Identification Number:
SI 00870 TN 22
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. 22, 04/20/2020

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

This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.

Summary of Changes

SI 00870.025 Documenting And Reviewing A PASS

Implemented consistency with formatting of section headers.

A.1. Re-structured the content into paragraph form.

A.2. Re-structured the content into paragraph form. Spelling correction.

A.3.b. Grammatical changes. Changed language from “tickle” to “follow up.”

A.5. Grammatical changes.

B.1 Changed “he/she” to “he or she.” Changed dates to expanded form.

B.3.b. Grammatical change.

B.4. Spelled out numbers under ten.

B.5.a. Inserted text that had been accidentally omitted. Grammatical corrections.

B.5.b. Changed dates to expanded form. Modified date ranges to accommodate JAWS reader requirements. Inserted text that had been accidentally omitted.

B.5.d. Changed “he/she” to “he or she.”

B.5.e. Grammatical correction. Removed abbreviations and symbols to accommodate JAWS reader requirements.

B.5.f. Grammatical correction.

C.3. Corrected POMS reference.

D. Removed reference to eView and irrelevant policy link.

SI 00870.025 Documenting And Reviewing A PASS

A. PASS Review Requirements

1. Discuss PASS with the individual

Contact the individual within 30 days after receiving the PASS application. Discuss the application even if you have not reviewed it. Provide an overview of the PASS process: how it works, what SSA will do and what is expected of individuals. Emphasize adherence to the PASS savings and spending schedule and reaching the plan's milestones. If the individual wishes to pursue the PASS, follow the instructions in this section. If the individual chooses not to pursue the PASS, document the file and send a notice per SI 00870.040.

2. Review the PASS

The PASS Specialist should use discretion and best judgment to support the allowance of a PASS plan. Review the PASS as soon as possible. Any delay can result in loss of a job or training opportunity. While reviewing the SSA-545-BK, insure that all relevant questions are answered and all the forms and releases have been signed, where appropriate. Determine whether all elements of a PASS are present and addressed per SI 00870.006.

3. Modify the PASS

A. Policy for modifying the proposed plan

If modifying the proposed plan could result in a favorable decision, offer the individual an opportunity to do so before disapproving a PASS. For modifications to an active PASS, see SI 00870.050 .

B. Procedure for modifying a PASS

When offering an individual the opportunity to modify a PASS, follow the procedures and take the following steps:

  1. 1. 

    Identify any unresolved issue in the proposed plan as submitted per SI 00870.006 .

  2. 2. 

    Advise the individual, payee, or representative and agency of the need to modify the plan. Obtain a signed authorization before speaking with someone other than the individual or payee regarding modifications to the plan. Mail out the proposed revision for the individual's signature. Document the file and follow up in 15 days.

  3. 3. 

    If the individual makes the requested changes, determine the start month per SI 00870.007 .

  4. 4. 

    If the individual does not respond, make a follow up request and follow up in 15 days.

  5. 5. 

    If the individual or agency responds by asking for additional time, follow up accordingly.

  6. 6. 

    If the individual neither modifies the plan nor requests additional time, make a systems input and issue a notice per SI 00870.040 .

  7. 7. 

    Document all contacts in file and retain as plan addenda.

4. Determine the starting month

Determine the starting month per SI 00870.007 .

5. Determine the exclusion

Compute the income and resource exclusion as follows:

  • Determine the total estimated PASS expenditures. Compute this amount based on SSA-545-BK section D.1 and contact with the individual, if needed.

  • Subtract from this total the value of current resources to be used for the PASS. The remainder is the amount that must be paid with income that will be excluded under the PASS. Derive the current resources from SSA-545-BK sections D.2 and E.1 and contact with the individual, if needed.

  • Determine the income exclusion that is most advantageous to the individual, considering countable income (including any known SSDI COLA, interest on excluded resources, etc.), fluctuations in income (seasonal or otherwise), and the schedule of planned expenditures.

    NOTE: If SSDI benefits or RSI benefits based on a disability are excluded, you may estimate when they cease due to SGA. Check the Trial Work Period (TWP) field in the Disability Control File (DCF). Be sensitive to the need to amend a PASS due to changes in expenditures or income (including COLAs), see SI 00870.050 .

  • Determine the highest amount of excluded resources expected to accumulate in any month prior to the first progress review. This is the amount of resources to be excluded under the PASS until it is amended, extended, reviewed, terminated, or completed.

