Identification Number:
SI 00870 TN 18
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. 18, 07/31/2019

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

Congress wrote the Plan to Achieve Self-Support (PASS) provision into the original Supplemental Security Income (SSI) statue to give blind and disabled individuals every opportunity to return to competitive employment.

PASS excludes some income and resources that SSA normally count for SSI purposes. A PASS participant must use the excluded income and resources to achieve a specific work goal. This section outlines processing suspensions, terminations and resumptions of PASS.

Summary of Changes

SI 00870.070 Suspension Or Termination Of A PASS

Header Added language to incorporate SI 00870.080.

A. Corrected language to clarify and agree with systems requirements.

B. Added additional applicable circumstance.

C.1 Language clarified and guidance added, non-applicable language removed.

C.2 Language clarified and guidance added, non-applicable language removed.

D.1 Grammatical corrections and clarification language added , non-applicable language removed.

D.3 Changed to D.4

D.3 Additional instructional language added for guidance.

D.4 Grammatical corrections. Additional language added for clarification and guidance , non-applicable language removed.

E. Entire E subsection removed to be incorporated in SI 00870.040.

E.Header changed to incorporate SI 00870.080.

E. Reference to redundant information removed.

E.1 Redundant information removed. Additional clarifying language and guidance added, clarifying information added for guidance.

SI 00870.070 Suspension, Termination Or Resumption Of A Plan to Achieve Self-Support (PASS)

A. Suspension

The PASS expert will suspend a PASS when the PASS participant fails to meet the criteria to extend the PASS in SI 00870.055

B. Termination

A PASS terminates when:

  • the individual's eligibility for Supplemental Security Income (SSI) benefits terminates, or

  • the PASS is in suspended status for 12 consecutive months or longer from the date of the PASS suspension decision and the individual has not resumed the plan, or

  • a new PASS with a new work goal is provided.

C. Reinstatement of a PASS

The PASS expert may approve an individual’s request to reinstate a suspended PASS when the individual resolves the reason(s) for suspension or requests an amendment. At the PASS expert's discretion, the PASS expert may reinstate an individual’s PASS that was suspended for more than 12 months, even if it has terminated, as long as the individual’s SSI benefits have not terminated.

Reinstate the PASS as of the appropriate month. For example, if the PASS is suspended:

  • for failure to cooperate (FTC), reinstate it with the month the individual begins to cooperate,

  • because the individual failed to explain the reason for a missed milestone, reinstate it with the month the individual accomplishes the milestone,

  • because the plan is no longer viable given the individual’s living situation, reinstate it with the month the individual’s living situation changes and regains viability,

  • because the PASS expert considered the individual to have sufficient funding for all expenses, reinstate it with the most advantageous month (including as early as the first month of suspension) that the individual:

    • shows that he or she did not, in fact, have sufficient funding, or

    • amends the plan to include additional expenses

The PASS expert reinstates the plan effective the month the PASS expert issues a notice of reinstatement. Issue notices and document the file per SI 00870.040.

D. Effective Dates

1. Income Excluded Under PASS

A PASS is suspended or terminated effective the month the PASS expert issues notice of suspension or termination. Set-aside income will count for eligibility and payment calculations as of the suspension or termination month. The individual must account for any set-aside income throughout the month of the suspension or termination event; this includes any months affected by Retrospective Monthly Accounting (RMA) (see SI 02005.001).

2. Resources Only Excluded Under PASS

A PASS, under which only resources are set aside, is suspended or terminated effective with the month the PASS expert issues notice of suspension or termination. Previously set-aside resources count as of the first moment of the month following the suspension or termination letter unless otherwise excluded (see SI 01130.000 ff.). It does not matter whether the individual plans to use these funds for the planned expenditures after the PASS expert suspends or terminates the plan.

