5101:1-39-18 Medicaid: income exemptions and disregards.

(A) "Countable income" is the total income in cash or in kind less the income exemptions and disregards outlined in the following section. Countable income is compared to the need standard in determining medicaid eligibility.

(1) "Exemptions" means items which are excluded from consideration as income. Exemptions are combined by category and subtracted from the gross income. The subtotal is rounded down to the nearest whole dollar.

(2) "Disregards" means the amounts of income deducted in determining eligibility. Disregards are combined by category and subtracted from the gross nonexempt income. The subtotal is rounded down to the nearest whole dollar.

(3) Income paid by public or private agencies or community groups which is either designed by law to be disregarded or given for a special purpose for medical or social services that are not food, shelter, or clothing, shall be disregarded.

(B) The following income exemptions are designated by law to be disregarded in whole or in part when determining countable income.

(1) Rural housing loans made by farmers home administration (FHA) to help individuals and families acquire and/or make needed improvements to a home or other property.

(2) The value of surplus commodities donated by the U.S. department of agriculture.

(3) Payment for subsidized adoption.

(4) Tax-exempt portions of payments received by Alaskan natives as a result of the Alaska Native Claims Settlement Act, Public Law 94-203.

(5) Payments made for supporting services or reimbursement of out-of-pocket expenses to volunteers participating in any program created as a result of Titles II and III, Section Section Section 418 of Public Law 93-113. Examples are foster grandparents program, retired senior volunteer program (RSVP), senior companions, senior health aides, service corps of retired executives (SCORE), and active corps of executives (ACE).

(6) Benefits received under Title VII, nutrition program for the elderly of the Older Americans Act of 1965, Public Law 92-258.

(7) The value of supplemental food assistance received under the Child Nutrition Act of 1966, as amended, and the special food service program for children under the National School Lunch Act, as amended, Public Law 92-433 and Public Law 93-150.

(8) Payments to individual volunteers receiving compensation under Title I of Domestic Volunteer Service Act of 1973, Public Law 93-113, Section 404(g). Examples of operating programs are Volunteers In Service to America (VISTA) and University Year for Action (UYA).

(9) Under the provisions of Public Law 95-171, assistance received as a result of a presidentially declared disaster which occurred on or after June 1, 1976, shall be excluded from countable income. For presidentially declared disasters which occurred after December 31, 1976, but before January 1, 1978, assistance can be excluded beginning January 1, 1978 only.

(10) Any cash (other than remuneration for sheltered employment and incentive payments) provided by a governmental medical or social services program is not income. To be considered "governmental" in this context, the program must be authorized by federal, state or local law to make payments for medical or social service purposes. Payment from a governmental program which is disbursed by a nongovernmental agency, is considered a payment from a governmental program for purposes of this section. Reimbursements for medical or social services already received that are not in excess of the medical or social services expenses are not considered income. Any amount of the reimbursement that is in excess of the medical or social services expenses incurred is considered unearned income.

(11) HUD (metropolitan housing authority) payments covering rent/utility bills which exceed the twenty-five per cent rent payment limitations stipulated by the Brooke Amendment.

(12) Any wages, allowances, or reimbursement for transportation and attendant care costs when received by an eligible handicapped individual employed in a project under Title VI of the Rehabilitation Act of 1973 as added by Title II of Public Law 95-602.

(13) Retroactive payments paid as a result of a state hearing.

(14) Retroactive payments paid as a result of reconsideration of SSI benefits.

(15) Experimental housing allowance program payments made under annual contributions contracts entered into prior to January 1975, under Section 23 of the U. S. Housing Act of 1937, as amended. This program is designed to aid low-income families secure adequate housing.

(16) Home energy assistance (HEA), support and maintenance assistance (SMA), paid to clients in cash or in-kind per Public Law 97-377, Public Law 97-424, and Public Law 98-21.

