TN 21 (03-92)

Citations:

Social Security Act – Sections 1611, 1612(b), 1614(a), 1619(a), and 1619(b);

P.L. 99-643 and P.L. 101-508;

20 CFR 416.976 and 20 CFR 416.1112;

PPS-114/SSR 84-26

A. Definition

IRWE are expenses for items or services which are directly related to enabling a person with a disability to work and which are necessarily incurred by that individual because of a physical or mental impairment.

B. Policy - December 1, 1990 and later

1. General

Effective December 1, 1990, we may deduct IRWE to determine countable earned income in both initial claims and posteligibility situations regardless of whether we previously established the person's eligibility without considering IRWE. (See SI 00820.540C below for policy guidelines for periods prior to December 1990.)

2. Eligibility requirements

A payment for a service or item is excludable as IRWE for SSI payment/ eligibility purposes when:

• the individual:

  is disabled (but not blind); and

  is under age 65; or

  received SSI as a disabled individual (or received disability payments under a former State plan) for the month before attaining age 65; and

• the severity of the impairment requires the individual to purchase or rent items and services in order to work; and

• the expense is reasonable; and

• the cost is paid in cash (including checks or other forms of money such as money orders, credit and/or charge cards) by the individual and is not reimbursable from another source (e.g., Medicare, private insurance); and

• the payment is made in a month the individual receives earned income for a month in which he/she both worked and  received the services or used the item; or

  the individual is working but makes a payment before the earned income is received.

  (See SI 00820.560B for instructions on deducting expenses paid while working. See SI 00820.560C for instructions on deducting expenses paid prior to work. For instructions on deducting expenses paid after work has stopped, see SI 00820.560D.)

3. IRWE Used for other daily activities

An expense may meet the criteria for an IRWE even if it also is used for daily activities other than work.

4. Application of exclusion

1. The IRWE exclusion only applies to earned income. IRWE in excess of the earned income an individual receives during the month are never deducted from unearned income. (See SI 00820.560 for allocating expenses.)

2. The IRWE exclusion is applied to earned income in the sequence below:

   • immediately after deducting:

     any portion of the general income exclusion which has not been deducted from unearned income; and

     the $65 earned income exclusion; and

   • immediately before deducting one-half of the remaining earned income.

NOTE: IRWEs are an exclusion to earned income, not a deduction. To input IRWE exclusions in MSSICS, enter a (Y) to the question “Do you have any special expenses related to your illness or injury that you paid which are necessary for you to work” on the INEQ screen. The expenses are input on the IBIE screen. (Do not code IRWE exclusions on the IWAG screen under deductions.)

See also

MSOM INTRANETSSI 014.032

5. SGA determinations

1. IRWE may be deducted from earned income when determining substantial gainful activity (SGA) for initial title II and title XVI situations and in title II continuing eligibility situations. (See
   DI 10520.001 for SGA.)

2. For concurrently eligible individuals, the amount deducted for SGA purposes  must be the same for both title II and title XVI.

3. The amount excluded in the SSI payment/eligibility computations may differ from the amount used to determine SGA due to the use of other exclusions. (See SI 00820.545 for information on the interaction of IRWE and other provisions.)

4. The same rules are applied for SGA purposes and SSI payment/ eligibility purposes when determining:

   • whether an item or service meets IRWE criteria; and

   • the value of the item or service.

C. Policy - Pre-December 1, 1990

1. General

For an item or service to be considered an IRWE, the criteria in SI 00820.540A and SI 00820.540B.2. through SI 00820.540B.5. above must be met, and the individual who is disabled must be initially eligible for SSI as described in SI 00820.540C.2. below.

2. Initial eligibility

To qualify as initially eligible, for purposes of the IRWE exclusion, an individual must meet:

• all SSI nonincome criteria; and

• the SSI (Federal) income test (i.e., total countable income without benefit of the IRWE exclusion, must be at or below the federal benefit rate (FBR)).

Once initial eligibility is established, the IRWE exclusion is used for computation purposes.

3. Continuous eligibility

1. An individual remains qualified for the use of IRWE for so long as he/ she is continuously eligible for an SSI benefit (whether or not the individual alleges working or having IRWE).

2. An individual remains continuously eligible if the individual:

   • continues to meet all SSI nonincome criteria, and

   • has total countable income, with use of the IRWE exclusion, that does not exceed the FBR plus any applicable federally administered optional State supplementation; or

     is eligible under section 1619(b).

3. Ineligibility for SSI benefits for even 1 month necessitates the individual reestablishing federal eligibility without using IRWE.

4. If an eligible individual enters a Medicaid institution (FLA-D) and remains eligible, but a benefit is not payable because of the $30/month payment limit (E01), the individual is considered continuously eligible for the IRWE exclusion.