TN 9 (07-00)
SI 00870.006 Elements Of A PASS
A. Policy - occupational goals
1. Occupational goal
Each PASS must have an occupational goal. The individual should have either a specific work goal or a description of the type of job he or she expects to have at the end of the plan. A PASS may specify VR evaluation as a goal if a milestone is included to choose a specific occupational goal (see SI 00870.006A.9.). Additionally, the occupational goal must be the earliest point on the person's chosen career path that would generate earnings sufficient to pay for the following:
living expenses that the person has at the outset of the PASS. If the living expenses increase due to circumstances beyond the individual's control, the occupational goal can be amended to reflect a higher income point on the career path. For example, the increase in expenses could be due to a decrease in food stamps or a housing subsidy because of the person'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.
The work goal should be expected to increase the individual's prospect for self-support. A person's increase prospect for self-support is measured in terms of higher earnings potential upon completion of the PASS. Higher earnings potential may exist even if the person 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 occupational goal
An individual can have only 1 PASS for a particular occupational goal. A PASS (with the same work goal) may be resumed under certain conditions. See the requirements in SI 00870.080 for resuming a PASS.
A second PASS for an occupational goal, that would not meet the requirements for resuming a PASS per SI 00870.080, may be approved if the prior PASS was approved prior to 12/97. See SI 00870.025B.1.b. for the special conditions for approving a second PASS for the same work goal.
3. The goal must be feasible
The individual must have a reasonable chance of performing the work associated
with the occupational goal, taking into account his or her:
4. The plan for achieving the goal must be viable
The plan for achieving an otherwise feasible goal must be realistic, taking into account:
the individual's education and training needs;
any assistive technology required;
the interval steps (and the corresponding time frame to complete each step) necessary to actually secure employment or start a business (a detailed business plan must be submitted with any PASS that has a self-employment goal, and the business plan itself must be viable). These steps or milestones, which demonstrate the person'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 person will have sufficient means to cover PASS expenses, living expenses, and other necessary expenses.
5. Earnings requirements
a. SSDI beneficiary not eligible for SSI without a PASS
Social Security Disability Insurance (SSDI) and Retirement and Survivors Insurance (RSI) beneficiaries who receive a benefit based on disability, who would not be SSI eligible 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 an occupational goal that will generate earnings that reflect the person's ability to engage in substantial gainful activity (SGA). An earnings level should be sought that would be sufficient to replace the benefits of the individual and any auxiliaries, residing with the individual, whose benefits eventually could be affected by the individual's work.
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 an occupational goal in which he would earn about $1,500 a month. The PASS expert advises Thomas that if he earns $1,500 a month and is considered to be performing SGA, his SSDI benefit will cease and he'll 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 occupational goal. He later modifies his PASS to pursue the same field but at a more advanced level, which should permit him to earn about $2,500 a month.
b. Individual already eligible for SSI
An individual, already eligible for SSI, must choose an occupational goal that will generate enough earnings to reduce the person's SSI benefit substantially. The reduction need not occur as soon as the individual begins working but within a reasonable amount of time, generally 12-18 months (e.g., the person expects periodic pay raises to substantially increase earnings).
6. Relevance of prior education, training, and work experience
Prior education, training, or work experience is relevant to the extent that it would permit achievement of the occupational goal without a step or expense listed in the PASS. See SI 00870.006E.1. for what an individual who had an earlier PASS must demonstrate before a new PASS can be approved.
EXAMPLE: Jim Yoder, who receives SSDI and SSI benefits, submits a PASS with the occupational 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 second 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 expert 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 expert discusses this with Jim. The PASS expert 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 occupational goal as a (resident) doctor and to require only 2 years for the necessary biology course work.
7. Supported-employment goals
An individual in a supported employment program may submit a PASS whose goal is to achieve stabilization in that job, or to work more hours, or to work with less support (fewer hours of job coaching per week, for example). Such plans should specify:
If it subsequently appears that the targeted level of performance can be changed in order to provide additional countable income, the PASS can be amended accordingly.