6. Making the systems input

a. PASS approved

If the individual is receiving SSI, follow the instructions in SM 01005.170 and SM 01305.105 .

Input in the SSR EN field as type “D” income:

  • the amount of income to be excluded (earned and unearned); or

  • $.01 (1 cent) with a “C” frequency code when only resources are being excluded or for an active PASS with no current income exclusions.

If an SSI application is pending, advise the FO of the appropriate inputs. For instructions on entering PASS information in the SSI Claims System, see MS 08114.067.

b. PASS not approved

Input type “D” income of $.01 (1 cent) with an “N” frequency code for the month the denial notice is dated.

7. Issuing notices

Send a manual notice of approval or disapproval per SI 00870.040 .

8. Scheduling reviews

a. Progress checks

Schedule a progress check within 30 to 60 days of approval, or the first milestone, if earlier. Usually a brief telephone call can confirm the participant is following the plan steps and does not have questions. Set up a schedule of subsequent progress checks between progress reviews based on the circumstances of each PASS. PASS participants frequently encounter problems related to saving PASS funds as agreed, retaining proof of expenditures, and handling unanticipated expenses shortly after being approved, see SI 00870.055 .

b. Progress reviews

Schedule progress reviews based on the following:

  • time allowed ends for “Vocational Rehabilitation (VR) evaluation”;

  • critical milestones;

  • 6-month intervals during which funds will be accumulated for PASS expenses but not disbursed;

  • when the individual files a self-employment tax return;

  • when achievement of the occupational goal is expected; and

  • any other factor you consider appropriate.

B. Procedure for Special Considerations

1. Prior PASS

Advise the individual that a new PASS may not be considered until an explanation is provided as to why he or she is not working in the occupational goal of a previous PASS. Before a new PASS can be approved, the individual must provide evidence that he or she is unable to work in the prior occupational goal. This might be evidence that the individual’s condition has worsened to the point that the prior goal is no longer feasible, or that the individual was unable to find employment. Allow a reasonable period of time for the individual to provide such evidence.

If the individual cannot provide the evidence and the prior PASS was approved before December 1997, review the prior PASS. If the prior PASS is unavailable or, upon review, the approval did not mandate any milestones necessary for achieving the goal, and the individual wishes to pursue the same work goal, you may approve a new PASS with the same goal.

2. Earnings requirements

Determine whether the occupational goal satisfies the earnings requirements as described in SI 00870.006 A.5. If it does not, follow the instructions for modifying the PASS. If the individual refuses to modify the plan, follow instructions to deny the plan.

3. Feasibility of goal and viability of plan

a. Assuming feasibility and viability

Assume that an occupational goal is feasible and the plan for achieving it is viable if the goal is “VR evaluation,” or if the PASS was prepared by any of the following:

  • a State VR counselor;

  • a public or private vocational counselor, case manager, social worker, or other individual who is licensed or certified by (1) a government agency, (2) the Commission on Rehabilitation Counselor Certification (CRCC), or (3) the Certification of Insurance Rehabilitation Specialists Commission (CIRSC); or

  • an individual acting on behalf of an agency that has been certified by the above or accredited by an appropriate but unrelated local or nationally recognized organization such as the American Association for Counseling and Development or the National Rehabilitation Association.

If in doubt, ask for evidence of the preparer's credentials or those of the organization for which the preparer works and create a precedent file.

b. Evidence to the contrary

Do not apply the assumption if there is evidence to the contrary. Some examples of such evidence are:

  • an obvious mistake or oversight on the part of the preparer that could jeopardize successful completion of the PASS;

  • a history of problems with plans developed by the preparer; or

  • the individual would have insufficient income and resources to pay for usual living and PASS expenses if the PASS is approved.

c. Evaluating feasibility of the goal

If the assumption does not apply, consider the work goal in terms of:

  • the nature of the individual's impairment and the limitations imposed by it, based on available evidence, including medical evidence in the FO or the diagnostic code on the SSR or MBR;

  • the individual's age (extreme youth or advanced age may contribute to making some occupational goals unrealistic);

  • the individual's strengths and abilities, based on available indicators; and

  • any observations made by the CS who conducted the initial PASS interview.

d. Evaluating viability of the plan

Do not routinely question the feasibility of a work goal or the viability of a plan if the assumption does not apply. Evaluate the viability of the plan based on consideration of the factors in:

  • the individual’s prior work history, education, and training;

  • how milestones, and target dates for completing them, relate to the occupational goal; and

  • the individual's familiarity with the requirements and duties of the occupational goal.

