The FO or the claimant or recipient will record the person's allegation concerning
IRWE either on the SSA-821-BK (Work Activity Report - Employee), or on the SSA-820-BK (Work Activity Report - Self-Employed Persons). The FO may also record and document
issues of IRWE on a Report of Contact (SSA-5002) or the DCF REMARKS screen.
In the process of obtaining information about alleged IRWE, ask the person with a
disability to explain for which impairment(s) the reported item or service is needed.
For example, if the person alleges two impairments, and reports the use of two medical
devices, four drugs, and a physician's treatment on a regular basis, record the person's
understanding of which impairment is treated by each of the alleged items and services.
Verify that the alleged impairment agrees with either:
the DDS established medical basis of disability (DI 26510.015G), and/or
a disability supported by other medical records (see DI 10520.020E).
The medical records must establish the existence of an impairment that is being treated
by a physician or other health care provider.
1. Comparison of IRWE, impairment and work activity
Often, it may be obvious to the FO interviewer, based on the person’s impairment(s)
and description or his or her work activity, that an item or service is impairment-related
and needed to enable him or her to work. When there is agreement between the IRWE,
the impairment(s) and the work activity, record the justification for this conclusion
on a Report of Contact (SSA-5002) or in the DCF REMARKS screen.
If a comparison of the IRWE, the impairment(s), and/or work activity does not indicate
agreement, it will be necessary to verify that the item or service is actually required
to control a disabling condition, or is necessary for the person to travel to and
from work, or that it is essential for him or her to perform the physical and/or mental
demands of his or her job.
2. Background information from person
When it is necessary to verify agreement between the IRWE and the work activity, obtain
a signed and dated SSA-827 (per DI 11005.055) from the person with a disability and document the following information, as appropriate,
on an SSA-5002:
a thorough description of the physical and mental activities required in the person’s
a description of the drug, item or service and for which impairment it is needed;
the name and address of the treating physician or health care provider.
3. Question to verifying source
When contacting the verifying source concerning the person’s need for an item or service,
send an SSA-L732 with the signed and dated SSA-827 to the physician or health care
provider and request the following information as appropriate and personalized to
the person’s situation:
the impairment(s) for which the person is being treated;
is this drug, item or service necessary for the person to have the physical and/or
mental capacity to perform the job duties as described, or to travel to and from work
(describe job duties).
4. Issue of need unresolved
When the question regarding need is still unresolved after all efforts to verify the
person’s need for an item or service through a physician or other authoritative source,
consult the regional office before disallowing the IRWE. If the regional office should
require any assistance in making the IRWE determination, it may contact DCRDP, OPDR,
Employment Policy Team.