POMS Reference

Table of contents Recent changes
Contact
Back
This change was made on Mar 8, 2018. See latest version.
Text removed
Text added

SI 00820.550: Work Expense Development and Documentation

changes
← * →
  • Effective Dates: 03/09/2015 - Present
  • Effective Dates: 03/08/2018 - Present
  • TN 24 (03-95)
  • TN 64 (03-18)
  • SI 00820.550 Work Expense Development and Documentation
  • A. Policy
  • A. Policy for documentation of Work Expenses
  • All allegations and/or evidence of BWE and IRWE must be documented in file.
  • Document all allegations/evidence of Blind Work Expense (BWEs) and Impairment Related Work Expense (IRWE) in file.
  • B. Procedure — Documentation
  • Document BWE and IRWE respectively per 1. and 2. below.
  • Document BWE and IRWE as in SI 00820.550B.1. and SI 00820.550B.2.
  • 1. Allegation of BWE
  • Document BWE as described below:
  • Document BWEs as described below:
  • STEP
  • ACTION
  • 1
  • Assume that any working blind individual earning more than $65 a month has BWE. For example, most earnings are subject to income taxes which qualify as BWEs.
  • Most earnings are subject to income taxes, which qualify as BWEs. If an individual were earning over the earned income exclusion of $65 per month, we would apply BWE to the income taxes of the blind individual. List these income tax exclusions on the Blind/Impaired Work Expenses page in the SSI claim system/MSSICS.
  • 2
  • If earnings are above $65 per month, obtain an allegation from the individual that either:
  • If earnings are above $65 per month, obtain an statement from the individual that either:
  • * claims a BWE, specifying the type and amount of expense; or
  • * explains why he/she has no BWE.
  • * explains why there is no BWE.
  • 3
  • Record this statement in remarks on the Blind/Impaired Work Expenses (IBIE) screen in MISSICS, the remarks on the application or redetermination form, on a SSA-795 (Statement of Claimant or Other Person), or on a Report of Contact (RC). For MISSICS cases when no BWE is alleged, show “No BWE” in the expense field and “0.00” in the amount field on the IBIE screen and document the explanation in remarks.
  • Record this statement in remarks on the Blind/Impaired Work Expenses page in Supplemental Security Income (SSI) claim system (i.e., MSSICS/SSI claim system), the remarks on the application or redetermination form, on a SSA-795 (Statement of Claimant or Other Individual), or on a SSA-5002 (Report of Contact or R/C in SSI claim system). For SSI claim system cases when no BWE is alleged, select the radio button ‘There are no expenses to record” and document the reason.
  • 2. Allegation of IRWE
  • Document IRWE according to the following steps:
  • Document IRWE as described below:
  • STEP
  • ACTION
  • 1
  • Ask about IRWE when:
  • * a disabled individual's earned income exceeds $65 in any month; or
  • * at least one member of an eligible couple is disabled and has earned income, and the couple's total earned income exceeds $65 in any month; or
  • * a disabled individual's earned income exceeds $65 in any month; or
  • * at least one member of an eligible couple is disabled and has earned income, and the couple's total earned income exceeds $65 in any month; or
  • * a disabled individual has earned income of $65 or less, the individual is subject to spouse-to-spouse deeming, and the couple's total earned income exceeds $65.
  • 2
  • Record the individual's response in:
  • * item 9 on SSA-821-BK (OS 15025.010), showing “none” if no IRWE are alleged; or
  • * items 8B and 9 on SSA-820-BK (OS 15025.001), showing “none” if no IRWE are alleged; or
  • * question 35 of the SSA 8000-BK; or
  • * question 14 of the SSA 8203-BK; or
  • * a statement (on an SSA-795 or an R/C, etc.) describing the IRWE claimed or that no IRWE is alleged.
  • * SSI claim system, when no IRWE is alleged, select the radio button ‘There are no expenses to record” and document the reason in the remarks box.
  • * item 7 on SSA-821-BK (OS 15025.010), check the “NO” box if no IRWE are alleged; or
  • * items 8 and 9 on SSA-820-BK (OS 15025.001), check the “NO” box if no IRWE are alleged; or
  • * question 55 of the SSA 8000-BK (Application for Supplemental Security Income); or
  • * question 14 of the SSA 8203-BK (Statement for Determining Eligibility for Supplemental Security Income Payments; or
  • * a statement on an SSA-795 (Statement of Claimant or Other Individual) or SSA-5002 (Report of Contact or an R/C in SSI claim system) describing the IRWE claimed or no IRWE is alleged.
