TN 13 (02-18)

A. Policy for work goals

1. Plan a specific work goal

Each PASS must have a specific work goal. A PASS may specify vocational rehabilitation (VR) evaluation as a goal (see SI 00870.006A.9. in this section). If a milestone is included to choose a specific work goal (see SI 00870.006A.9. in this section). Additionally, the work goal must be the earliest point on the individual's chosen career path to generate earnings sufficient to pay for the following:

• living expenses that the individual has at the outset of the PASS. If the living expenses increase due to circumstances beyond the individual's control, amend the plan to reflect a higher income point on the career path. Examples of the increases in expenses include a decrease in food stamps or housing subsidy because of the individual's increased earnings;

• all out-of-pocket medical expenses (including health insurance premiums) not subject to reimbursement; and

• all work-related expenses, including any outstanding PASS expenses. (For information on Impairment Related Work Expenses, see DI 10520.001.)

We expect the work goal to increase the individual's outlook for self-support. We measure an individual's increased outlook for self-support in terms of higher earnings potential upon completion of the PASS. Higher earnings potential may exist even if the individual is working in the same job. The individual may use the PASS to increase the number of work hours or reduce excludable work expenses (e.g., decrease job coach costs) and, thus, increase countable income for SSI purposes.

2. Limit of one PASS per work goal

An individual can have only one PASS for a particular work goal. A PASS participant may resume a PASS with the same work goal under certain conditions. See the requirements in SI 00870.080 for resuming a PASS.

NOTE: If a PASS was approved prior to December 1997 and the requirements in SI 00870.080 for resuming the PASS cannot be met, a PASS Specialist can approve a second PASS for the same work goal. For the special conditions for approving a second PASS for the same work goal, see SI 00870.025B.1.

3. The goal must be feasible

The individual must have a reasonable chance of performing the work associated within the work goal, taking into account:

• impairment(s), and the limitations imposed by it;

• age, in some cases; and

• strengths and abilities.

4. The plan for achieving the goal must be viable

The plan for achieving an otherwise feasible goal must be viable, taking into account:

• the individual's education and training needs;

• any assistive technology required;

• the interval steps (and the corresponding period to complete each step) necessary to secure employment or start a business. (An individual must submit a detailed business plan with any PASS involving a self-employment goal, and the business plan itself must be viable.) These steps or milestones, which demonstrate the individual's progress towards achieving the goal, should be described sufficiently so that completion of the steps can be readily discernible and, if appropriate, measurable;

• other needs that become apparent during evaluation of the PASS; and

• whether the individual will have sufficient means to cover PASS expenses, living expenses, and other necessary expenses.

5. Earnings requirements

a. Policy for a Social Security Disability Insurance (SSDI) or Retirement and Survivors Insurance (RSI) beneficiary who is not eligible for SSI without a PASS

An individual receiving an SSDI or an RSI benefit based on disability who is not eligible for SSI without excluding some or all of their income under a PASS, must pursue a work goal with a specific earnings level. Such individuals must choose a work goal that will generate earnings that reflect the individual’s ability to engage in Substantial Gainful Activity (SGA). If the title II benefit is higher than the SGA amount, the individual should seek an earnings level sufficient to replace the benefits of the individual and any auxiliaries residing with the individual.

EXAMPLE: Thomas receives $1,000 a month in SSDI benefits based on his work record. His wife and children, who live with him, receive an additional $500 a month in auxiliary benefits, for a family total of $1,500. Thomas submits a PASS with a work goal in which he would earn about $1,500 a month. The PASS expert advises Thomas if he earns $1,500 a month and is performing SGA, his SSDI benefit will cease and he will receive benefits only for those months in which his earnings fall below the SGA level. As a result, Thomas and his family may end up with less money than at present, considering taxes and other work-related expenses. Thomas agrees that he needs to rethink his work goal. He later modifies his PASS to pursue work in the same field but at a more advanced level, which should permit him to earn $2,500 a month.

b. Policy for an individual already eligible for SSI

An individual who is already eligible for SSI must choose a work goal that will generate enough earnings to substantially reduce their SSI benefit. The reduction must occur within a reasonable amount of time, based on the specific milestones and timeframe outlined in the PASS application (e.g., the individual expects periodic pay raises resulting in increased earnings).