For a self-employment goal evaluating the viability of the plan includes evaluating the business plan. For more information about business plans and examples of knowledgeable third parties that might help you evaluate the business plan, see SI 00870.026 .

e. Feasibility or viability is questionable

If you doubt the feasibility of the occupational goal or the viability of a plan, or the individual has had two or more unsuccessful plans, proceed as follows:

  • Discuss your concerns with the individual and the preparer, if the individual has given permission to contact the third party. If you continue to believe that the PASS should not be approved as submitted, discuss possible modifications.

  • If the individual is unwilling to modify the PASS, request the individual’s permission to have a knowledgeable third party evaluate the PASS.

  • With the individual's permission, contact a rehabilitation agency, preferably one that has worked with the individual in the past, or another knowledgeable source (e.g., a therapist or the individual's physician) to evaluate the PASS. Provide the third party with all pertinent information including your concerns.

NOTE: Any cost for this “second opinion” can be included as a PASS expense if the PASS is approved. If the individual will not agree to either a third-party evaluation or necessary modifications, explain why the PASS application cannot be approved before issuing a denial notice.

4. Timetable

Make sure that the plan specifies when:

  • all PASS activities began or will begin;

  • each milestone that marks progress toward the goal is to begin and be completed;

  • the goods and services will be obtained; and

  • the individual expects to begin working in the goal.

If no disbursements are projected to be made within the first 6 months and the reason is not obvious, obtain an explanation for the delay and ask the individual to submit any readily available documentation that supports the explanation.

Decide whether the timetable is acceptable.

If the timetable is not acceptable, follow the instructions for modifying a PASS.

EXAMPLE: Acceptable Timetable

FACTS: John Myers is a 16-year-old 11th grader who receives SSI. His only source of income is the income deemed from his parents. John wants to become a computer programmer and plans to take a two-year programming course at a community college after high school. His career counselor submits a letter indicating that he can handle a college curriculum.

CONCLUSION: You help John set up a PASS under which he can save money for his college tuition and the purchase of a computer after his graduation from high school. Under the PASS, John's parents will set aside money in a separate bank account to save for John's college expenses. The amount set aside will be deducted from John's deemed income.

When deeming stops, John's parents intend to give the money directly to him and have him put it in the separate account. John expects to begin using the funds for his college expenses beginning with his first semester.

Because John may change his college plans, this PASS should be monitored closely. Conduct a progress review (with an accounting) every 6 months until disbursements begin.

5. Expenses

a. PASS contents

Make sure the PASS contains the following:

  • a list and, if necessary, description of the items and services to be purchased (broad categories or groupings as listed in g. below are sufficient unless you question the expense);

  • an estimate of the cost for each article on the list (if the estimate seems unreasonable, obtain verification per d. below);

  • an explanation of why each article is needed to achieve the occupational goal (unless the reason is obvious);

  • an indication that the individual's income other than SSI and resources will cover the proposed PASS expenses;

  • an indication that the individual’s SSI benefits, resources and income will cover living expenses. If information provided on the SSA-545-BK is incomplete or questionable, supplement those answers by having the individual complete the Average Monthly Living Expenses form located in the Initial PASS Applications section of the PASS Clusters.

b. Business start-up costs

Treat all expenses incurred during the first 18 months, or longer if warranted, of a PASS involving self-employment as excludable start-up costs if the expenses are both necessary and reasonable. This provision also applies to ongoing expenses incurred during this period. You may approve expenses the individual incurs after the start-up period if the individual would not otherwise have sufficient remaining income and resources to cover living expenses, medical expenses, and work expenses as described in SI 00870.006 A.1.

EXAMPLE: In August 2018 a State VR counselor contacts a PASS expert about setting up a PASS for Joan King. Joan is a blind SSI recipient who has a private insurance benefit of $425 a month and plans to open a candy shop in December 2018.

To open the shop, Joan will need $15,000 worth of stock and counter supplies; $350 for the first year's liability, fire, and theft insurance; $150 for utilities hook-up; $250 for the first month's rent; and a security deposit of $500. Thereafter, costs will be an estimated $1,000 a month for stock, $350 a year for insurance, $250 a month for rent, and $125 for utilities.

The counselor says that VR will provide the initial stock and counter supplies, and that the PASS will be needed to help with the other items.

