of your work

Do subsidies or special conditions affect my SSI payments?

No, we do not consider subsidies or special conditions when we figure your SSI payment amount.

Unsuccessful Work Attempt (UWA) (SSDI and SSI eligible)

What is a UWA?

A UWA is an effort to do substantial work, in employment or self-employment, which you stopped or reduced to below the substantial gainful activity (SGA) level after a short time (6 months or less) because of:

What is the benefit of a UWA if you receive Social Security Disability Insurance?

When we make a SGA decision to determine if your disability continues or ceases because of your work, we do not count your earnings during a UWA.

Can a UWA occur during the Extended Period of Eligibility (EPE)? Yes. During the EPE (see EPE), we consider a UWA as part of our SGA decision for months up to and including the month we decide your disability has ceased.

Can a UWA occur during the Trial Work Period (TWP)?

No. We do not consider a UWA during the TWP (see TWP) or after we decide that your disability has ceased.

Does a UWA affect your monthly Supplemental Security Income (SSI) payment?

For SSI, we only consider a UWA at the time you file an initial claim. After that, we do not consider a UWA in figuring your SSI payment.

Impairment-Related Work Expenses (IRWE) (SSDI and SSI eligible)

How can IRWE help you?

We deduct the cost of certain impairment-related items and services that you need to work from your gross earnings when we decide if your work is substantial gainful activity (SGA). It does not matter if you also use these items and services for non-work activities.

When will we deduct your IRWE?

We deduct IRWE for SGA purposes when:

  • The item(s) or service(s) enables you to work;
  • You need the item(s) or service(s) because of a physical or mental impairment;
  • You pay for the item(s) or service(s) and are not reimbursed by another source such as Medicare, Medicaid, or a private insurance carrier;
  • The cost is “reasonable”, that is, it represents the standard charge for the item or service in your community.

How do we use IRWE to figure your Supplemental Security Income (SSI) monthly payments?

If you receive SSI benefits, we will exclude IRWE from your earned income when we figure your monthly payment amount if you meet the requirements above and you paid the expense in a month that you received earned income or performed work while you used the IRWE.

Can IRWE be deducted during a non-work month?

Generally, you must be working in the month you pay for an IRWE. However in certain situations, we can deduct IRWE amounts for expenses you pay before you start or after you stop work.

What types of expenses are deductible?

The following table outlines the types of expenses that are deductible as IRWE.

Examples of Deductible and Non-Deductible IRWE (SSDI and SSI eligible)

TYPE OF EXPENSEIRWE DEDUCTIBLENOT DEDUCTIBLE
Transportation Costs The cost of structural or operational modifications to your vehicle that you need to travel to work, even if you also use the vehicle for non-work purposes.

The cost of driver assistance or taxicabs you need because of your disability rather than the lack of public transportation.

Mileage expenses at a rate determined by us for an approved vehicle and limited to travel to and from work.

The cost of your vehicle whether modified or not.

The costs of modifications to your vehicle that are not directly related to your impairment or critical to the operation of your vehicle, for example, paint or pin striping.

Your travel expenses related to obtaining medical items or services.
Attendant Care Services
    Services performed in the work setting.

    Services performed to help you prepare for work, the trip to and from work, and after work; for example, bathing, dressing, cooking, and eating.

    Services that incidentally also benefit your family, for example, meals shared by you and your family.

    Services performed by your family member for a cash fee where he/she suffers an economic loss by reducing or ending his/her work to help you, for example, if your spouse must reduce his or her work hours to help you get ready for work.
    Services performed on non-workdays or help with shopping or general housekeeping, for example, cleaning and laundry.

    Services performed for someone else in your family, for example, babysitting.

    Services performed by your family member for payment “in-kind”, for example, room and board.

    Services performed by your family member for a cash fee where he/she suffers no economic loss. This includes services provided by your non-working spouse.