6. Relevance of prior education, training, and work experience

Prior education, training, or work experience is relevant if it would permit achievement of the work goal without a step or expense listed in the PASS. For information regarding what an individual who had an earlier PASS must demonstrate before a new PASS can be approved, see SI 00870.006E.1. in this section.

EXAMPLE: Jim, who receives SSDI and SSI benefits, submits a PASS with the work goal of being a pathologist. Jim has a bachelor's degree in history. He also received some medical training when he worked as an Emergency Medical Technician (EMT). Jim's PASS includes milestones of receiving a degree in biology in 4 years, completing medical school in 4 years, serving 1 year as an intern and 2 years as a resident in order to become a pathologist.

The PASS specialist learns that Jim's degree in history exempts him from all but the required courses in the biology curriculum but Jim's EMT training has no relevance to becoming a doctor. The PASS specialist discusses this with Jim. The PASS specialist also advises Jim that the expected earnings of a resident appear to be sufficient to pay for his living expenses, out of pocket medical expenses, and work-related expenses. Consequently, Jim modifies his PASS to list his work goal as a (resident) doctor and to require only 2 years for the necessary biology course work.

7. Supported-employment goals

An applicant in a supported-employment program may submit a PASS with a goal to achieve stabilization in that job, to work more hours, or to work with less support (fewer hours of job coaching per week, for example). Such plans should specify:

• the targeted level of performance in terms of the supports required; and

• the length of time it will take the individual to reach the goal.

Subsequently, if the applicant can earn additional income, the PASS specialist can amend the targeted level of performance.

8. Basic living skills

Basic living or homemaking skills are not an occupational goal, but the PASS specialist can approve training in such skills if the individual requires them to achieve a work goal.

9. VR evaluation

We may approve a PASS with the goal of “VR evaluation” in order to help the individual select a specific work goal. Until the applicant selects a specific goal, the PASS should cover only the costs associated with having a public or private VR agency or professional perform a diagnostic study or evaluation. A VR evaluation usually takes three to six months. A request for an evaluation period of more than six months must be justified.

10. Self-employment goals

A PASS with a self-employment goal must include a detailed business plan. The lack of a business plan should not delay an individual's submission of a request for a PASS. The PASS could initially cover any costs associated with developing a business plan or a business plan evaluation. (For more information about business plans, see SI 00870.026.)

11. Achievement of the work goal

An individual achieves a work goal when the individual is actually employed and the individual’s earnings are sufficient to cover living, uncovered-medical, and work-related expenses that existed before the PASS.

B. Policy for allowable expenses

1. Overview of allowable expenses

To be allowable, an expense must:

• be for items and services that the individual needs in order to achieve the work goal. The PASS should include an explanation as to why the goods and services are needed;

• not have existed before the individual began activities to achieve the work goal (which can predate submission of the PASS and SSI eligibility). The increased costs for a pre-existing expense that are caused by the PASS may be allowed;

• be of a reasonable cost; and

• reflect start-up costs.

NOTE: For examples of allowable expenses, see SI 00870.025A.

2. Necessary expenses

We can allow expenses only for items and services the individual needs to achieve the work goal.

The individual should provide an explanation as to why an item is necessary.

3. Reasonable cost

The cost of the item should be reasonable. The price should reflect the usual cost for the item in the market place.

4. Start-up costs

Start-up costs refer to the expenses associated with someone getting a job or starting a business. PASS expenses are limited to the start-up costs for the particular work goal. For an individual starting a business, the start-up costs include the expenses to start the business through the first 18 months, or longer if needed, for business operations. The use of an item as a business expense in determining net earnings from self-employment (see SI 00820.200) does not preclude its use as a PASS expense during the calendar years (or fiscal years) that encompass the start-up period of a business. For additional detail, see SI 00870.025B.5.b.

5. Items of unusual value

An individual who wishes to purchase an item of unusual value must provide a satisfactory explanation of why a less costly alternative, such as renting or purchasing a less expensive version of the item will not suffice for achieving the work goal.

6. Education

An applicant requesting education or tuition as a PASS expense must explain why they need the education to achieve the work goal. They must provide the course curriculum or course of study from an accredited source.

7. Computer equipment

For other than obvious computer needs, the PASS must explain how an individual’s request for hardware or software serves their particular needs, and why less costly alternatives will not meet these needs. Less costly alternatives may include renting a computer. For individuals who attend a school with available computers for students' use, the PASS should include an explanation as to why using the school's computers are insufficient.