(a) "Home energy assistance" means any assistance related to home energy (e.g., payment/vouchers for heating and/or cooling bills, weatherization, blankets, storm doors, etc.).

(b) "Support and maintenance assistance" means in-kind (noncash) assistance from a private nonprofit organization recognized by ODHS to meet food, clothing, or shelter needs (e.g., bags of groceries, clothing, payment of utility bills, etc.); or cash or in-kind assistance from a rate-of-return entity providing home energy, supplier of home heating oil or gas, or a municipal utility providing home energy.

(c) The assistance is only in-kind and is provided by a private nonprofit organization recognized by the ODHS; or it is cash or in-kind assistance furnished by a supplier of home heating oil or gas, an entity providing home energy whose revenues are primarily derived on a rate-of-return basis regulated by a state or federal governmental body, or a municipal utility providing home energy; and

(d) The assistance is provided on the basis of need for such support.

(17) Section 1612(b)(4)(A) of the Social Security Act provides for income, which is determined by SSA as necessary income to fulfill a plan for achieving self-support (PASS), to be exempt in accordance with the terms and duration of a SSA approved PASS.

The PASS program is offered by the SSA to applicants and recipients of SSI who have additional income (RSDI, veterans benefits, etc.) and are participating in a program administered by the rehabilitative services commission or other social agency.

The program allows SSI recipients to set aside a portion of their countable income each month. The amount set aside is deposited into a separate identifiable account, and it is to be used only for an occupational objective which is approved by SSA and the social agency. Training for employment and purchasing of a specially equipped automobile are examples of occupational objectives.

SSI matches the amount set aside and issues this amount to the recipient in the form of an increased SSI warrant.

(18) The payments under the provisions of the Agent Orange Compensation Exclusion Act ( Public Law 101-201 ) received on or after January 1, 1989 are not counted as income. The Agent Orange Compensation payments must be documented and identifiable from countable income. These payments are also not counted as income in the patient liability/post eligibility determinations.

Interest received on these funds banked with a financial institution is not exempt and is counted as unearned income in the month of receipt and as a countable resource the month after the month of receipt.

(19) The payments received under the provisions of Section Section Section 105 of Public Law 100-383 by individuals of Japanese ancestry is not counted as income. The payments must be documented and identifiable separate from countable income. These payments are also not counted as income in the patient liability/post eligibility determinations.

Interest received on these funds banked with a financial institution is not exempt and is counted as unearned income in the month of receipt and as a countable resource the month after the month of receipt.

(20) Effective August 1, 1994, the Nazi Persecution Victims Eligibility Act ( P.L. 103-286 ) excludes from income any payments made to individuals because of their status as victims of Nazi persecution. This provision supercedes previous provisions for the exclusion of certain payments made by the governments of Germany, Austria, and the Netherlands, insofar, as they are made to victims of Nazi persecution. For determinations made prior to August 1, 1994, payments to victims of Nazi persecution from the German, Austrian, and Dutch governments are excluded from income and resources.

Interest received on these funds banked with a financial institution is counted as unearned income in the month received and as a countable resource the month after the month of receipt.

(21) The payments under the provisions of the Radiation Exposure Compensation Act ( Public Law 101-426 ) is not counted as income. These payments must be documented and identifiable separate from countable income. These payments are also not counted as income in the patient liability/post eligibility determinations.

Interest received on these funds banked with a financial institution is not exempt and is counted as unearned income in the month after the month of receipt.

(22) Earned income tax credit (EITC) payments in the form of a refund of federal income tax or in the form of an advance payment by an employer are disregarded in the month of receipt and in the following month. The second month after the month of receipt funds, which have been retained, are counted as a resource.

Interest received on these funds banked with a financial institution is not exempt. The interest is counted as unearned income in the month received and as a countable resource the month after the month of receipt.