8. Basic living skills
Basic living or homemaking skills are not an occupational goal, but training in such skills can be approved if they are needed to achieve an occupational goal.
9. VR evaluation
A PASS may be approved with the goal of “VR evaluation” in order to help the person select a specific work goal. Until a specific goal is chosen, the PASS should only cover the costs associated with having a public or private vocational rehabilitation (VR) agency or professional perform a diagnostic study or evaluation. A VR evaluation usually takes 3 to 6 months. A request for an evaluation period of more than 6 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 submittal of a request for a PASS. As with a VR Evaluation, the PASS could initially cover any costs associated with the person developing a business plan, a Business Plan Evaluation. (See SI 00870.026 for more information about business plans.)
11. Achievement of the occupational goal
An employment goal is achieved when the individual is actually employed and the person's earnings are sufficient to cover the individual's living, uncovered-medical, and work-related expenses that existed before the PASS (or increased during the PASS due to circumstances beyond the individual's control). At this point, the PASS stops.
B. Policy - allowable expenses
1. Allowable expenses - general
To be allowed, expenses must:
be for items and services that are needed in order to achieve the occupational goal. An explanation as to why the goods and services are needed should be included with the PASS;
not have existed before the individual began activities to achieve the occupational 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, considering the items or services being obtained; and
reflect start-up costs.
NOTE: See SI 00870.025B.5.g. for examples of allowable expenses.
2. Necessary expenses
Only expenses for items and services that are needed by the individual in order to achieve the occupational goal can be allowed. The individual should provide an explanation as to why the item is needed.
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 opening a business. PASS expenses are limited to the start-up costs for the particular work goal. For someone opening a business, the start-up costs include the expenses to start the business through the first 18 months, or longer if needed, of the business' operation. 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. Also 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 occupational goal.
6. Computer equipment
For other than obvious hardware and software needs, the PASS must explain how the particular hardware and software to be purchased serve the individual's particular needs, and why less costly alternatives will not meet these needs. Less costly alternatives may include renting and leasing a computer. For PASS users who attend a school that has computers available for the students' use, the PASS should include an explanation as to why using the school's computers would not be sufficient.
The PASS must explain why other means of transportation (paratransit, other public transportation, cab, etc.) will not serve the individual's needs. Possible reasons are that other means of transportation are not:
available, or available at the times and locations needed;
safely accessible to the individual; or
of use to the individual (e.g., no wheelchair access).
If purchasing a vehicle is the transportation mode that meets the person's needs, the individual should select a vehicle that:
If the individual already owns a vehicle, an explanation should address the need to purchase another vehicle (e.g., why repairing/maintaining the current vehicle won't be sufficient).
NOTE: Some individuals with disabilities own a vehicle but cannot operate it. 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.
8. Vehicle-related expenses
Expenses related to owning a vehicle can be allowed under a PASS. Such expenses include, but are not necessarily limited to:
registration and licensing fees;
fuel costs, which must relate directly to travel for activities that are necessary in order to achieve the occupational goal; and
maintenance and insurance costs.
Expenses for fuel, maintenance, and insurance can be allowed based on:
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.
9. Job coaching expenses
Job coaching expenses are limited to assistance directly pertaining to completing the tasks required by the job. Attendant care or other services provided by the job coach are not job coaching expenses and must be considered separately.
A knowledgeable source, such as VR or the employer, may be contacted to verify the need for job coaching services as well as the person's prospects for reducing the hours of the services per the PASS. Generally, a reasonable charge for these services will reflect the amount the local State VR pays for similar services.
10. Supported employment—extended or follow-along services
The level of performance that a PASS specifies as its occupational goal is a factor in determining whether the proposed expenses can be allowed. Expenses necessary to attain the specified level of performance can be allowed, even if they are still being paid once the person is working in the job.
Although extended or follow-along services normally would not be allowable under a PASS, they may be allowed if the individual is trying to increase the hours he or she works or decrease his or her reliance on and costs for ongoing supports. See SI 00870.002B for definitions of extended or follow-along services and stabilization.
