TN 64 (03-18)

SI 00820.550 Work Expense Development and Documentation

A. Policy for documentation of Work Expenses

Document all allegations/evidence of Blind Work Expense (BWEs) and Impairment Related Work Expense (IRWE) in file.

B. Procedure — Documentation

Document BWE and IRWE as in SI 00820.550B.1. and SI 00820.550B.2.

1. Allegation of BWE

Document BWEs as described below:

STEP

ACTION

1

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 statement from the individual that either:

  • claims a BWE, specifying the type and amount of expense; or

  • explains why there is no BWE.

3

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 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 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:

  • 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 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: 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 BWE or IRWE

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

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.

b. Verifying cost of BWE

Make sure to verify the expenses associated with the BWE.

  • Accept the individual's allegation of the expense amount when

    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

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.

b. Verifying the cost of an item or service

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).

Follow the instructions in DI 10520.030B to verify IRWE in all other circumstances.

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.

3. Post-eligibility Situations

a. BWE/IRWE previously developed

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:

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 SI 00820.550C.1. and SI 00820.550C.2.

information on the SSR is unverified

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. 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 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 deduction.

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.

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, 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

To ensure an accurate estimate of future expenses, use the following steps.

  1. 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.

  2. 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).

  3. 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.


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SI 00820.550 - Work Expense Development and Documentation - 03/08/2018
Batch run: 03/08/2018
Rev:03/08/2018