Earned and Unearned Income, Work Incentives, and SSI
Work incentives in the table below are light red.
| STEP 1 | ||
|
Unearned Income |
$________ | |
|
Subtract General Exclusion |
– $20.00 | |
|
Equals Countable Unearned Income |
= $________ | |
| STEP 2 | ||
| Earned Income (Gross Wages) | $______ | |
| Subtract Student Earned Income Exclusion | – $ _____ _ | |
|
Equals New Countable Earned Income |
= $_______ | |
| Subtract Earned Income Exclusion (subtract an additional $20 if GE was not used in Step 1) | – $ 65.00 | |
|
Equals New Countable Earned Income |
= $_______ |
|
| Subtract Impairment Related Work Expense | – $ _____ _ | |
|
Equals New Countable Earned Income |
= $_______ |
|
| Divide by 2 | รท 2 | |
| Division answer | = $________ | |
| Subtract Division answer from New Countable Earned Income | – $________ | |
|
Equals New Countable Earned Income |
= $_______ |
|
| Subtract Blind Work Expense (if blind) | – $ _____ _ | |
|
Equals New Countable Earned Income |
= $_______ |
|
| STEP 3 | ||
|
Total Countable Unearned Income
(from Step 1) |
$_______ | |
|
Plus Total New Countable Earned Income (from Step 3) |
+ $_______ | |
|
Equals New Countable Earned and Unearned Income |
= $_______ |
|
| STEP 4 | ||
| Total New Countable Earned and Unearned Income (from Step 3) | $_______ | |
| Subtract PASS Plan (if approved) | – $ _____ _ | |
|
Equals Newest Total Countable Income |
= $_______ |
|
| STEP 5 | ||
| SSI FBR (includes any State Supplement) | $________ | |
| Subtract Total Countable Income (from Step 4) | – $________ | |
|
Equals New Adjusted SSI Payment |
= $_______ |
|