11. Deferred expenses
Although a PASS may be approved, a decision on certain items or services may be deferred until a later date. This will occur only for those items the person will need after the successful completion of one or more milestones. Deferring a decision on an expense is a way of ensuring the person's need for an item while protecting the person from the risk of prematurely contracting for item and services 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 was working 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
12/2000, to obtain his license by 6/2001, and to start his delivery service in 9/2001.
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 likelihood of Joe's business succeeding.
The PASS expert approves the PASS. However, since Joe cannot achieve his goal unless he obtains a commercial driver's license, the PASS expert 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. The expert discusses this with Joe.
Joe obtains the license in 5/2001 ahead of schedule. As a result, the PASS expert allows the deferred expenses.
12. Savings/spending schedule
In addition to meeting the requirements above in SI 00870.006B.1. through SI 00870.006B.11., a PASS must indicate:
when the items and services will be used with respect to attaining the work goal;
what income and/or resources the individual will set aside to purchase the items and services;
whether the funds will be used for periodic payments (e.g., monthly) of expenses or saved for a future payment; and
how the individual will keep the funds being set aside under the PASS separate and identifiable from other funds.
Ordinarily, disbursements for items and services should be made as soon as possible. For periods during which no disbursements are planned but funds are being set aside, accumulated savings will be verified at intervals determined by the PASS specialist in each case, but at least every 6 months.
13. Deducting expenses paid by deemor
Funds paid or set aside by a deemor for a PASS expense are subtracted from the eligible individual's countable income after deeming. (See the example in SI 00870.025B.5.b. Also see SI 01320.140 and SI 01320.710A for related information about deeming.)
14. Job search expenses
A PASS can include expenses someone has to find a job, such as transportation, employment agency services, and resume 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. If practical, job search activities should be conducted concurrently with other PASS-related activities.
C. Policy - expenses that cannot be allowed
No expense can be allowed that:
is not purchased by the individual or deemor;
is for items or services that the individual can readily obtain from the providing agency for free;
is for items or services for which the individual will be promptly reimbursed (e.g., health insurance);
is for 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). This does not apply to an expense that either began due to the current PASS but before the PASS was submitted for SSA approval or to an increase in the cost of a pre-existing expense because of the PASS; or
is used to reduce countable income after the start-up period described in SI 00870.006B.4. For example, after the start-up period for a business, that part of 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 -- time considerations for PASS
1. General PASS time considerations
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 employment 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
A PASS must specify beginning and ending dates. It also must specify target dates for reaching milestones that reflect progress toward achievement of the occupational goal.
The target date for reaching a milestone and/or the ending date of a PASS may be extended if circumstances beyond the individual's control have delayed achievement of the milestone or occupational goal and all other requirements continue to be met.
Until new regulations are in place, a PASS may be extended beyond 36/48 months only in intervals up to 6 months.
A business will be given a minimum start-up period of 18 months unless the individual indicates that less time will be needed for the business to sustain its operations. A request for a start-up period of a longer duration than 18 months must be justified.
E. Policy - miscellaneous
1. Multiple PASSes
There is no limit to the number of PASSes an individual can have, but an individual can have only one PASS at a time. Before a subsequent PASS can be approved:
a final accounting must be completed for the prior PASS (see SI 00870.070A.4.); and
the individual must show that he or he can either no longer work at, or obtain work in, a prior occupational goal for which the individual obtained all of the necessary goods and services.
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
SSA can approve a PASS for an aged individual only if the individual 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, signed by the individual and, if applicable, the representative payee.
4. Funds for pursuing the PASS
Approval of a PASS permits income and resources to be excluded in determining eligibility for SSI. A PASS can benefit only someone who has such income and/or resources and who meets SSA's disability or blindness criteria.
5. Third parties as PASS representatives
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 life) 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. See GN 03305.001 and GN 03340.001. for more information about the issues of consent and access.