E. Final Accounting

1. Conducting the Final Accounting

The PASS expert conducts a final accounting when the PASS is suspended or terminated. The PASS expert compares the money spent on PASS approved expenditures (accounted items) with the excluded funds. The PASS expert determines whether the excluded funds and the approved expenditures are “equal” to each other. When the excluded funds equal, or are considered equal to, the approved expenditures, no further action is necessary. See examples in section 4 below.

When the amount of the excluded funds is not equal to the amount spent on the approved expenditures, the PASS expert may need to make a retroactive adjustment to the record as discussed further in this section.

2. Excluded Funds Equal Approved Expenditures

Excluded funds are considered “equal” to approved expenditures if the total for the excluded funds does not exceed the total for approved expenditures (including items still planned to be purchased) by more than any administrative waiver tolerance amount in SI 02260.030. No overpayment will arise for periods during which the PASS was in effect as long as these figures are equal. See examples in section 4 below.

NOTE: 

This “considered to equal” computation incorporates the instructions in SI 02260.030 that the agency may administratively waive an overpayment up to a tolerance amount; this applies the administrative waiver without requiring the individual with a suspended or terminated PASS to request a waiver.

3. Excluded Funds Do Not Equal Approved Expenditures

If the excluded funds exceed the approved expenditure amount by more than the tolerance discussed in section D.2, the participant must return the unaccounted excess funds to SSA. The PASS expert will calculate and remove type "D" income equal to the amount of unaccounted funds.

Terminate the type "D" income exclusion in the EN field on the SSI record (SSR) see SM 01305.105 and SM 01305.101. Make any other changes as needed, such as inputs for other exclusions e.g. Impairment Related Work Exclusions (e.g. IRWE).

Adjust the type "D" income retroactively as appropriate when the excluded funds exceed (and are not considered to equal) the approved expenditures. Do not make any retroactive input until you have completed a final accounting for the PASS.

4. Examples of a Final Accounting

Example 1: After the PASS expert determined that Mr. Johnson reached his goal as of 7/15, the PASS expert reconciles the approved PASS expenditures with the amount of excluded income. Mr. Johnson submits receipts totaling $5,350. The total amount of income excluded under the PASS was $5,700. Since the difference is less than the administrative waiver tolerance provided in SI 02260.030, ($1,000 for 7/15), no overpayment exists. If the difference was more than $1,000, the PASS expert would adjust the type “D” earned income retroactively.

Example 2: During a progress review for a PASS that has been in existence for less than 12 months, the individual informs the PASS expert that she is no longer pursuing the goal. She set aside $1,200 of her SSDI benefit as explained in her plan. Although she saved the funds as required by the plan, she did not use the funds as planned. The PASS expert advise her that they will suspend the PASS unless they approve an amendment with a timetable and milestone(s) for using the saved funds. She does not wish to submit an amendment. The PASS expert offers to help her pursue a different work goal under a new PASS. She declines the offer. Because the expenditures do not equal the excluded income (and assuming that administrative finality is not a factor), the PASS expert adjusts the type “D” earned income back to the first month of the PASS.

NOTE: 

The overpayment generated as a result of removing type “D” earned income will not always equal the amount of unaccounted for funds. The individual cannot be overpaid more SSI than they received regardless of the exclusion amount. For example, the PASS expert excluded $1,000 /month for 01/2018-03/2018 of SSDI benefits. Due to the exclusion, the individual received $910 /month in SSI (based on the claimants living arrangements, state supplement amount, etc.) for 01/2018-03/2018. After completing the accounting process, the individual had $3,000 of unaccounted PASS funds. As a result, the PASS expert removes all $3,000 of type “D” earned income from 01/2018-03/2018. The system recalculates SSI eligibility for 01/2018-03/2018 now using the previously excluded income, which results in ineligibility for all three months. The individual is overpaid $2,730. Even though the individual did not account for $3,000, they also did not receive $3,000 in SSI for the period


SI 00870 TN 18 - Plans to Achieve Self-Support for Blind or Disabled People - 7/31/2019