(23) The Austrian social insurance payments received under the provisions of the Austrian General Social Insurance Act, paragraphs 500 through 506, are not counted as income. The Austrian social insurance payments must be documented and identifiable from countable insurance. These payments are also not counted as income in the patient liability/post eligibility determinations.

Interest received on these funds banked with a financial institution is not exempt and is counted as unearned income in the month of receipt and as a countable resource the month after the month of receipt.

(24) Escrow accounts established and credited as the direct result of the assistance group's involvement in the family self-sufficiency program on or after May 13, 1992. These escrow accounts are only considered available when the assistance group is no longer receiving an federal, state, or other public assistance for housing.

Interest received on these funds banked with a financial institution is not exempt and is counted as unearned income in the month of receipt and as a countable resource the month after the month of receipt.

(25) VA aid and attendance and household allowances. When the individual who receives an allowance pays someone else to provide services, that payment is income (earned or unearned) to the person providing the services unless that individual is a person from whom income is deemed to the original recipient of the allowance.

(26) The value of any commercial transportation ticket for travel among the fifty states, the District of Columbia, Puerto Rico, Virgin Island, Guam, American Samoa, or the Northern Mariana Islands, which is received as a gift and is not converted to cash. This exclusion applies to tickets received by medicaid eligible individuals or their eligible spouses or by ineligible parents or spouses for whom income may be deemed to the eligible individual.

When a commercial transportation ticket that has been excluded is cashed, the cash received is income in the month of receipt and is a countable resource the month after the month of receipt.

(27) Effective March 1, 1995, basic health insurance, child care or child care allowances, auxiliary aid and services for disabled individuals and the national service educational award provided for individuals participating in a national service program established under the National and Community Service Trust Act of 1993 ( Public Law 103-82 ). Payments received as a living allowance shall be considered earned income.

(28) Payments received under the provisions of the "Ohio Victims of Crime Program" are not counted as income for medicaid financial eligibility and patient liability/post eligibility computations.

Interest received from these funds banked with a financial institution is not exempt and is counted as unearned income in the month of receipt and as a countable resource the month after the month of receipt.

(29) Many federal statutes provide for the exclusion from income and resources of certain payments made to members of Indian tribes and groups. Due to the number of statutes that affect medicaid eligibility, ODHS will exclude from income and resources for medicaid purposes any payments that are also excluded under the supplemental security income (SSI) program.

Any interest received on these payments banked with a financial institution is not exempt and is counted as unearned income in the month received and as a countable resource after the month of receipt.

Any resource that is purchased with these payments is not automatically exempt and must meet medicaid resource requirements.

(30) Cost-of-living subsidies received by OBRA waiver recipients from the Ohio department of mental retardation and developmental disabilities (MRDD) are not counted as income for the medicaid financial eligibility and patient liability/post eligibility computations.

(31) As a result of the settlement contained in H.B. 2015, none of the payments made from any fund established pursuant to a class settlement in the case of Susan Walker v. Bayer Corporation, et al, 96-C-5024 (N.D. Ill) shall be considered income or resources in determining eligibility and/or patient liability.

Interest received as a result of payments from this settlement is not excluded for income and resource purposes.

(32) A dedicated account in a financial institution, the sole purpose of which is to receive and maintain SSI past-due benefits which are required or allowed to be paid into such an account and the use of which is restricted by section 1631 (a)(2)(F) of the Social Security Act. Refer to rule 5101:1-39-26 of the Administrative Code for additional information on dedicated accounts.

(33) Section 4735 of the Balanced Budget Act of 1997 provides that none of the payments made from any fund established pursuant to a class action settlement in the case of "Factor VIII or IX Concentrate Blood Products Litigation," MDL 986 (NO. 93-C-7452, (N.D. Ill) are to be considered as income or resources in determining eligibility and/or patient liability.

Interest received as a result of payments from this settlement is not excluded for income and resource purposes. Use of the funds to purchase resources must be evaluated as to the exempt or nonexempt status of the resource.