8. Vehicles

If the PASS includes the purchase of a vehicle as an expense, the individual must explain why other means of transportation (para-transit, other public transportation, cab) will not serve their needs. In some cases, other means of transportation may not be the following:

• available at the times and locations needed;

• reliable;

• safely accessible; or

• of use to the individual (e.g., no wheelchair access).

If purchasing a vehicle best meets the individual's needs, they should select a vehicle that will handle the transportation requirements for the duration of the PASS. If the individual already owns a vehicle, they must explain why they need to purchase another vehicle (e.g., why repairing/maintaining the current vehicle will not be sufficient).

NOTE: Some individuals with disabilities own a vehicle but cannot operate it themselves. They have someone else drive them. An inability to operate a vehicle does not preclude the purchase of a vehicle as an allowable PASS expense if the individual explains how he or she will use the vehicle to help achieve the work goal.

9. Vehicle-related expenses

We can allow expenses related to owning a vehicle under a PASS. Such expenses include, but are not necessarily limited to the following:

• registration and licensing fees;

• fuel costs, which must relate directly to travel for activities that are necessary to achieve the work goal; and

• routine maintenance and insurance costs.

We can allow expenses for fuel, maintenance, and insurance based on the following:

• actual cost, if the individual provides evidence of the actual cost of these expenses; or

• the mileage allowance chart in DI 10520.030G. Since the mileage allowances reflect insurance, fuel, and routine maintenance expenses, no additional allowances can be made for these items.

10. Job coaching expenses

SSA limits job-coaching expenses to assistance directly pertaining to completing the tasks required by the job. Consider attendant care or other services provided by the job coach separately.

We may contact a knowledgeable source, such as a VR agency or an employer, to verify the need for job coaching services as well as the individual's prospects for reducing those services through the PASS. Generally, a reasonable charge for these services will reflect the amount the local State VR agency pays for similar services.

11. Supported employment - extended or follow-along services

The level of performance that a PASS specifies as its work goal is a factor in determining whether we can allow the proposed expenses. We allow expenses necessary to attain the specified level of performance, even if the individual is already working in the job.

Although we typically do not allow extended or follow-along services under a PASS, allow such services if the individual is trying to increase the hours worked or decrease reliance on and costs for ongoing supports. For definitions of extended or follow-along services and stabilization, see SI 00870.002B.

12. Deferred expenses

In certain circumstances, we may approve a PASS but defer a decision on certain PASS items or services until a later date. This will occur only for those items the individual needs after completing one or more milestones. Deferring a decision on an expense is a way of ensuring the individual's need for that item. Additionally, deferral protects the person from the risk of prematurely contracting for an item or service and being unable to fulfill the terms of the agreement if the PASS stops before the item or service has been paid.

EXAMPLE: Joe, 40, quit high school in the 10th grade and worked as a laborer when he had a heart attack in 1992. He has been on SSI since. He wants to start a business to deliver carryout orders from restaurants, and has already lined up a number of restaurants.

Joe submits a PASS that includes a detailed business plan and requests the exclusion of $350 a month in SSDI benefits to pay for obtaining a commercial driver's license, a delivery van, and advertising. He plans to begin driver's education classes in
December 2000, to obtain his license by June 2001, and to start his delivery service in September 2001.

Joe's VR counselor and doctor have confirmed that Joe's goal is feasible and that his plan for achieving it is realistic. Joe also submits a letter from the local Chamber of Commerce attesting to the likelihood of Joe's business succeeding.

The PASS specialist approves the PASS. However, since Joe cannot achieve his goal unless he obtains a commercial driver's license, the PASS specialist defers approval of the expenses for purchasing the van and advertising, and excludes only the amount of Joe's SSDI benefits needed to cover the costs of obtaining the driver's license.

Joe obtains the license in May 2001. As a result, the PASS specialist allows the deferred expenses.

13. Savings/spending schedule

In addition to meeting the requirements in SI 00870.006B.1. through SI 00870.006B.12. in this section, a PASS must indicate:

• when the individual will use the items and services with respect to attaining the work goal;

• what income or resources the individual will set aside to purchase the items and services;

• whether the funds will be used for periodic payments (monthly) of expenses or saved for a future payment; and

• how the individual will keep the set aside funds under the PASS separate from other funds.

Ordinarily, the individual should make disbursements for items and services as soon as possible. If funds are set aside for a down payment or later expense, we will verify accumulated savings at intervals determined by the PASS specialist in each case, but at least every six months.