  • 3. When to Develop
  • Develop work expenses per 1. and 2. above when you:
  • * complete an initial application or a redetermination (unless the work expenses were developed as part of a monthly/quarterly wage verification process); or
  • * receive a report that the recipient has started working;or
  • * receive a report that the expenses have changed.
  • Develop BWE and IRWE per SI 00820.550B.1. and SI 00820.550B.2. when you:
  • * complete an initial application or a redetermination (unless the work expenses were developed as part of a monthly or quarterly wage verification process); or
  • * receive a report the recipient has started working; or
  • * receive a report the expenses have changed.
  • NOTE: A change in the amount of earnings of a blind worker implies a change in expenses since the amount of taxes deducted probably changed.
  • NOTE: Develop BWE exclusions for months the individual has earnings. These exclusions should be verified and include the taxes on these wages, as well as any other applicable expenses, before adjudicating an initial claim or redetermination. A change in the earnings of a blind individual implies a change in expense since the amount of taxes deducted has probably changed.
  • 4. Allocation of Work Expenses
  • 4. Allocation of BWE or IRWE
  • Document the file to support your allocation of work expenses. (See SI 00820.560 for instructions on allocating work expenses.)
  • Document the file to support your allocation of BWE or IRWE. (For instructions on allocating work expenses, see SI 00820.560.)
  • C. Procedure — Verification
  • 1. Evidence of BWE
  • * Verifying that criteria for BWE are met
  • * Stop file documentation when the expense is listed on the chart in SI 00820.555. The items listed on the chart meet the criteria for a BWE.
  • * Document the file to reflect how an item is reasonably attributable to the earning of income when the item is not listed on the chart.
  • * Verifying cost of BWE
  • * Document the file with photocopies of bills, receipts, etc., from the individual to corroborate the allegations.
  • Inform every working blind individual of the requirement to maintain records of work expenses and to produce such records when requested. Explain why we need to see these records.
  • a. Verifying the criteria for BWE are met
  • When completing a redetermination or adjudicating a claim be sure to:
  • * The expenses listed on the chart in SI 00820.555 meet the criteria for a BWE and do not require documentation.
  • * Document the file to reflect how an item is reasonably attributable to earning income when the item is not on the chart.
  • NOTE: You may use form SSA-L4201-BK per SI 00820.145B.3. to verify BWE for which the employer has a record of the expense (e.g., taxes, FICA) and the evidence is not otherwise available.
  • * Accept the individual's allegation of the expense amount when:
  • b. Verifying cost of BWE
  • bills, receipts, etc., cannot be obtained (e.g., lack of receipts for food purchased for a dog guide, meals, transportation, etc.);and
  • Make sure to verify the expenses associated with the BWE.
  • * Accept the individual's allegation of the expense amount when
  • the allegation appears reasonable.
  • bills, receipts, etc., cannot be obtained (e.g., lack of receipts for food purchased for a dog guide, meals, transportation, etc.) and the allegation appears reasonable. A reasonable expense is the amount customarily charged for covered or similar services and supplies.
  • * Document the file with photocopies of bills, receipts, etc., from the individual to corroborate the allegations, store these documents electronically.
  • Inform every working blind individual of the requirement to maintain records of work expenses and to produce such records when requested. Explain these records will help us document excludable expenses for SSI purposes.
  • NOTE: You may use form SSA-L4201-BK (Letter To Employer Requesting Wage Information) in SI 00820.145 to verify BWE for which the employer has a record of the expense (e.g., taxes) and the evidence is not otherwise available. Store the completed 4201 electronically.
  • 2. Evidence of IRWE
  • * Verifying the need for an item or service
  • * Refer to the chart in SI 00820.555 for guidance in common types of expenses deductible as IRWE.
  • * Accept an allegation, as verification of need, that a prescription drug is used to control the disabling condition, enabling the individual to function at work, when:
  • there is a paid bill for the drug; and
  • a. Verifying the need for an item or service
  • When verifying these expenses, receipts should be supplied by the individual and the expenses should be related to a disabling condition they are under care for.
  • * Refer to the chart in SI 00820.555 for guidance on common types of expenses excludable as IRWE.