Medical Devices Deductible devices include wheelchairs, dialysis equipment, pacemakers, respirators, traction equipment, and braces. Any device you do not use for a medical purpose.
Prosthesis Artificial hip, artificial replacement of an arm, leg, or other parts of the body. Any prosthetic device that is primarily for cosmetic purpose.
Residential Modifications If you are employed outside of home, modifications to the exterior of your house that permit access to the street or to transportation; for example:
  • Exterior ramps
  • Railings
  • Pathways
If you are self-employed at home, modifications made inside your home in order to create a workspace to accommodate your impairment. This includes enlarging a doorway into an office or workroom and/or modifying office space to accommodate your dexterity challenges

If you are employed outside of home, modifications to the interior of your house.

If you are self-employed at home, cannot deduct any modification-related expenses that you will deduct as a business expense when determining SGA.

Routine Drugs & Routine Medical Services
    Regularly prescribed medical treatment or therapy that is necessary to control your disabling condition, even if control is not achieved. This includes, but is not limited to:

    • Anti-convulsant drugs

    • Anti-depressant medication
    • Psychotropic medication
    • Blood level monitoring
    • Radiation treatment
    • Chemotherapy
    • Corrective surgery for spinal disorders
    • Counseling, mental health and therapy services
    • Your physician’s fee relating to these services.
    Drugs and/or medical services used for your minor physical or mental health problems, for example:

    • Routine physical examinations

    • Allergy treatments
    • Dental examinations
    • Optician services.
Diagnostic Procedures Procedures related to the control, treatment, or evaluation of your disabling condition; for example, brain scans, and electroencephalograms. Procedures not related to your disabling condition, for example, allergy testing.
Non-Medical Appliances & Devices In unusual circumstances, devices or appliances that are essential for the control of your disabling condition either at home or at work; for example, an electric air cleaner if you have severe respiratory disease. Your physician must verify this need. Devices you use at home or at the office that are not ordinarily for medical purposes and for which your doctor has not verified a medical work-related need. These include:
  • Portable room heaters
  • Air conditioners
  • Dehumidifiers
  • Humidifiers
Other Items & Services
    Expendable medical supplies; for example, incontinence pads, elastic stockings, and catheters.

    The cost of a service animal including food, licenses, and veterinary services.

An exercise bicycle or other device you use for physical fitness, unless verified as necessary by your physician.

Health insurance premiums.

Plans to Achieve Self-Support (PASS) (SSDI and SSI eligible)

How can a PASS help you?

A PASS allows you to set aside other income besides your Supplemental Security Income (SSI) and/or resources for a specified period of time so that you may pursue a work goal that will reduce or eliminate the SSI or Social Security Disability Insurance (SSDI) benefits you currently receive. For example, if you receive SSDI, wages, or other income, you could set aside some of that money to pay expenses for education, vocational training, or starting a business as long as the expenses are related to achieving your work goal.

We do not count the income that you set aside under your PASS when we figure your SSI payment amount. We do not count the resources that you set aside under your PASS when we determine your initial and continuing eligibility for SSI.

A PASS can help you establish or maintain SSI eligibility and may increase your SSI payment amount. For example, if you receive $800 per month in SSDI, you have too much income to be eligible for SSI. But if you otherwise qualify for SSI and have a work goal, you could use some of your SSDI to pay for PASS expenses to help you reach your work goal. Because we would not count the portion of your SSDI you are using toward your PASS, this could reduce your countable income enough so you could be eligible for SSI.

In addition, other agencies may not count income that SSA has excluded for a PASS when they determine your eligibility for housing assistance or the Supplemental Nutrition assistance Program (food stamps).

Who can have a PASS?

If you receive SSI or could qualify for SSI after setting aside income or resources so that you may pursue a work goal, you could benefit from a PASS.

What are the requirements for a PASS?

Your Pass must:

  • Be designed especially for you;

  • Be in writing. We prefer that you use our form, the SSA-545-BK. . You can get copies of the PASS form, SSA-545-BK, at your local office, from any PASS Expert, or from our website at www.socialsecurity.gov/online/ssa-545.html;

  • Have a specific work goal that you are capable of performing;

  • Have a specific timeframe for reaching your goal;

  • Show what income you receive (other than your SSI payments) and/or resources you have that you will use to reach your goal;

  • Show how you will use your income and resources to reach your work goal;

  • Show how the money you set aside will be kept separate from other funds;

  • Be approved by us; and

  • Be reviewed periodically by us to assure your plan is actually helping you make progress towards your work goal.