(34) Compensation received for services by an individual appointed to a temporary position within the bureau of census established for purposes relating to the 2000 decennial census of the United States as specified in Section 3 of the Decennial Census Improvement Act of 1999 shall not cause a reduction in benefits provided through any program such as medicaid which is financed in whole or in part by federal funds. This income exemption applies only with respect to compensation for services performed during the calendar year 2000 and does not apply if the individual performing the service involved is appointed (or first appointed to any other temporary census position) prior to January 1, 2000.

Interest received on these funds when banked with a financial institution is not exempt and must be counted as unearned income in the month of receipt and as a countable resource in the months following the month of receipt.

(C) OWF, DA, SSI, RSS, social services, auxiliary warrants, and prevention, retention and contingency payments received by an assistance group are exempt when determining medicaid eligibility.

(D) Any individual, regardless of age, who receives a grant, scholarship or fellowship and pays tuition and/or fees to an educational institution, qualifies for an exemption.

(1) Effective July 1, 1993, all student financial assistance provided under programs in Title IV of the Higher Education Act or under the bureau of Indian affairs student assistance programs must be disregarded as income and resources in the determination of eligibility or level of benefits in the medicaid program.

(2) Grants, scholarships and fellowships, other than those provided in Title IV of the Higher Education Act, or under bureau of Indian affairs student assistance program, awarded by nonprofit agencies, private concerns or by local, state, federal, or foreign governmental units to enable an individual to further his education and training by scholastic or research work are exempted as income up to the amount necessary to cover the cost of the student's required tuition, fees and other expenses necessary to securing an education.

(a) Required tuition and fees include only those amounts billed by the educational institution. Other expenses necessary to securing an education include expenses for textbooks and educational materials, transportation to and from school, and any impairment-related expenses necessary to attend school or perform schoolwork, e.g., special prosthetic devices necessary to operate school machines or equipment.

(b) This exemption does not apply to aid received from relatives and friends or from amounts which in any way represent payments or compensations for services to any past, present or future employer. Any portion of a grant, scholarship or fellowship, (other than those provided in Title IV of the Higher Education Act, or under the bureau of Indian affairs student assistance program) which is used for general living expenses or for any purpose other than required tuition, fees and expenses necessary to secure the education is to be counted unearned income.

(E) A relocation assistance benefit paid by a public agency to a public assistance recipient who has been relocated as a result of a program of area redevelopment, urban renewal, freeway construction, or any other public development involving demolition or condemnation of existing housing, is exempt.

(F) Income which is received once in a while or unpredictably may be totally disregarded if such income amounts to ten dollars or less per month of earned income and twenty dollars or less per month of unearned income. If the infrequent or irregular income exceeds ten dollars per month (if earned income) or twenty dollars per month (if unearned income), this disregard does not apply. When this disregard does not apply, the entire amount of the income is counted. This disregard does not apply to income received regularly, e.g., once each month, regardless of the amount of such income.

(G) Payments made to an individual for a child placed in his home by a public or private nonprofit child placement or child care agency are totally exempt. The child need not be unrelated to the foster parent. The child must be currently living in the household of the foster parent for this exemption to apply.

(H) One-third of the child support payments received by or on behalf of a blind or disabled child from an absent parent is disregarded from the income of the blind or disabled child. The remaining two-thirds is unearned income of the blind or disabled child. This disregard applies only to voluntary or court-ordered support received from the blind or disabled child's absent parent directly or through the child support enforcement agency.

(1) Child support payments received by a medicaid-eligible aged, blind or disabled parent on behalf of a child(ren) are not income to the aged, blind or disabled parent.

(2) Child support arrearage payments received by a medicaid-eligible aged, blind or disabled parent on behalf of a child(ren) who is now an adult, are not counted as available income to the medicaid-eligible aged, blind, or disabled parent.

(I) Home produce used by the household for its own consumption is exempt. "Home produce" refers to farm and garden produce, e.g., vegetables, fruit, livestock, eggs, etc., usually grown or used by the household.