  • * Find that, a prescription drug is used to control the disabling condition, enabling the individual to function at work, when:
  • * there is a paid bill for the drug; and
  • * the information on the container indicates:
  • * a physician and a licensed pharmacist were involved in providing the drug; and
  • * the drug is for the individual.
  • * Follow the instructions in DI 10520.030A. to verify IRWE in all other circumstances.
  • the information on the container indicates that:
  • b. Verifying the cost of an item or service
  • a physician and a licensed pharmacist were involved in providing the drug; and
  • Accept the individual's allegation as to the recurring use and cost of an IRWE when:
  • * at least one available receipt documenting the cost is submitted;
  • * additional receipts are unavailable for the recurring expense (e.g., hearing aid batteries, incontinence pads, etc.); and
  • * the allegation of use is consistent with the nature of the expense (e.g., the individual states he has only a couple of receipts for the box of 60 incontinence pads he buys every month as his condition requires him to use two pads a day).
  • the drug is for the individual.
  • * Follow the instructions in DI 10520.030A. for verification of IRWE in all other circumstances.
  • * Verifying cost of an item or service
  • * Accept the individual's allegation as to the recurring use and cost of an IRWE when:
  • Follow the instructions in DI 10520.030B to verify IRWE in all other circumstances.
  • at least one available receipt documenting the cost is submitted;
  • NOTE: You may use form SSA-L4201-BK (Letter To Employer Requesting Wage Information) in SI 00820.145. to verify the cost of the IRWE when the expense is excluded by the employer from the individual's earnings.
  • additional receipts are unavailable for the recurring expense (e.g., hearing aid batteries, incontinence pads, etc.); and
  • 3. Post-eligibility Situations
  • the allegation of use is consistent with the nature of the expense (e.g., the individual states that he has only a couple of receipts for the box of 60 incontinence pads he buys every month as his condition requires him to use two pads a day).
  • * Follow the instructions in DI 10520.030B. for verification of IRWE in all other circumstances.
  • a. BWE/IRWE previously developed
  • NOTE: However, you may use form SSA-L4201-BK per SI 00820.145B.3. to verify the cost of the IRWE when payment of the expense is deducted by the employer from the individual's earnings.
  • Review SSI claim system to determine the months we previously verified BWE/IRWE. If BWE/IRWE were developed previously, compare the recipient's (and spouse's, if applicable) responses with information on the Supplemental Security Record (SSR). Then, proceed as follows:
  • 3. Posteligibility Situations
  • * BWE/IRWE previously developed
  • Review the IBIE screen or the remarks screen in MISSICS to determine the months the BWE/IRWE were previously verified. If BWE/IRWE were developed previously, compare the recipient's (and spouse's, if applicable) responses with information on the Supplemental Security Record (SSR). Then, proceed as follows:
  • IF...
  • AND...
  • THEN...
  • the alleged amounts and dates of work expense information agree with the verified information on the SSR
  • no changes are alleged.
  • no further BWE/IRWE development is necessary. Show these months as verified.
  •  
  • changes are alleged
  • develop and verify BWE/IRWE per 1 and 2 above.
  • develop and verify BWE/IRWE per SI 00820.550C.1. and SI 00820.550C.2.
  • information on the SSR is unverified
  • —
  • develop and verify BWE/IRWE per 1 and 2 above.
  • * BWE/IRWE not previously developed
  • Develop and verify per 1 and 2 above.
  • develop and verify BWE/IRWE per SI 00820.550C.1. and SI 00820.550C.2.
  • b. BWE/IRWE not previously developed
  • Develop and verify according to SI 00820.550C.1. and SI 00820.550C.2
  • D. Procedure — Special Considerations
  • 1. More Than One Employer Involved
  • Add total earnings from all employers. Deduct combined work expenses from this total.
  • Add total earnings from all employers. Exclude BWE/IRWE expenses from this total.
  • NOTE: There is no need to relate a specific expense to a particular source of earnings.
  • 2. Self-Employment
  • Carefully review records and/or the portion of the tax return used to determine NESE per SI 00820.210. Check that none of the expenses deducted in determining NESE are also being claimed as work expenses.
  • Carefully review records and the portion of the tax return used to determine Net Earnings from Self-Employment (NESE) in SI 00820.210. Ensure the individual either claiming a particular expense as IRWE/BWE, or deducting it to determine NESE, but not both.
