Volume I Issue 5 February 1996
SSI'S PASS: EXTRA MONEY
TO PURCHASE ASSISTIVE TECHNOLOGY
Copyright 1996, Neighborhood Legal Services, Inc.
INTRODUCTION
We explained in our introductory, October 1995 newsletter that many advocates lack the expertise needed to handle assistive technology (AT) cases. To remedy this problem, our AT Advocacy Project will publish this newsletter 8 to 12 times per year to "get out the word" on AT. We just finished a three-part series on Medicaid. Future newsletters will cover, for example: Medicare; VESID and the Commission for the Blind; the Physically Handicapped Children's Program; private insurance; Veteran's Administration benefits; special education; and charities.
Our newsletters are designed as a curriculum on AT, with each issue three-hole punched to allow for storage in a notebook. Call the AT Project at 716-847-0650 if you want back issues or if you want to be added to our mailing list.
This month we discuss the Plan for Achieving Self Support (PASS) as a potential AT funding source. The PASS is a Supplemental Security Income (SSI) work incentive provision which can make cash available to pay for AT and other items needed to reach a work goal.
HOW THE PASS WORKS1
SSI is a program for the financially needy. To get SSI disability benefits a person must have limited income and resources. Countable resources (i.e., "liquid resources") cannot exceed $2,000 for an individual. The monthly SSI check will be determined by subtracting countable income from an SSI base rate.
For example, Tom is spinal cord injured, lives alone and receives $470 in monthly Social Security Disability (SSD) benefits. SSI disregards the first $20 of his SSD under its unearned income exclusion. The remaining $450 is then subtracted from the 1996 SSI living alone rate of $556. Tom's monthly SSI check is $106 ($556 - 450 = $106) and, like all SSI recipients, he automatically qualifies for Medicaid.
A PASS allows a person to save income or resources to pay for items related to a work goal. When income or resources are set aside in an approved PASS, that money is not counted in determining SSI eligibility. With a PASS the person with a disability can: increase the monthly SSI check; retain SSI eligibility when income or resources are increasing; or obtain SSI in the first instance.
Consider Tom, above, who is paralyzed from the waist down, has limited use of his hands and uses a wheelchair. Tom is starting an accounting business and wants to buy an environmental control unit to place on his wheelchair. It will allow him to operate lights, turn on a computer, answer a telephone and perform other functions at his new office from a switch on his wheelchair. New York's Office of Vocational and Educational Services for Individuals with Disabilities (VESID) has funded many of his business start-up costs. After exhausting VESID's dollar limits, Tom still needs $6,000 to purchase the environmental control unit.
Tom proposes a PASS, agreeing set aside $450 of his $470 monthly SSD check to save toward purchase of the environmental control unit. Tom's PASS is approved. The first $20 of SSD is excluded under normal SSI budgeting rules. The other $450 is also excluded and not counted as income. His SSI check will now increase from $106 to $556 per month and he will continue getting Medicaid automatically. Using the PASS, Tom can save enough money to purchase the environmental control unit in about 14 months.
Any kind of income can go into a PASS, including wages, disability payments or income of a parent or spouse that is considered available to the SSI applicant or recipient (i.e., "deemed income"). Any liquid resource can also go into a PASS, including savings, an inheritance, a personal injury award or retroactive disability payments.
CRITERIA FOR PASS APPROVAL
A PASS must be in writing and submitted to the Social Security Administration (SSA) for approval. Anyone can write the PASS, including the person with a disability. We recommend that a trained advocate or rehabilitation professional assist in drafting the PASS. SSA is required to assist in writing a PASS if requested to do so.
There is no approved form. However, we at Neighborhood Legal Services developed a form several years ago for writing PASSes. We strongly recommend using our form or one like it.2
The written PASS must contain several items:
* a specific occupational objective;
* a list of items to be funded and their cost;
* the income/resources to go into the PASS;
* specific savings and disbursement goals; and
* a timetable for achieving the goal.
The SSI recipient must comply with the terms of an approved PASS.
WHAT ITEMS CAN BE FUNDED WITH A PASS?
A PASS can fund any item that is directly or indirectly connected to achieving a work goal. SSI's policy manual contains an extensive list of items that can be funded using a PASS.3 The following is a short list of items, including AT devices, that can be funded with a PASS:
* college or trade school tuition;
* tools and equipment, including specially adapted items for a job or home office;
* a computer and related equipment, includ- ing adaptations to allow use in school, work or in a home office;
* a vehicle and/or any special modifications to it; and
* assistive seeing, listening or speaking de- vices to aid a person in school or at work.