(J) The amount of income earned by a child who is a student regularly attending a school, college, etc., is exempt. "Earned income" refers to all payments made to the student as compensation for services and includes payment from neighborhood youth corps, work-study and similar programs, as are wages from regular employment and self-employment income.

(1) To qualify for an exemption the individual must be both:

(a) A child under age eighteen (to meet the definition of "child" he must be neither married nor the head of a household).

(b) A student regularly attending school, college, university or a course of vocational or technical training designed to prepare him for gainful employment. Regular attendance is defined as full-time attendance. The statement of the school official as to whether the child is a full-time student is acceptable.

(2) This exemption is available in addition to the exemption applicable to the receipt of a grant, scholarship or fellowship, and any other earned income exemption.

(3) The amount of earned income which can be exempted under this provision is one thousand two hundred dollars in a calendar quarter with an overall limit of one thousand six hundred twenty dollars per calendar year. This provision permits the student-child to earn a significant amount of earnings in one quarter, i.e., the summer months, to cover school expenses and not lose his medicaid eligibility as long as he stays within the yearly limit. This exemption applies only to a student-child's own earned income.

(K) Twenty dollars of any income, earned or unearned other than income paid on the basis of need is disregarded. Only one twenty-dollar disregard is applied per couple. This disregard shall be applied in the manner that is most advantageous to the individual. The general guidelines are as follows:

(1) If there is earned income only, apply the entire amount of the disregard to that income.

(2) If there is unearned income only, apply the entire amount of the disregard to that income.

(3) If there is both earned and unearned income, the disregard is first applied toward the unearned income. Any amount of the disregard remaining is then applied to the earned income.

(L) The disregard allowed from an eligible individual's earned income is sixty-five dollars plus one-half of the remaining income. The purpose of this disregard is to cover the work-related expenses including mandatory deductions, union dues, transportation, etc. An eligible couple shall receive only one sixty-five dollars and one-half of the remainder disregard. The earned income disregard is applied to the gross earnings except in cases of self-employment. Then the earned income disregards apply to the net income.

(M) Earnings which are used to pay for blind work expenses are excluded from income.

(1) Blind work expenses represent any earned income of a blind person which is used to meet any expenses reasonably attributable to earning the income.

(2) The expenses are deducted from earned income if the blind person is under age sixty-five, or is sixty-five or older and received SSI due to blindness for the month before attaining age sixty-five.

(3) The exclusion applies only to earned income. Expenses in excess of the earned income an individual receives during the month are never deducted from unearned income.

(4) The exclusion is applied to earned income immediately after applying any portion of the twenty dollars general income disregard which has not been deducted from unearned income and all other earned income exclusions except the exclusion of income used to fulfill an approved plan for achieving self-support (PASS).

(5) The cost for any work-related item paid by a blind person may be deducted regardless of any nonwork benefit that may be derived from the item or the item's relationship to the person's blindness. A blind individual can claim the amount withheld for federal, state, and local income taxes even though other factors may affect his tax liability (e.g., Number of dependents, business loss, etc.).

(6) Examples of items that can be deducted include, but are not limited to, a dog guide and the attending costs of maintaining the dog (food, license, veterinary services, etc.), Union dues, professional association dues, other fees, transportation to and from work (mileage is twenty-eight cents per mile), vehicle modification, training to use an impairment-related item or an item which is reasonably attributable to work, social security taxes (but not social security taxes withheld from sick pay), mandatory pension contributions, meals consumed during work hours, attendant care services, structural modifications to the individual's home to create a work space or to allow the individual to get to and from work, medical devices, or prostheses.

(7) The following items cannot be deducted from earned income as an exclusion: in-kind payments, expenses deducted under other sections (e.g., PASS), expenses which will be reimbursed, life maintenance expenses (e.g., meals consumed outside of work hours, self-care items, general educational development, savings plans such as IRA's or voluntary pensions, life and health insurance premiums, items furnished by others that are needed in order to work or expenses claimed on a self-employment tax return).

