SI 00870.006 PASS: THE PLAN AND THE EXCLUSIONS
SI 00870.006 Elements Of A PASS
A. POLICY -- OCCUPATIONAL GOALS
1. Occupational Goal
Each PASS must specify and clearly describe a single occupational goal.
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:
o 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;
o all out-of-pocket medical expenses (including health insurance
premiums) not subject to reimbursement; and
o 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.
NOTE: A PASS may specify VR evaluation as a milestone toward choosing an
occupational goal.
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 00870.025 B.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/her:
o impairment, and the limitations imposed by it;
o age, in some cases; and
o strengths and abilities.
4. The Plan for Achieving The Goal Must Be Viable
The plan for achieving an otherwise feasible goal must be realistic,
taking into account:
o the individual's education and training needs;
o any assistive technology required;
o 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;
o other needs that become apparent during evaluation of the PASS; and
o 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 00807.006D.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:
o the targeted level of performance in terms of the supports required;
and
o how long it will take the individual to reach the goal.
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:
o 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;
o 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;
o be of a reasonable cost, considering the items or services being
obtained; and
o 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 ff.) 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.
7. Vehicles
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:
o available, or available at the times and locations needed;
o reliable;
o safely accessible to the individual; or
o 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:
o can be expected to handle the individual's transportation requirements
for the duration of the PASS; and
o meets the requirements in SI 00870.006B.6
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:
o registration and licensing fees;
o fuel costs, which must relate directly to travel for activities that
are necessary in order to achieve the occupational goal; and
o maintenance and insurance costs.
Expenses for fuel, maintenance, and insurance can be allowed based on:
o actual cost, if the individual provides evidence of the actual cost of
these expenses; or
o the mileage allowance charts for BWE (SI 00820.535) or IRWE (SI00820.540), whichever
chart is most advantageous. 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/she works or decrease his/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 SI00870.006B.11
., a PASS must indicate:
o when the items and services will be used with respect to attaining the
work goal;
o what income and/or resources the individual will set aside to purchase
the items and services;
o whether the funds will be used for periodic payments (e.g., monthly)
of expenses or saved for a future payment; and
o 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 SI01320.710A.
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 otherPASS-related activities.
C. POLICY -- EXPENSES THAT CANNOT BE ALLOWED
No expense can be allowed that:
o is not purchased by the individual or deemor;
o is for items or services that the individual can readily obtain from
the providing agency for free;
o is for items or services for which the individual will be promptly
reimbursed (e.g., health insurance);
o 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);
o 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
o 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 SI00820.200 ff.)
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.
3. Extensions
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.
4. Self-Employment
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:
o a final accounting must be completed for the prior PASS (see SI
00870.070A.4.); and
o the individual must show that he/she 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/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 ff. and GN 03340.001 ff. for more
information about the issues of consent and access.
[Last Change: 09/00]