Who Can Help You Set Up a Plan to Achieve Self-Support (PASS)? (SSDI and SSI eligible)

Anyone may help you with your PASS; for example, vocational counselors, social workers, benefit specialists or employers. We will evaluate the plan and decide if it is acceptable. We can also help you put your plans in writing.

SSA has specially-trained employees (PASS Specialists) that work with the PASS program. When you submit a written PASS proposal to a PASS Specialist, he or she will review it to:

  • Make sure the work goal is reasonable;

  • Make sure that you need the items and services listed on the PASS application to reach the work goal;

  • Make sure the expenses are reasonably priced; and

  • Work with you to make any needed changes.
The following Internet site provides a map that you can use to locate the PASS Cadre for your area. www.socialsecurity.gov/disabilityresearch/wi/passcadre.htm.

 

Where can you get more information about a PASS?

You can get a PASS Specialist’s telephone number by calling our toll-free number 1-800-772-1213
between 7 a.m. and 7 p.m. Monday through Friday or visit our website at: www.socialsecurity.gov/disabilityresearch/wi/passcadre.htm.

You can ask for a pamphlet entitled Working While Disabled — A Plan for Achieving Self-Support (SSA Publication No. 05-11017). It is also available online at www.socialsecurity.gov/pubs/EN-05-11017.pdf. You can also get a copy from your local office or by calling our toll-free number 1-800-772-1213 between 7 a.m. and 7 p.m. Monday through Friday.

Examples of a PASS (SSDI and SSI eligible)

A Sample PASS (SSI ONLY)

Example 1 – Wages Being Excluded under an approved PASS

  • Billy wants to go to school to become a social worker.

  • Billy works part time and earns $665 per month.

  • We figure Billy’s countable income using the earned income formula (See SSI ONLY EMPLOYMENT SUPPORTS)

    $665 - $20 = $645 - $65 = $580
    $580 / 2= $290 in countable income.

  • Billy’s earned income reduces his SSI benefit of $721 by $290 per month to $431.

  • He agrees to spend the $290 in countable income on his education and we approve a PASS.

  • We set aside this income and his SSI increases by $290/month for the PASS timeframe. Billy receives $721 in SSI benefits, and has $290 to use for approved PASS expenses.

A Sample PASS (SSDI ONLY)

Example 2 – SSDI Being Excluded under an approved PASS

  • Maria wants to go to school and become a paralegal.

  • She receives $800 in SSDI benefits

    • Maria’s employment goal needs to be expected to generate enough income to eliminate SSDI. (Have expected earnings over $1,070 per month SGA for 2014)

    • Maria determines she needs $780 per month for tuition, books, and school supplies. We can exclude up to $780 per month in SSDI income. This represents the full amount of Maria’s SSDI payment after deduction of the SSI general exclusion. This will make Maria eligible for the full SSI payment ($721 for 2014).

  • Maria must use the SSI payment of $721 for living expenses and use the PASS funds of $780 for approved plan expenses.

Ticket to Work (TTW) (SSDI and SSI eligible)

What is a Ticket?

The TTW Program is an innovative program for persons with disabilities who want to work and participate in planning their employment. The TTW Program increases your available choices when obtaining employment services, vocational rehabilitation (VR) services, and other support services you may need to get or keep a job. It is a free and voluntary service. You can use the Ticket if you choose, but there is no penalty for not using it. You might not be subject to a continuing disability review while you are using your Ticket.

How can I take part in the Ticket Program?

This program is available in all 50 states and 10 United States Territories. Many Social Security Disability Insurance and Supplemental Security Income disability beneficiaries are eligible to obtain services from a state VR agency or another approved provider of their choice. We call these approved providers “Employment Networks.” Employment Networks (ENs) are private organizations or government agencies that have agreed to work with Social Security to provide employment services to beneficiaries with disabilities. You can participate in the program by contacting an EN or by calling the Ticket Call Center at the number below. For a list of approved ENs, please visit www.socialsecurity.gov/work.