(8) Documentation is required for any exclusions that are being claimed. If documentation cannot be obtained, the CDHS shall accept the individual's allegation of the expense amount if the amount appears reasonable (e.g., lack of receipts for dog food, etc.).

(N) Workers' compensation payments are awarded to an injured employee or his survivor(s) under the federal and state worker compensation laws. The payments may be made by a federal and state agency, an insurance company, or an employer.

(1) The worker's compensation payment, less any expenses incurred in obtaining the payment, is considered unearned income.

(2) Any portion of a workers' compensation award or payment that the authorizing or paying agency or employer designates for medical expenses or legal or other expenses attributable to obtaining the award is not income. The expenses may be past, current, or future. The workers' compensation payments designated for such expenses may be received in a lump sum or as a continuing payment. If the award notice includes monies designated for expenses, but does not specify the amount designated, verification from the paying agency or employer must be obtained.

(3) If an individual alleges having incurred expenses that exceed amounts designated for expenses as stated above, or for which no amount was designated, the expenses must be verified by the applicant/recipient as an essential factor in obtaining the payment. If an individual is claiming medical expenses related to the injury, he must verify that the expenses will not be paid directly to the paying agency or employer.

(4) There is no resource exclusion that applies to workers' compensation payments that have been deducted from income. Any monies excluded above are excluded in the month of receipt and are considered a countable resource the month after the month of receipt.

(O) Impairment-related work expenses are expenses for items or services which are directly related to enabling a person with a disability to work and which are necessarily incurred by that individual because of a physical or mental impairment.

(1) The need for an impairment-related item or service is established where an individual's disability is sufficiently severe to result in functional limitations requiring assistance in order for him or her to work.

(2) A payment for a service or item is excludable when the individual is disabled (but not blind) and is under age sixty-five or received SSI as a disabled individual for the month before attaining age sixty-five and:

(a) The severity of the impairment requires the individual to purchase or rent items and services in order to work; and,

(b) The expense is reasonable; and,

(c) The cost is paid in cash (including checks or other forms of money such as money orders, credit and/or charge cards) by the individual and is not reimbursable from another source (e.g., Medicare, private insurance); and,

(d) The payment is made in a month the individual receives earned income for a month in which he both worked and received the services or used the item, or, the individual is working but makes a payment before the earned income is received.

(3) This exclusion only applies to earned income. Exclusions in excess of the earned income an individual receives during the month are never deducted from unearned income.

(4) In some cases there may be a question as to whether the amount which the individual paid or is paying for a service or item is within "reasonable limits." If there is a question that the amount is unrealistic or the cost of the service or item on its face appears unrealistic (e.g., payment of three hundred dollars for a pair of wooden crutches), the CDHS should contact other sources in the community who provide the same item or service to ascertain the standard costs for such an item or service. When the inquiries to other sources provide cost information establishing that the cost the individual paid is unreasonable, i.e., exceeds standard costs, then the highest standard cost figure secured from the sources contacted, not to exceed the actual amount paid, should be used as the deductible amount. Documentation should be placed in the case file.

(a) No deduction is allowed to the extent that payment has been or will be made by another source. No deduction will be allowed to the extent that the individual has been, could be or will be reimbursed for such cost by any other source (such as through a private insurance plan, medicare or medicaid, or other plan or agency).

(b) The individual must verify the need for the item or service with the prescribing physician or other prescribing source. It must be verified that the services or items used are actually required to control the disabling condition, or are necessary for the person to travel to and from work, or that they are essential for the individual to perform the physical and/or mental demands of the job.

(c) In order to obtain a well-founded opinion from the prescribing source as to whether an impaired individual needs an item or service to enable them to work, it will be necessary to obtain a thorough description of the physical and mental activities required in the individual's job.