14. Deducting expenses paid by deemor

We subtract funds paid or set aside by a deemor for a PASS expense from the eligible individual's countable income after deeming. (See the example in SI 00870.025B.4. For related information about deeming, see SI 01320.140 and SI 01320.710A.)

15. Job search expenses

A PASS can include expenses for a job search, such as transportation, employment agency services, and resumé development and distribution. The individual should describe the specific actions and the timing of those actions to find employment, taking into account the kind of work and the job market. The individual should conduct job search activities concurrently with other PASS-related activities if possible.

C. Policy for expenses SSA cannot allow

We cannot allow the following expenses:

• the individual or deemor did not purchase;

• items or services that the individual can readily obtain from another agency for free;

• items or services for which the individual will be promptly reimbursed (e.g., health insurance);

• items or services purchased in connection with a prior PASS, unless a satisfactory justification is provided (e.g., the individual paid for certain college courses in connection with a prior PASS but, for medical reasons, was unable to complete them);

• reflects an outstanding debt unrelated to the current PASS or a prior PASS, or was in existence prior to the current PASS unless it was being purchased under a suspended or terminated PASS and is needed for the current PASS as well (see SI 00870.070 for information about PASS suspensions and terminations).

  NOTE: This does not apply to the following:

  (1) an expense that either began due to the current PASS but before the PASS was submitted for our approval, or

  (2) an increase in the cost of a pre-existing expense because of the PASS; or

• used to reduce countable income after the start-up period described in SI 00870.006B.4. in this section. For example, after the start-up period for a business, the cost of an item that is used as a business expense when determining net earnings from self-employment (see SI 00820.200), can no longer be used as a PASS expense.

D. Policy on time considerations for PASS

1. Time limits for PASS

As of January 1, 1995, the Social Security Act requires that the time limits for PASS take into account the length of time that the individual needs to achieve the individual's work goal. Prior to that date, a PASS could not exceed 36 months (or 48 months when a lengthy educational or training program was involved).

2. New plans for PASS

A PASS must specify beginning and end dates. It also must specify target dates for reaching milestones that reflect progress toward achievement of the work goal.

3. Extensions on the target date

Extend the target date for reaching a milestone or the end date of a PASS if circumstances beyond the individual's control delay achievement of the milestone or work goal and the individual meets all other requirements.

Extend a PASS only in intervals up to six months beyond the original approved end date.

4. Self-employment

Allow a business a minimum start-up period of 18 months unless the individual indicates they need less time to sustain business operations. A request for a start-up period of a longer duration than 18 months must be justified. (See SI 00870.026 for more information on a self-employment PASS.)

E. Policy for miscellaneous items

1. Multiple PASS plans

An individual can have only one active PASS at a time, but once a plan ends, an individual can apply for another. Before we can approve a subsequent PASS:

• complete a final accounting for the prior PASS (see SI 00870.070D); and

• the individual must show that they can either no longer work at or obtain work in the prior work goal.

NOTE: An overpayment that stems from a final accounting does not preclude the evaluation of a subsequent PASS on its own merits. However, the repayment of an overpayment related to one PASS is not an allowable expense for purposes of another PASS.

2. Aged individuals

Approve a PASS for an aged individual only if they received SSI benefits based on blindness or disability (or State aid based on disability) for the month before turning age 65.

3. Written plan

A PASS must be submitted in writing, preferably on Form SSA-545-BK (Plan to Achieve Self-Support (PASS)), signed or attested by the individual and, if applicable, the representative payee.

4. Funds for pursuing the PASS

Approval of a PASS permits the exclusion of countable income and resources in determining eligibility or payment amount for SSI. An individual must have countable income or resources to be excluded and must meet SSA’s disability or blindness criteria.

5. Third-party assistance

A PASS applicant or participant may authorize a third party to act on his or her behalf in matters pertaining to the PASS by submitting to SSA a signed statement that identifies the third party and the limits (including the length) of the authorization.

For example, the statement, “I authorize (agency or individual) to act on my behalf in all matters pertaining to my PASS for the life of my PASS” would permit SSA to communicate openly with the third party about all matters pertaining to the PASS. This statement does not have to be on a particular form. For more information about the issues of consent and access, see GN 03305.001 and GN 03340.001.

If the individual wishes to provide consent to SSA to disclose information and records regarding the PASS to the third party, the individual should identify this third party on the SSA-545-BK in sections G and I.