You advise Joan that she can set aside funds under her PASS to cover at least the first 18 months of the business' operation, December 2018 thru May 2020, that are not otherwise paid by VR. Her start-up costs include:

  • the $350 for the first year's insurance plus any additional insurance premiums for coverage due through May 2020;

  • the $750 for the combined security deposit and first month’s rent plus recurring monthly rent of $250.00 due through May 2020;

  • the $150 for utilities hook-up plus the cost for utilities through May 2020; and

  • re-stocking of inventory at $1,000 a month through May 2020.

You advise Joan that you will exclude $405 of her insurance benefit, since the $20 general exclusion would apply, and any earnings from the store she chooses to set aside for her PASS until either:

  • she has paid for all of the start-up costs; or

  • beginning June 2020 or later, she earns a sufficient income from the store to cover her living, medical, and work expenses (see SI 00870.006 A.1.).

c. Relation of expenses to occupational goal

Determine whether each of the planned expenditures is needed to achieve the goal. Allow only those, or that part of the cost of the expense, that did not exist when the individual began actively pursuing the goal (which may have been before the individual submitted the PASS).

See when it may be appropriate to defer the decision on a particular expense SI 00870.006 B.11.

If you doubt the need for a particular expense, contact any provider or agency involved for an explanation. If no provider or agency is involved, obtain an explanation and any available related documentation from the individual.

d. Reasonable cost

Determine whether a less expensive alternative would meet the individual's needs. If not, check various reliable resources for the cost of similar goods or services. If the cost is excessive by comparison, or you cannot find a similar item, determine the item's current market value (CMV) per SI 01110.400 .

Fees for services are based on actual time spent providing the services. If the PASS indicates that necessary services were provided before the PASS was submitted, document the file with the individual's signed statement (e.g., on an SSA-795 or the SSA-545-BK) confirming that the services were provided. If the individual has already paid for these services, obtain proof of payment.

For items rented or leased by the hour, day, etc., allow only charges for units of time related to the PASS unless:

  • the charge reflects a minimum rental period; or

  • a longer rental period is more economical or practical than frequent shorter periods.

EXAMPLE: An individual who runs a cleaning service uses a floor buffer two days a month. The daily rental rate is $40, which equates to $960 a year. The individual could buy the buffer for $600. You may allow the cost of buying the buffer. If the individual cannot afford to buy it, or wishes to rent until he or she is better established, you may allow the expense for renting it.

e. PASS preparation fees

You must document the file as to whether the fee (or some portion of it) for preparing a PASS is reasonable. In assessing the reasonableness of the fee, consider the overall involvement the preparer had in the development of the PASS, such as aptitude testing, counseling, and any other pertinent services.

If the preparer has filed an SSA-1696-U4 to serve as the individual's representative, be sure that no part of the preparation fee is for services performed as the representative. Payments to a representative involve a specific SSA billing process (see GN 03920.001 ff.).

If a PASS must be modified, do not approve charges for preparing the modification. Do not allow fees for monitoring the person's progress towards an approved work goal.

EXAMPLE: A PASS includes a $1,000 expense for a local private VR agency's assistance with the PASS. The PASS expert contacts the agency to determine whether the expense is reasonable.

The PASS expert learns that the agency has been certified by the state, worked closely with the individual in developing the PASS, and conducted an assessment of the individual's interests and abilities to help identify an appropriate occupational goal. The agency also plans to monitor the PASS to ensure that the individual complies with all requirements.

The agency estimates that a counselor spent 12 hours assessing the individual's vocational abilities and an additional 8 hours developing the PASS. It values this assistance at $35 per hour, for a total of $700. The rest of the fee is for the planned monitoring services.

You determine that $420 (12 hours at $35 per hour) is reasonable for a vocational assessment by a state-certified private VR agency. You also determine that $280 (8 hours at $35 per hour) is a reasonable fee for preparing the PASS itself. However, you inform the VR agency and the individual that fees for monitoring a PASS are not allowable expenses, and that the PASS will have to be modified to remove the $300 portion of the overall fee that is for monitoring.

f. Items of unusual value

If the PASS calls for the purchase of an item of unusual value, such as a vehicle or a computer, the individual must explain why the item is necessary to reach the goal. The individual must justify the cost of the item if it does not appear to be reasonable. You must explain that the expense cannot be approved without this information.

Determine whether the item is necessary, and whether the cost is reasonable. To make the determination use the criteria in SI 00870.006 . If you need assistance in evaluating the individual's explanation of why the item is necessary, or justification of the cost you may consult an objective, knowledgeable third party, a professional in the field of vocational rehabilitation and employment, someone in computer sales, RO systems staff, etc.