Where do I get more information?

For more information on the TTW Program, including a list of approved ENs, call 1-866-YOURTICKET (1-866-968-7842) or for TTY call 1-866-833-2967 between 8 a.m. to 8 p.m. Eastern time (Monday through Friday).

You can find information about the TTW Program online at www.socialsecurity.gov/work.

Continued Payment Under a Vocational Rehabilitation Program or Similar Program (Section 301) (SSDI and SSI eligible)

How do I qualify for continued payment under Section 301?

If we find that you are no longer disabled due to medical improvement, your benefit payments usually stop. However, if you are participating in an appropriate program of vocational rehabilitation (VR) or similar services, your benefits may continue until your participation in the program ends.

To qualify for continued payments under Section 301:

  • You must be participating in an appropriate program of the VR or similar services that began before your disability ends under our rules; and

  • We must review your program and decide that your continued participation in the program will increase the likelihood of your permanent removal from the disability benefit rolls.

What is an appropriate program of the VR or similar services?

Here are some examples of appropriate programs:

  • The Ticket to Work; or

  • A Vocational Rehabilitation Agency using an individualized plan for employment (IPE); or

  • Support services using an individualized written employment plan; or

  • A Plan to Achieve Self-Support (PASS); or

  • An individualized education program (IEP) for an individual age 18 through 21.

How long may my benefits continue?

Under Section 301, your benefits may continue until you:

  • Complete your program; or

  • Your participation in the program stops; or

  • We decide that your continued participation in the program will not increase the likelihood of your permanent removal from the disability benefit rolls.

Expedited Reinstatement (EXR) (SSDI and SSI eligible)

What is EXR?

EXR is a safety net for people who successfully return to work and lose their entitlement to Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits and payments. If your cash payments ended because of your work and earnings, and you stop work within 5 years of when your benefits ended, you may be able to have your benefits started again right away through a request for EXR.

How does EXR help you?

If you have stopped receiving benefits due to your work, we may be able to restart them again. The EXR provision allows you to receive up to 6 months of temporary cash benefits while we conduct a medical review to decide if we can reinstate your benefits. You may also be eligible for Medicare and/or Medicaid during this provisional benefit period.

Who can we reinstate?

You are eligible to request EXR if you meet all the following requirements:

  • Your previous entitlement to SSDI benefits terminated due to performance of substantial gainful activity (SGA); or your previous SSI disability/blindness eligibility terminated because of excess earned income or a combination of earned and unearned income;

  • You are not performing SGA in the month you apply for EXR;

  • You are unable to work at the SGA level due to your medical condition;

  • Your current medical impairment(s) is the same as, or related to, your original disabling impairment(s); and

  • You request EXR within 5 years from the month your benefits stopped.

What happens after my request for reinstatement is approved?

The month we reinstate your disability payments begins your initial reinstatement period (IRP). The IRP can last for 24 months (not necessarily consecutive), and ends when you have received 24 months of payable benefits. If you receive SSDI benefits, we can pay you for any month during the IRP that your earnings are not substantial gainful activity (SGA) (see SGA). If you receive SSI benefits, the normal income counting rules apply (see SSI ONLY EMPLOYMENT SUPPORTS).

When is a month not counted as a payable month?

If you receive SSDI, any month you perform SGA, or did not receive a payment due to any of the following reasons:

  • prisoner suspense

  • sanction penalty

  • deportation

  • alien outside of the United States

  • failure to provide a Social Security Number

If you receive SSI, any month a payment is not due based on the normal payment and computation rules (excess income or resources) is not considered a payable month. However, months of eligibility under 1619(b) (see MEDICAID WHILE WORKING) or months in which your entire check is withheld to recover an overpayment, are counted as payable months.

When is the IRP completed?

The IRP is completed when you have received a total of 24-months (not necessarily consecutive) of payable benefits.

What happens after completion of the IRP?

If you receive SSDI benefits, you are entitled to: