Identification Number:
SI 00870 TN 32
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ORDES
Title:Plans to Achieve Self-Support for Blind or Disabled People
Type:POMS Transmittals
Program:Title XVI (SSI)
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part SI – Supplemental Security Income
Chapter 008 – Income
Subchapter 70 – Plans to Achieve Self-Support for Blind or Disabled People
Transmittal No. 32, 01/03/2022

Audience

PSC: PASS SPECIALIST;
FO/TSC: CS, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

ORDES

Effective Date

Upon Receipt

Background

Two important work supports – the Student Earned Income Exclusion (SEIE) and Achieving a Better Life Experience (ABLE) account – were not listed in the POMS section "Policy – Relationship of PASS to Other Work-Related Provisions". These supports are herein added, along with a description of their interaction with PASS. Moreover, the advantage of the 1619 provisions is now explained, as is the relationship of Property Essential to Self-Support (PESS) to PASS. Also, Section 301 sequencing is now corrected, several acronyms are now defined, and multiple forms now contain hyperlinks.

Summary of Changes

SI 00870.010 Related Work Incentive Policies

Subsection A: Explained the differences between PESS and PASS. Expounded on the benefit of the 1619 provisions for SSI recipients. Added and described the SEIE and ABLE account as work supports related to PASS.

Subsection B: Changed descriptive pronouns to be non-gender and non-binary.

Subsection C: Defined acronyms and included hyperlinks to indicated SSA forms. Corrected the sequencing of the Section 301 process (e.g., submitting the SSA-4290-F5 after an initial DDS decision, not before).

SI 00870.010 Related Work Incentive Policies

A. Policy -- Relationship of Plan to Achieve Self-Support (PASS) to Other Work–Related Provisions

PASS is part of a comprehensive work incentive "package." This section discusses the relationship of a PASS to other work-related provisions.

1. Impairment-Related and Blind Work Expenses

The impairment-related work expense (IRWE) provision allows for the exclusion of earned income used to pay for work expenses incurred because of the person's disability. (See SI 00820.540 for more information on IRWE.)

The blind work expense (BWE) provision allows an individual who is blind to exclude earnings used to pay for work related expenses. To qualify as a BWE, a work expense does not have to be incurred because of the recipient's blindness. (See SI 00820.535 for more information on BWE.)

Unlike PASS, neither IRWE nor BWE may be used to reduce countable unearned income or resources.

Countable income cannot qualify for a PASS exclusion and IRWE or BWE provision simultaneously. An expense excluded under a PASS for countable income purposes may also be excludable as an IRWE for a substantial gainful activity (SGA) determination since these are separate determinations.

When countable income can qualify for both PASS and IRWE or BWE, use the exclusion most advantageous to the individual.

2. Property Essential to Self-Support (PESS)

The PESS provision provides for the total or partial exclusion of property needed for self-support under certain conditions. The main distinctions between PESS and PASS are that PASS exclusions:

  • not only can cover resources, but income as well;

  • apply to those who receive SSI based on blindness or disability, but not to those whose initial claims were approved for SSI based on the claimants being over age 65 (See SI 00870.006E2);

  • have a time limit; and

  • do not have an inherent dollar limit.

(See SI 01130.500 for more information on PESS.)

3. Sections 1619(a) and (b)

Earned income set aside under a PASS is deducted from gross earnings when performing a 1619(a) payment computation or an individualized 1619(b) threshold calculation. 1619(a) allows for continued Supplemental Security Income (SSI) payments when an recipient's gross earnings are at or above the SGA level. 1619(b) allows for continued rights to Medicaid eligibility and payment reinstatement when a recipient's earnings cause ineligibility for regular SSI cash payments but are lower than a state-specific threshold. (For more information about section 1619, see SI 02302.010.)

4. Substantial Gainful Activity (SGA)

SGA provisions do not affect nor limit the applicability of the PASS exclusions in any way. The PASS income exclusion is not applied when determining monthly earnings for SGA purposes.

NOTE: If a beneficiary filed or needs to file an initial SSI application to qualify for PASS but is engaging in SGA, they do not qualify for PASS because they would not meet the disability criteria for eligibility. In such instances, the technician cannot adopt even an existing disability determination.