(d) When the individual is claiming a deduction for IRWE, the CDHS must document in the case record the individual's description of the impairment(s), the physical and/or mental activities required for the job, the services or impairment-related items prescribed and who is providing the service and/or item.

(e) The CDHS must also obtain a statement from the provider as to what impairment(s) the item is required, would the individual have the functional capacity to perform the demands and duties of his/her job without the item, and the amount and date the individual paid for the item.

(f) The individual must provide proof that he or she paid for the item or service. A verifying statement signed by the individual and copies of canceled checks or paid receipts, etc., would be adequate to prove payment. The proof must also include a statement that no reimbursement will be received for the IRWE and that no agency or other source is underwriting the expense for the individual.

(g) Whenever services (attendant care, transportation) are involved, the case record must contain documentation as to whether or not the provider of the service is a family member. If the provider is a family member, the following documentation must also be included on the statement completed by the individual and the attendant: a statement of the attendant's duties and periods of time when performed, certification that services have been rendered and that payment in cash (including checks or other forms of money, but not payment "in kind") is being received from the individual, evidence that payment is made on a regular basis (e.g., canceled checks), a statement which establishes the history of the individual's need for an attendant, i.e., information which establishes prior ongoing employment of an attendant before the issue of IRWE became relevant to the impaired individual, and a statement which establishes how the family member suffers an economic loss by serving as attendant (e.g., identify the job which the attendant relinquished, or document the reduction of hours in other remunerative work, and record the date that work stopped or hours were reduced). A family member is anyone who is related to the individual by blood, marriage, or adoption, whether or not that person lives with the individual.

(h) The exclusion is applied to earned income in the following sequence: immediately after deducting any portion of the twenty-five dollar general income disregard which has not been deducted from unearned income and the sixty-five dollar earned income exclusion and immediately before deducting one-half of the remaining earned income.

(i) If the cost of an item has been deducted in figuring net earnings from self-employment, it cannot be deducted as a work expense.

(j) If a medical or transportation expense is allowed as an IRWE, that same expense cannot be used to meet the individual's spenddown. Only transportation expenses that are medically necessary for the treatment of a disability or illness are allowed as a spenddown expense.

(k) The following are some types of expenses that are not deductible: union dues, professional association dues, licenses, income taxes, social security taxes, mandatory and voluntary pension contributions, meals consumed during work hours.

(1) Training and/or nonmedical equipment/services must be for an impairment-related item or service in order to be deductible.

(2) The costs of routine medical services are not deductible unless the medical services are necessary to control the disabling condition so as to enable the individual to work.

(l) The following are types of expenses that may be considered as deductions for impairment-related work expenses:

(1) Rentals or leases - the allowable deductible amount is the actual monthly charge that does not exceed the standard or normal rental or lease charge for the same or similar items in the individual's community.

(2) Transportation costs which the impaired individual necessarily incurs because of his or her impairment are deductible as specified below:

(a) Modified vehicles - where structural or operational modifications are made to a vehicle (e.g., a handbrake is specially installed on an automobile for the individual whose impairment involves the legs, or an electric lift is added to a van for the individual who is wheel-chair confined), without which the impaired individual could not get to and from work, the actual cost of the modification (but not the cost of the vehicle) is deductible if paid by the impaired individual.

(b) In addition to the cost of modification, the operating costs of a modified vehicle which are directly related to work (and for travel to and from place of employment) are also deductible. For the purpose of IRWE, the determination of operating costs of a vehicle is based upon the class of that vehicle and on a mileage rate corresponding to that class. Operating costs include: depreciation, finance charges, gas and oil (including taxes), maintenance and repairs, parts and tires, tolls and parking, insurance, licenses, title, registration and inspection fees, and local, state and federal taxes. These operating costs are based on data compiled by the federal highway administration. Additional deductions for the cost of any of the above items are not permitted.