We recommend pursuit of other funding sources first, turning to the PASS for items that cannot otherwise be funded. For instance, VESID and the Commission for the Blind and Visually Handicapped (CBVH) will pay for education and will purchase tools, computers and other assistive devices under certain circumstances and up to certain dollar limits. A person can turn to VESID, for example, to pay for tuition up to its dollar limits and use the PASS to pay for excess costs. Medicaid, Medicare or private insurance policies may cover some assistive devices and not others. Determine what those funding sources will pay for and turn to the PASS for other items.
TIME LIMITS FOR THE PASS
SSA will initially approve a PASS for up to 18 months. If one has complied with its terms and other criteria are met, SSA can approve the PASS for 18 more months. Under the old rules, SSA could extend the PASS for an additional 12 months, but no more, if the plan involved education or training.
A 1994 law requires SSA to draft rules allowing PASSes to be extended for more than 36 or 48 months when necessary to achieve a work goal. To date SSA has not enacted new regulations or revised its policy manual. However, in January 1995 it issued an "Emergency Teletype" to advise its field offices that the absolute 36/48 month time limit no longer exists. The Emergency Teletype authorizes one or more six month extensions beyond the 36/48 month limit when necessary to complete the plan in the approved PASS.4
The elimination of time limits will help persons who, because of a disability, cannot complete a college program within four years. It will also help those who require more than a four year degree to achieve a work goal.
AN APPROVED PASS CAN BE AMENDED
Let's go back to Tom, above, who will soon move into his office and is 12 months into his approved PASS. He failed to plan for several expenses necessary for him to work and succeed in business. Tom needs to: make his bathroom wheelchair-accessible; widen doorways; purchase computer software that is compatible with his voice-activated computer; and pay for advertising to bring in business. VESID has assisted Tom up to its dollar limits. He now needs an extra $9,000 for these new items.
Tom submits a written amendment to include these items and to extend the PASS for 20 more months. If approved, he will continue to put his full SSD check (minus the $20 exclusion) into the PASS and continue to get SSI at the full living alone rate. If Tom can secure a loan, he can use the PASS to make monthly payments for these items.
CONCLUSION
PASS writing requires an understanding of special SSI rules. Attorneys are not needed to write PASSes, however. Many independent living center advocates, VESID counselors and others have successfully written PASSes for the persons they serve.
This article provides a brief overview of the PASS. A more thorough review with specific examples is contained in a 30-page chapter of the Benefits Management manual which Neighborhood Legal Services co-authors each year.5 If you plan to become active writing PASSes, we recommend the Benefits Management manual as a resource. We also recommend that you obtain copies of SSA's relevant manual provisions as referenced in the notes below.
NOTES:
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1. SSI's rules governing the PASS are found in 20 CFR 416.1180 - .1182 and in Social Security's Program Operations Manual System (POMS) SI 00870. You can obtain a copy of the POMS through your local Social Security office.
2. For a copy of our PASS form, send a self-addressed envelope to the AT Advocacy Project. If you want the form on computer disk (WordPerfect 5.1), send us a formatted 3 and 1/2 inch or 5 and 1/4 inch IBM-compatible disk.
3. See POMS SI 00870.025D.
4. Call the AT Project if you would like a copy of SSA's Emergency Teletype.
5. See Benefits Management for Working People with Disabilities: An Advocate's Manual (1996), ch. 4 (can be ordered through the AT Project at a cost of $45 or less if ordering multiple copies).
* sponsored by Cross Systems Training Group
* half-day sessions
* work incentives video available
* for information call Tobi Bickweat at VESID
(518) 473-7630
* sponsored by Cornell University
* several three-day sessions
* Central/Eastern New York locations
* call (607) 255-7727 for information
The AT Advocacy Project will search our Fair Hearing Decision Database for a Medicaid decision involving a specific AT device.
Recently, a caller sought advice concerning prior approval for an "environmental control unit (ECU)." Within minutes we were able to locate a relevant fair hearing decision which approved funding for an ECU and printed the decision. That decision, sent to us by a New York City attorney, was then FAXed to the caller later that day.