5. Student Earned Income Exclusion (SEIE)

The SEIE applies to SSI recipients under age 22 who are working and regularly attending school. The SEIE allows technicians to exclude up to a certain limit of gross wages per month, up to a maximum cumulative limit per calendar year. Any earned income for the student – over the monthly and/or annual SEIE limits – could be excludable under a PASS. While SEIE excludes only earned income, an SSI recipient could have unearned income excluded under a PASS. (For more information about SEIE, see SI 00820.510.)

6. Achieving a Better Life Experience (ABLE)

An ABLE account allows SSI recipients and Social Security Disability Insurance (SSDI) beneficiaries to save money in a tax-advantaged savings account, which can pay for qualified disability expenses (QDEs), including those associated with education and work. The account holder must be blind or disabled with a condition that began before their 26th birthday.

Up to and including $100,000 of the balance of funds in an ABLE account is excludable as a resource for SSI purposes. Total annual contributions to an account are capped by the Internal Revenue Service (IRS) Gift Tax Exclusion Amount, unless an employed beneficiary meets the criteria in SI 01130.740C1, in which case the contribution limit could rise significantly.

The fact that an individual uses their own income to contribute to their ABLE account does not mean that the same income is excludable for SSI purposes. However, such income could be eligible for a PASS exclusion upon an approved plan. In addition, both PASS and ABLE allow funding and disbursements toward expenditures for education, employment training, and employment support, as these are examples of costs related to achieving a work goal for PASS and considered QDEs for ABLE. (For more information about ABLE, see SI 01130.740.)

B. Policy – Relationship of PASS to Section 301 Benefits

The Section 301 provision allows continuation of disability or blindness benefit payments to certain individuals whose disability or blindness medically ceases while they are participating in an appropriate program of vocational rehabilitation (VR) services, employment services, or other support services. See DI 14505.010B.

Effective March 1, 2006, a PASS qualifies as an appropriate program for the purpose of Section 301 determinations. A PASS qualifies because it is a program of employment or other support services carried out with an agency of the Federal Government (SSA), under an individualized written employment plan similar to an Individualized Plan for Employment (IPE) used by State VR agencies.

NOTE: This policy applies to new determinations made on or after March 1, 2006. Apply this policy to cases pending in the administrative review process (including appeals and cases remanded from Federal court). Do not reopen final determinations made prior to March 1, 2006 that were correct under the policy then in use.

1. Eligibility for Section 301 Benefits Based on Participation in a PASS

Eligibility for Section 301 payments applies if:

  • the individual is participating in a PASS that was approved before the date of disability or blindness cessation, and

  • participation will continue beyond the two grace months after disability or blindness cessation, and

  • we have determined that the individual’s completion of the plan, or continuation in the plan for a specified period of time, will increase the likelihood that they will not return to the disability or blindness benefit rolls.

See DI 14505.010A.

NOTE: The Office of Disability Operations (ODO) is responsible for determining whether an individual is eligible for Section 301 payments. See DI 14510.015.

2. Participation in Plan

For the purpose of Section 301 benefits, the individual is determined to be participating in a program if they are taking part in the activities and services outlined in the plan. See DI 14505.010C.

For continued eligibility for Section 301 benefits, we consider that an individual is participating in a program even during temporary interruptions or suspensions of the plan. For an interruption or suspension to be considered temporary, the individual must resume taking part in the activities and services outlined in their plan no more than three full calendar months after the last day of the month the interruption or suspension occurred. See DI 14505.010D.

3. Other Provisions and Section 301 Payments

SGA, the Trial Work Period (TWP), and Extended Period of Eligibility (EPE) do not apply to individuals who receive Title II Section 301 payments. For Title XVI cases, SSI income and eligibility provisions continue to apply, i.e., income counting, resource limits, IRWE, BWE, and the SEIE.

While the individual is receiving Section 301 payments, an existing PASS can be amended, yet a new PASS cannot be approved, since it has been determined that the individual is no longer disabled or blind. See SI 00870.010C3 for instructions on advising ODO of a change in an individual’s PASS.

4. Termination of Section 301 Payments

Section 301 payments will be terminated effective with the month after the earliest of the following:

  • The month the individual completes the plan; or

  • The month the individual stops participating in the plan for any reason; or

  • The month ODO determines that the individual’s continued participation in the plan will no longer increase the likelihood that they will remain off the rolls.

