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Work Incentives: Both SSI & SSDI

Individuals with disabilities often have expenses related to their illnesses or conditions that are necessary to maintaining their health, recovery, and ability to work. Maintaining health care benefits can often be more valuable than the cash benefit. Both SSI and SSDI have provisions to assist individuals with these expenses

Impairment Related Work Expenses

Impairment Related Work Expenses (IRWEs) are applicable to both SSI and SSDI recipients, but they are applied at different times and in different ways.

  • An IRWE is a necessary out-of-pocket expense that enables the person to go to work.
  • IRWEs must be related to the person’s disability.
  • Common examples include medication co-pays, special equipment, and special transportation.
  • An example of a work-related expense that is not an IRWE would be the company’s uniform – since all employees must buy the uniform and it is not related specifically to the person’s disability.
  • SSA does not reimburse recipients for these expenses, but rather reduces the calculated countable income.
  • For SSI recipients, the IRWE and exclusions are subtracted before other countable income calculations.
  • For SSDI recipients, the IRWE is subtracted from countable income at the end of the TWP when SSA assesses if earnings met SGA during TWP.
IRWE Example: SSI
Example: 5 prescriptions, $10 co-pay each
Gross Earnings From Work: $500
General Exclusion: ($20)
Earned Income Exclusion: ($65)
IRWE ($50)
Monthly Earnings after Exclusions = $365
$1 Counted for Every $2 Earned: $365/2
Countable Income: = $182.50
Maximum SSI check - Countable Income: $943*-$182.50
Amount of SSI Check: $760.50
Total Income: $1,260.50


IRWE Example: SSDI
Example: 5 prescriptions, $10 co-pay for each
Gross Earnings from work after TWP: $1200
IRWE ($50)
Considered Income: = $1,150
Earning SGA? NO

*Based on 2024 Federal Benefit Rates

Health Insurance and Returning to Work

The health insurance benefit is often as valuable to an individual as the cash payments, so it is important to know what will happen to Medicaid and Medicare when a person goes to work.

  • SSI recipients continue to be eligible for Medicaid, as long as they receive any SSI (even if only one dollar)
  • Federal Rule 1619B: Medicaid will continue if SSI payments stop due to earnings from work below a certain threshold (see the Medicaid Eligibility website for current threshold)
  • SSDI recipients are eligible for Medicare as long as they receive a benefit payment
    • If payments stop after TWP, Medicare coverage will continue for 93 months after the last month of TWP
    • After the 93 months, Medicare can be purchased under certain conditions
    • Medicare Part A premiums would then apply

SOAR Resource

See SOAR resources about Employment and Work Incentives!