If the individual cannot justify the need for the item, or can justify the need but not the stated cost, but the PASS can still be allowed, advise the individual that the PASS can be amended to include the item (or revised cost for the item) at such time as satisfactory justification is provided.

When considering whether to defer your decision on an expense pending completion of a particular milestone, take into account any effect that deferral would have on other types of assistance the individual receives, such as food stamps. Discuss your reasoning with the individual and explain why deferral may be in the individual’s best interest. Consider a short-term rental or lease as an appropriate alternative until the individual reaches one or more milestones under the PASS.

g. Examples of allowable expenses

The following list, which is not all-inclusive, contains examples of items and services for which expenses can be allowed under a PASS, provided that they satisfy the criteria in this section:

  • attendant care

  • basic living skills training, see SI 00870.006 A.8.

  • childcare

  • dues and subscription costs for publications for academic or professional purposes

  • equipment, supplies, operating capital, inventory required to establish and carry on a trade or business, see SI 00870.026

  • equipment and tools, including safety equipment, whether specific to the individual's condition or designed for use by a non-disabled person

  • finance and service charges connected with obtaining any of the above, including finance and service charges related to a bank account that is set up solely for the purpose of keeping PASS funds separate and identifiable

  • food and shelter while temporarily absent from one's permanent residence to attend educational, training, employment, trade, or business activities, if there is also a cost associated with maintaining the permanent residence

  • job coaching or counseling services

  • job search or relocation expenses

  • meals consumed during work hours (including job training and school)

  • modifications to buildings, vehicles, etc., for operational or access purposes for persons with disabilities

  • PASS preparation fees

  • taxes and government-imposed user fees (e.g., permits and licenses) connected with obtaining any item on this list, except that income taxes or government-imposed penalties or fines are not allowable

  • transportation: hire of private or commercial carriers, or hire of person to drive the individual's vehicle

  • transportation: lease, rental, or purchase of a vehicle, plus associated costs for fuel, insurance, maintenance, registration, taxes, etc.

  • transportation: public transportation and common carriers

  • tuition, books, supplies, and all fees and costs imposed by or in connection with an educational or occupational training facility, including fees for tutoring, testing, counseling, etc.

  • uniforms, specialized clothing, safety equipment, and appropriate attire (e.g., suits, dresses) needed for job interviews or to begin working in an office or professional setting

C. Processing PASS Appeals

1. Policy for PASS reconsideration requests

SSA regulations provide individuals with the option of having an informal conference as part of the reconsideration process. The regulations further state that the conference is to be conducted by the person who will make the decision on the case

2. Processing PASS reconsideration requests

a. Individual requests case review

If the individual requests a case review rather than an informal conference, make sure that the case is reviewed by a PASS expert other than the one who made the initial determination.

b. Individual requests conference

If the individual requests an informal conference via telephone, contact the individual to ascertain the best time to conduct the teleconference.

Review the case and be prepared to discuss the issue(s) with the individual. If the individual has pertinent material to submit, ask him or her to mail the material directly to you or to have the local SSA office mail or fax it to you.

After the teleconference, write your decision and issue the notice to the individual or provide the field office with language for the notice. Remind the field office to send a copy of the notice to you. Also, make corresponding systems inputs or, if appropriate, advise the field office as to the required inputs.

If the individual insists on a face-to-face conference and travel to another site will be required, obtain permission to travel. If travel is denied, refer the reconsideration request to the manager of the servicing field office. Advise that office to follow the instructions in SI 00870.020 C.

3. Processing PASS hearing requests

If an individual requests an appeal of the reconsideration determination made by a PASS expert, follow the instructions for handling Title XVI hearing requests provided in SI 04030.030 and MS 04420.001 .

D. Procedure to Maintain an Electronic PASS Library

Maintain an electronic library of approved and disapproved PASS cases.

Use the material in this library for reviews of PASS changes, progress checks and reviews, expense evaluations, and as templates for new plans. While it is not necessary to retain all documents associated with each case, you must retain the SSA-545-BK, all notices, appeal requests, verification of savings and expenditures, and final accounting in all cases.

Follow national folder retention policy to determine destruction date for non-electronic PASS folders, see SM 01201.910 A.


SI 00870 TN 22 - Plans to Achieve Self-Support for Blind or Disabled People - 4/20/2020