  • Determine what expenses can be excluded from earned income as work expenses. If necessary, refer the individual to the Internal Revenue Service (IRS) for information about permissible self-employment deductions.
  • Determine what expenses can be excluded from earned income as work expenses. If necessary, refer the individual to the Internal Revenue Service (IRS) for information about permissible self-employment deduction.
  • EXAMPLE: Individual is self-employed and a wage earner
  • EXAMPLE: Mr. Griffin, a blind SSI recipient, is self-employed selling brushes. He also works one night a week as an employee typing transcripts from recordings. Mr. Griffin's self-employment requires him to travel by cab (at a cost of $60 per month) to the brush manufacturer to pick up samples. He also must travel by cab to the office where he works, at a cost of $40 per month.
  • FACTS: Mr. Griffin, a blind SSI recipient, is self-employed selling brushes. He also works one night a week as an employee typing transcripts from recordings. Mr. Griffin's self-employment requires him to travel by cab (at a cost of $60 per month) to the brush manufacturer to pick up samples. He also must travel by cab, at a cost of $40 per month, to the office where he is employed.
  • CONCLUSION: You determine that the $60 monthly cab fare to pick up samples has been used in arriving at his NESE and cannot be deducted from his earned income as a work expense. You deduct as a work expense the $40 monthly cabfare for travel to and from the office where he is employed.
  • CONCLUSION: You determine he used the $60 monthly cab fare to pick up samples in his calculation for NESE. You cannot exclude this amount from his earned income as a work expense. However, because he did not include the $40 monthly cab fare for travel to and from the office of his employment in his NESE calculation for the year, you can exclude this amount as a work expense.
  • 3. Work Expenses of a Couple
  • If both members of a couple are eligible and both work, deduct from the couple's earned income each individual's work expenses to the extent that they do not exceed that individual's earnings. Do not deduct excess work expenses of one member of the couple from the earned income of his or her spouse. (See B.2. above when it is necessary to document IRWE in couples' cases and SI 00820.545C when deeming is an issue.)
  • If both members of a couple are eligible and both work, exclude from the couple's earned income each individual's work expenses to the extent they do not exceed the individual's earnings. Do not exclude excess work expenses of one member of the couple from the earned income of his or her spouse. (For more information on when it is necessary to document IRWE in couples' cases, see SI 00820.550B.2. and SI 00820.545C when deeming is an issue.)
  • 4. Estimating Future Work Expenses
  • * Estimate an individual's future expenses based on expenses paid in the most recent period per SI 00810.600-610. This could be the period just redetermined or a shorter period if there has been a pertinent change in circumstances, such as additional expenses.
  • For example, if the individual had more expenses in the last 3 months than in previous months and those expenses are expected to continue, use that amount in your determination. Consider any expected decrease in expenses (e.g., installment payments on tools that will be paid off).
  • * Do not estimate an anticipated expense in the near future (e.g., purchase of more equipment) until there is proof that the expense exists. Tell the individual to let you know as soon as a new expense develops so you can make any appropriate adjustments at that time.
  • * You may use the nationally approved personal computer income protection program to project BWE and IRWE. (See SI 00820.150 and SI 00820.230 for estimating future earnings.)
  • To ensure an accurate estimate of future expenses, use the following steps.
  • * Estimate an individual's future expenses based on expenses paid in the most recent period. For more information, see SI 00810.600 and SI 00810.610. For information on estimating future earnings, see SI 00820.150 and SI 00820.230.
  • * The period in question could be the period just re-determined or a shorter period if there has been a pertinent change in circumstances, such as additional expenses.
  • For example, if the individual had more expenses in the last 3 months than in previous months and we expect those expenses to continue, use that amount in your determination. Consider whether there is an expected decrease in expenses (e.g., when installment payments on tools will end).
  • * Do not estimate an anticipated expense in the near future (e.g., purchase of more equipment) until there is proof the expense exists. Tell the individual to let you know as soon as a new expense develops so you can make any appropriate adjustments at that time.
The materials available at this web site are provided free of charge, for informational purposes only, and without warrant by True Link Financial, Inc., and are not legal advice or Social Security benefits advice. You should contact your attorney to obtain advice with respect to any particular issue or problem, or the Social Security Administration with any general inquiries. Click here to view this section of the POMS on the Social Security Administration website.