SI 00870.010 Related Work Incentive Policies
A. Policy -- Relationship of 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. The relationship of a PASS to the section 301 provision is discussed in SI 00870.010B.
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 a blind individual to exclude earnings used to pay for work related expenses (i.e., not necessarily incurred because of the individual'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.
Income used to pay for a particular work-related item may not be excluded from countable income under a PASS and under the IRWE or BWE provisions simultaneously. An expense excludable under a PASS for countable income purposes may also be excludable as an IRWE for an SGA determination since these are separate determinations.
When both PASS and IRWE or BWE apply, use the exclusion most advantageous to the individual.
2. Property Essential to Self-Support
The property essential to self-support (PESS) provision provides for the total or partial exclusion of property needed for self-support under certain conditions. (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. (For more information about section 1619, see SI 02302.010.)
4. Substantial Gainful Activity
SGA provisions do not affect or 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: In an initial claim, a determination that SGA is being performed precludes the need for a PASS determination since the person would not meet the disability criteria for eligibility.
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 he/she is 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. Also 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 will apply if:
• the individual is participating in a PASS that was approved before the date of disability or blindness cessation, and
• the individual started participating in the PASS before the date his/her disability or blindness ceased, and
• participation continues 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 he/she will not return to the disability or blindness benefit rolls.
See DI 14505.010A.
NOTE: 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 he/she is taking part in the activities and services outlined in the plan. See DI 14505.010C.
For continued eligibility for 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 his/her 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 TWP, and 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. A PASS may be amended while the individual is receiving section 301 payments; however, we cannot approve a new PASS after we have 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 he/she will remain off the rolls.
C. Procedure – Section 301 and PASS
1. Identifying Cases
The FO will identify cases with participation in a program of VR, employment, or other support services (including a PASS) when conducting a medical 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-F4 (Development of Participation in a Vocational Rehabilitation or Similar Program) with information about the individual and the program before sending the case to DDS (DI 14515.020).
The file must contain a copy of the approved PASS application (SSA-545), any supplemental forms including amendments, and the PASS approval notice before it 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 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 remarks on the SSR to identify approved PASS cases and the servicing PASS cadre. Enter the following information on the SSR Remarks field for every approved PASS case:
• PASS approval date (mm/dd/yy),
• PASS specialist’s phone number (including extension).
Be sure to update the SSR Remarks field 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 PASSes.
2. The SSA-4290-F4 – 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-F4 (DI 14515.020). The PASS specialist will be asked 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). The PASS specialist will also be asked:
• 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, the case will be forwarded to ODO to make a section 301 determination (DI 13005.040D.).
ODO will review the SSA-4290-F4 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 PASS specialist may be contacted by the ODO examiner if further documentation of the plan is required.
3. After Section 301 Determination
If section 301 payments are allowed, the case will be documented in one of several ways:
• Remarks on the MBR or SSR such as “section 301 payment case” or “section 301 case”,
• A “Y” in the 301 indicator of the DDSQ (see SM 06002.200), and/or
• A DCF event indicating “301 case” on the QCDR or ECDR screen (for a T2 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 he/she 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 his/her plan, or
• the individual completes his/her plan.
Use DOORS to obtain the fax number of the module with jurisdiction of the SSN. 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.