SSDI and SSI Work Incentives

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 a 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 you receiving more pay than the actual value of the services you perform. An example of subsidized work is employment at Sheltered Workshops. Sheltered employment is employment provided for individuals with disabilities in a protected environment under an institutional program. An employee working in a Sheltered Workshop or comparable facility for severely impaired people will ordinarily be considered not engaged in SGA. This is the case if the employee's “countable earnings” do not average more than the amount shown in the Earnings Guidelines.
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 any one of the following conditions are met: You receive more supervision than other workers doing the same or a similar job for the same pay. You have fewer or simpler tasks to complete than other workers doing the same job for the same pay. You are given additional or longer paid breaks than other workers doing the same job for the same pay. 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 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). This was because of your impairment or the removal of special conditions related to your impairment that you need to help you work.
What is the benefit of a UWA if you receive SSDI?	When we make an 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, 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 or after we decide that your disability has ceased.
Does a UWA affect your monthly 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.

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 you meet all the requirements below: 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, a private insurance carrier, or Employment Network (EN). 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. This applies 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 EXPENSE	IRWE DEDUCTIBLE	NOT 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, taxicabs, paratransit, special bus, or other types of transportation 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 they suffer an economic loss by reducing or ending their work to help you. For example, if your spouse must reduce their 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 they suffer no economic loss. This includes services provided by your non-working spouse.
Service Animals	Expenses paid in owning a guide dog or other service animal which enables you to overcome functional limitations to work. Deductible expenses include costs of purchasing the animal, training, food, licenses, and veterinary items and services. Other costs directly related to the care of the animal; such as transportation for training and veterinary services.	Expenses for non-service animal.
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. Examples include: Exterior ramps Railings Pathways If you are self-employed at home, modifications made inside your home 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, you cannot deduct any modification-related expenses that you will deduct as a business expense when determining SGA.
Prescription Drugs, Over-the-counter drugs & Medical Services	Regularly prescribed medical treatment or therapy that is necessary to control your disabling condition, even if control is not achieved. This includes co-payments and insurance deductibles, 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. However, per the 2018 Farm Bill, hemp products (e.g., CBD oil) containing no more than 0.3 percent THC are federally legal.  Therefore, as of December 20, 2018, such products are deductible as an IRWE.	Drugs and/or medical services used for your minor physical or mental health problems, for example: Allergy treatments Routine annual physical examinations Routine dental examinations Routine optician services (unrelated to a disabling visual impairment). Prescription drugs that are a violation of federal law (e.g. medical marijuana) cannot be deducted as an IRWE, even if allowed by state law.
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. Assistive technology that people with disabilities use for employment–related purposes; such as software applications, computer support services, and special tools which have been specifically designed to accommodate the person’s impairment.	An exercise bicycle or other device you use for physical fitness, unless verified as necessary by your physician. Health insurance premiums. Software and applications not related to a person’s disability and employment.

Plan 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 resources for a specified period. This allows you to 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, assistive technology used for employment–related purposes, or starting a business. Expenses must be 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 $1,000 per month in SSDI, you have too much income to be eligible for SSI. However, 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 have 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 include all the following:

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, from our website at www.ssa.gov/online/ssa-545.html, calling our toll free number 1-800-772-1213, visiting your local office, or from any PASS Expert.
Have a specific work goal that you can perform.
Have a specific timeframe for reaching your goal.
Show what income you receive (other than your SSI payments) and 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.
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 can help you. We will evaluate the plan and decide if it is acceptable. We can also help you put your plans in writing.

We have specially trained employees (PASS Specialists) that work with the PASS program. When you submit a written PASS proposal to a PASS Specialist, they 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.
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.ssa.gov/disabilityresearch/wi/passcadre.htm.

Where can you get more information about a PASS?

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

You can ask for a pamphlet entitled Working While Disabled — A Guide to Plans for Achieving Self-Support (SSA Publication No. 05-11017). It is also available online at www.ssa.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 (refer to the Earned Income Exclusion section).
$665 - $20 = $645 - $65 = $580.
$580 / 2= $290 in countable income.
Billy’s earned income reduces his SSI benefit of $841 by $290 per month to $551.
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 per month for the PASS timeframe. Billy receives $841 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 $1,000 in SSDI benefits:

The goal for Maria’s employment is to generate enough income to eliminate SSDI. (Have expected earnings over the SGA limit).
Maria determines she needs $980 per month for tuition, books, and school supplies. We can exclude up to $980 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.

Maria must use the SSI payment for living expenses and use the PASS funds for approved plan expenses.

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

How do I qualify for continued payment under Section 301?

If we find that you no longer have a disability due to medical improvement, or if you are age 18 and we find that your eligibility ends because you do not meet the adult requirements for disability, 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 meet all the requirements below:

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

An individualized education program (IEP) for an individual age 18 through 21.
The Ticket to Work.
A Vocational Rehabilitation Agency using an individualized plan for employment (IPE).
Support services using an individualized written employment plan.
A Plan to Achieve Self-Support (PASS).

How long may my benefits continue?

Under Section 301, your benefits may continue until:

You complete your program.
Your participation in the program stops.
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. Your cash payments may have ended because of your work and earnings, and you may have stopped work within 5 years of when your benefits ended. If so, 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. 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 is terminated due to performance of substantial gainful activity (SGA); or your previous SSI disability or blindness eligibility terminated because of excess earned income or a combination of earned and unearned income. You are unable or become unable to perform 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). 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). If you receive SSI benefits, the normal income counting rules apply.
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: A new 9-month trial work period. A new 36-month extended period of eligibility. A new 60-month period to file an EXR request if your reinstated benefits are stopped due to SGA. A new period of extended Medicare coverage.

Red Book

A Sample PASS (SSI ONLY)

Example 1 – Wages Being Excluded under an approved PASS

A Sample PASS (SSDI ONLY)

Example 2 – SSDI Being Excluded under an approved PASS