(c) Use the following chart to determine the allowable mileage rates for various vehicles.

Vehicle Class Allowable

----------------------------------------------- Mileage Rate

------------------------

(cents per mile)

------------------------

Subcompact 28.9

Compact 29.5

Intermediate 33.4

Full-sized car 37.9

Compact pickup 30.6

Full-sized pickup 35.1

Minivan 35.3

Full-sized van 44.8

Unknown 31.5

(d) Determine the monthly operating cost as follows: calculate the individual's daily mileage cost to and from work according to the rates shown above. Multiply the daily mileage cost by the number of days worked per week to obtain the weekly amount. Multiply the weekly amount by 4.3 to determine the monthly amount.

(3) An individual has a deductible transportation expense when a physician verifies that the individual, because of his or her impairment requires a special means of travel to and from work, and the individual's situation appears to warrant deduction of the expense. Evaluation of special transportation situations must be based on two factors: the availability of public transportation in the individual's community, and the individual's capacity to drive a vehicle to work. Public transportation means standard public forms of transit designed for use by the general public. If the individual can use public transportation and his or her impairment does not prevent getting to and from, and traveling on, public transit, transportation expenses may not be deducted as IRWE. If the individual cannot use public transportation because of physical or mental limitations resulting from impairment, when the need and payment are verified, the following special travel expenses may be deducted: the cost of a trip to and from work by taxicab; or the cost of the impaired individual's driving an unmodified vehicle to and from work (at the rate stated above); or the cost of paying another person (not a cab driver) to drive the individual to and from work in his or her own vehicle. The vehicle operating costs (as indicated above) are deductible, in addition to any reasonable amount paid the driver. If the driver is a family member, the payment in cash or by check for the service must be verified.

(4) Attendant care - attendant care services are those forms of physical assistance which help an impaired individual meet his or her essential personal needs at home or at work, such as bathing, toileting, dressing, cooking, eating, communicating, traveling to and from work, and similar personal needs. However, in many cases the attendant may perform services which do not fall under one of the above categories of personal needs. Therefore, the total amount paid to the attendant each month should not be deducted, but only the amount which covers those services related to assisting the individual to prepare for work, getting the individual to and from work, helping the individual on the job, and assisting the individual immediately upon returning home from work. In order to determine the amount to be deducted as an IRWE for attendant care services, prorate the attendant's earnings as follows: determine the number of hours spent each day by the attendant in providing the specified allowable services, divide the attendant's monthly earnings by the total number of hours worked in a month (or divide the weekly earnings by the number of hours worked in a week) in order to ascertain the hourly wage, multiply the number of allowable attendant care hours by the hourly wage to arrive at daily attendant care expenses, multiply the amount of allowable daily attendant care expenses by the number of work days in the month to arrive at the deductible expense for attendant care services for the month.

Eff 9-3-77; 12-31-77; 3-1-79; 10-1-79; 12-1-79; 1-3-80; 3-1-84; 10-1-88 (Emer.); 12-20-88; 7-1-89 (Emer.); 9-23-89; 10-1-89 (Emer.); 12-16-89; 2-7-91 (Emer.); 5-1-91; 7-18-91; 10-1-91; 1-1-92; 4-1-92; 6-1-92 (Emer.); 8-13-92; 10-1-92 (Emer.); 12-21-92; 8-18-93 (Emer.); 11-1-93; 3-1-94 (Emer.); 4-18-94; 7-1-94; 10-7-94; 1-1-95; 4-1-95; 7-1-96 (Emer.); 9-1-96; 5-1-97; 10-31-97 (Emer.); 1-26-98; 3-1-98 (Emer.); 5-1-98; 9-10-99
Rule promulgated under: RC 111.15 .
Rule authorized by: RC 5101.01 , 5101.011
Rule amplifies: RC 5101.01 , 5101.011
RC 119.032 REVIEW DATE: 1/26/03