C. Procedure – Section 301 and PASS

1. Identifying Cases

The field office (FO) will identify cases with participation in a program of VR, employment, or other support services (including a PASS) when conducting a medical continuing disability review (CDR) or age-18 redetermination personal contact. The FO will record information about the program on the form SSA-454-BK or SSA-3368-BK as appropriate (DI 14510.003A1).

The FO completes Part I, Section A of the SSA-4290-F5 (Development of Participation in a Vocational Rehabilitation or Similar Program) with information about the individual and the program after a determination of medical cessation by Disability Determination Services (DDS) (DI 14510.003C and DI 14515.020 ).

The file must contain a copy of the approved PASS application (SSA-545-BK), any supplemental forms including amendments, and the PASS approval notice before the file is forwarded to DDS. The FO will ask the PASS specialist to provide a copy of this material (via fax) if it is not already in the file. The FO may use the following website to identify the servicing PASS Cadre: http://www.socialsecurity.gov/disabilityresearch/wi/passcadre.htm.

It is important that the PASS specialist enter a Supplemental Security Record (SSR) Special Message to identify approved PASS cases and the servicing PASS Cadre. Enter the following information on the SSR Special Message for every approved PASS case:

  • PASS approval date (mm/dd/yy),

  • PASS specialist’s phone number (including extension).

Be sure to update the SSR Special Message if the PASS is suspended, resumed, or terminated by overlaying the approval date with the appropriate information and date. For example: “PASS term 12/05/05, 800-555-4567 x 123.”

The PASS specialist should also keep the Customer Information System (CIS) updated so it can be used to obtain current status on individual PASS participants.

2. The SSA-4290-F5 – Development of Participation in a VR or Similar Program

Once the case is at DDS, they will contact the PASS specialist by telephone or mail to complete Part II, Section C of the SSA-4290-F5 (DI 14515.020). DDS will ask the PASS specialist whether the individual is receiving VR services, employment services, or other support services under an individualized written employment plan similar to an IPE (i.e., a PASS). DDS will also ask the PASS specialist:

  • for the date the PASS was approved,

  • the date the individual began participating in the PASS,

  • whether the individual is taking part in the activities and services outlined in the plan,

  • what the work goal is,

  • a description of the education, work skills, and/or work experience the individual will acquire through the PASS, and

  • the expected end date of the PASS.

If the DDS determines that disability/blindness has medically ceased, they will forward the case to ODO to make a Section 301 determination (DI 13005.040D).

ODO will review the SSA-4290-F5 and the PASS to determine if completion or continuation of the plan for a specified period of time will increase the likelihood that the individual will be permanently removed from the disability/blindness rolls (DI 14510.020B). The ODO examiner may contact the PASS specialist if further documentation of the plan is required.

3. After Section 301 Determination

If ODO allows Section 301 payments, the case will be documented in one of several ways:

  • Remarks on the Master Beneficiary Record (MBR) or SSR such as “Section 301 payment case” or “Section 301 case”,

  • A “Y” in the 301 indicator of the Disability Determination Services Query (DDSQ) (see SM 06002.200), and/or

  • A Disability Control File (DCF) event indicating “301 case” on the CDR Query (QCDR) or Electronic Continuing Disability Review (ECDR) screen (for a Title II case only).

Section 301 payments terminate if the individual completes the PASS, the individual stops participating in the PASS, or ODO determines that the individual’s continued participation in the plan will no longer increase the likelihood that they will remain off the rolls. Therefore, the PASS specialist should advise ODO by fax immediately if:

  • the PASS work goal has been changed, or

  • the PASS end date has been changed, or

  • the individual begins working at the SGA level (see DI 14510.030), or

  • the individual stops participating in their plan, or

  • the individual completes their plan.

Use the Detailed Office/Organization Resource System (DOORS) to obtain the fax number of the module with jurisdiction of the case. Send the fax to the attention of “Disability Examiner” and annotate it, “Section 301 Case.”

NOTE: It is not necessary to advise ODO of temporary interruptions or suspensions of a PASS. See DI 14505.010 for the definition of temporary interruptions.

 


SI 00870 TN 32 - Plans to Achieve Self-Support for Blind or Disabled People - 1/03/2022