Impairment Related Work Expenses (IRWE)


Social Security allows disabled people who work to deduct certain expenses (some medical costs, etc.) from their gross monthly wages. These deductions, or IRWE’s, reduce the amount Social Security deducts from benefits, and can keep you from losing your Social Security altogether.

IRWE’s fall into several broad categories: out of pocket medical expenses (those not covered by insurance), medical devices and equipment; certain attendant care; some transportation costs; home modification expenses for the self employed; and some expenses related to residential living programs. IRWE’s must involve expenses that directly relate to both your ability to get to work or continue working and your disability.

For many people with HIV disabilities, out of pocket medical expenses are worth exploring. For example, many people with HIV suffer from neuropathy. If a disabled person with symptoms of neuropathy took a job that required standing, massage therapy might help with those symptoms. Legitimate IRWE’s must be “reasonable” in market value. At a “reasonable” $90 a visit three times a month, the cost of massage therapy could count as a $270 per month IRWE, if a doctor prescribed the treatment, and as long as you are working.

IRWE’s for Supplemental Security Income (SSI)

If you collect SSI at $870 a month and report wages, the first $85 you earn each month is exempt. Beyond that, SSI deducts $1 for every $2 you earn. If you were making $285 a month, you would lose $100 from your benefit (first $85 exempt, then half the other $200, or $100, deducted from your SSI). Your gross monthly would then be $770 from SSI plus the $285 you earned, for a total of $1055.

If you had out of pocket medical expenses amounting to $120 a month for massage, for example, the amount deducted from your check drops to $40. Your wages of $285 are reduced by the $85 exemption. The remaining $200 is reduced by $120 in IRWE’s. Social Security deducts half the remainder of $80, or $40. Your income now will be $870 minus $40, or $830, plus your wages of $285, for a total of $1,115.


You can only claim IRWE’s after you have completed your Trial Work Period (TWP). Any month in which you earn more than $700 gross (2009 figures) counts as one month in the TWP. If after your nine month TWP your earnings are always over $980 (2009 figures), your SSDI cash benefit entitlement stops (you should still retain your Medicare benefit).

If you earn $1200 a month at a part-time job, you are not entitled to your cash benefit after your TWP. But if you claimed $350 in IRWE’s, your countable monthly income of $1200 drops to $850. That amount is under $980, which is Social Security’s “Substantial Gainful Activity” (SGA) level of income. Your SSDI check would not be affected by wages of $850 because this is below SGA. Thus claiming IRWE’s during your Extended Period of Eligibility may prolong your cash benefit status if you have out of pocket medical expenses.

Expenses that may qualify . . .

IRWE’s are not narrowly defined in Social Security’s regulations. To qualify expenses must relate to your ability to work even though you are disabled. A doctor’s note or prescription could be required. And the expenses must be “reasonable” for the service or device required.

Out of pocket medical expenses that existed prior to your working may not qualify (health insurance premiums, prescription co-pays, etc.). But the IRWE regulations leave room for various interpretations. If you have expenses that you think may qualify, get a note or script from your physicians, consult with a benefits counselor, and contact Social Security. However, you can appeal any decision Social Security made regarding IRWE’s.

Some other expenses that may qualify as Impairment Related Work Expenses are as follows: some attendant care, if that care is needed at work or to get to and from work; medical equipment (braces, inhalators, wheelchairs), prosthetic devices and other equipment (page turners, computer adapters, etc.); physical fitness items prescribed by a doctor; drugs not covered by health insurance; some diagnostic procedures; transportation costs involved with modified vehicles or transportation costs if your impairment keeps you from using mass transit; modifications to your home (wheelchair ramps, etc.) if you work at home or need the modifications to get out of the house in the morning; and expenses necessary to keeping a disabled person in a residential treatment program or living situation.


IRWE's allow for exemptions that keep you from losing your cash benefit. If you’re out of pocket expenses meet all of the necessary criteria, you should document the cost of the expense and submit it to your local Social Security office. Allowable expenses will vary from person to person. Consult with your doctor and a benefits counselor to be sure your expenses qualify as an IRWE.