How Impairment-Related Work Expenses Affect Social Security Disability

Disability-related expenses can lower your income enough to qualify for Social Security disability benefits or SSI.

By , J.D. · University of Baltimore School of Law
Updated by Bethany K. Laurence, Attorney · UC Law San Francisco

The Social Security Administration (SSA) will assess whether you're eligible for disability benefits based on your income. But the SSA won't count certain expenses related to your disability.

Whether you're applying for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) disability benefits, Social Security will deny your application if you're doing a substantial amount of work, which the SSA calls "substantial gainful activity" (SGA). For 2024, SGA is defined as earning $1,550 or more per month.

Additionally, to get disability benefits through the SSI program, your income (earned and unearned) must be below a specific income limit. Even if your income is below the SSI limit, if you're working, some of your work income will be subtracted from your monthly SSI payment.

For all these calculations, Social Security will exclude the cost of certain "impairment-related work expenses" (IRWEs) from your earnings. IRWE exclusions can do a couple of things for you:

  • help you to be eligible for benefits when you first apply
  • help you remain eligible for SSDI, or
  • reduce the impact of your earnings on your SSI payments after you've been approved for benefits.

Here's what you need to know about impairment-related work expenses, including what qualifies as an IRWE.

What Are Impairment-Related Work Expenses?

Impairment-related work expenses are what you pay for special disability-related items or services you need to be able to work. (You can work while receiving disability as long as you earn less than the levels discussed above.)

Generally, Social Security doesn't exclude non-work-related disability expenses from your income when considering your eligibility. But as long as you use the item or service for work, the SSA will exclude the cost of your IRWEs from your earnings—even if you also use them when you aren't working. (20 C.F.R. § 404.1576(a).)

Here are the general requirements for items or services to be excluded as IRWEs:

  • You must need the item or service to be able to work.
  • You must need the item or service because of your mental or physical impairment.
  • You're not being reimbursed for the cost of the item or service by another source (like Medicare, Medicaid, or a private insurance company), and
  • The cost of the item or service is reasonable (compared to what is normally charged for the item or service in the area where you live).

What Items or Services Count as IRWEs?

Here is a chart that shows examples of which expenses can be excluded from your income as IRWEs and which can't be excluded. (20 C.F.R. § 404.1576(c).)

Type of Expense

Deductible as an IRWE

Not Deductible


  • the cost of changes you have to make to your car so that you can drive it—even if you also use the vehicle for personal purposes (for example, adding hand-controlled braking or acceleration devices)
  • the cost of paying someone to drive you to work because your disability prevents you from taking public transportation

  • the base cost of your car
  • the costs of changes made to your car that aren't related to your disability (for example, new paint or high-performance tires)
  • public transportation costs (for example, bus or cab fare)

Attendant Care Services

  • the cost of paying someone to perform services for you at work (for example, hiring someone to help with your personal care, like eating and toileting while at work, or someone to read or type for you)
  • the cost of paying someone to help you get ready for work and to help you when you get home from work (for example, assistance getting dressed, bathing, or preparing meals—even if these activities also incidentally help your family)

  • the cost of paying someone to help you with day-to-day activities. (for example, cleaning your house, grocery shopping, or doing your laundry)
  • the cost of paying someone to help you with caring for other people in your family (for example, child or adult daycare services)

Medical Devices

  • the cost of medical devices and prosthetics (for example, wheelchairs, dialysis equipment, crutches, pacemakers, respirators, traction equipment, walkers, and braces)

  • the cost of any medical device you use that isn't related to your medical condition and that doesn't enable you to work (for example, a sleep mask)

Work-Related Equipment

  • the cost of specialized equipment and tools designed to accommodate your impairment so you can do your job (for example, a one-handed typewriter or a screenreader)

  • the cost of equipment that isn't specifically designed to accommodate your impairment (for example, the office copy machine or coffee maker)

Changes to Your Home

  • if you work outside of your home, changes you have to make to the exterior part of your house that allow you to get to the street or to your transportation (for example, ramps or railings)
  • if you work at home, changes you have to make to adapt it to create a working space that accommodates the needs of your disability (for example, widening the doorway to your home office or lowering counters in your workspace)

  • if you work outside of your home, any changes you make inside your house, even if they are to accommodate your disability
  • if you're self-employed and work at home, the cost of any modifications you deduct as business expenses

Other items that can sometimes qualify as IRWEs include:

  • the cost of non-medical appliances when your circumstances clearly establish a medical and work-related need for the item (for example, an electric air cleaner for someone with severe respiratory disease who can't function in a non-purified air environment)
  • the cost of medications or medical procedures (including diagnostic procedures) if you must use them to control your impairments so you can work (for example, anticonvulsant drugs or blood level monitoring to control epilepsy or antidepressant medication for mental disorders), and
  • the cost of other medical supplies you need to be able to work (for example, incontinence pads, catheters, bandages, or face masks)

In addition, Social Security will deduct payments you make for physical therapy for your impairments and which you need to be able to work. And if you own a service animal that makes it possible for you to work, the costs of your animal's license, food, and veterinary care can be considered IRWEs.

Your mileage to and from work is also deductible from your earnings, at the IRS standard mileage rate.

Even if an item or service that you use isn't listed here, you should contact Social Security to see if it qualifies as an IRWE. Read on to find out how IRWEs and unincurred business expenses are deducted from your countable income.

Updated March 5, 2024

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