[Code of Federal Regulations]
[Title 20, Volume 2]
[Revised as of April 1, 2006]
From the U.S. Government Printing Office via GPO Access
[CITE: 20CFR416.269]

[Page 847-848]
 
                      TITLE 20--EMPLOYEES' BENEFITS
 
               CHAPTER III--SOCIAL SECURITY ADMINISTRATION
 
PART 416_SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED
--Table of Contents
 
                          Subpart B_Eligibility
 
Sec.  416.269  What is done to determine whether your earnings are too 
low to provide comparable benefits and services you would receive in 
the absence of those earnings.

    (a) What we determine. We must determine whether your earnings are 
too low to provide you with benefits and services comparable to the 
benefits and services you would receive if you did not have those 
earnings (see Sec.  416.265(d)).
    (b) How the determination is made. In determining whether your 
earnings are too low to provide you with benefits and services 
comparable to the benefits and services you would receive if you did not 
have those earnings, we compare your anticipated gross earnings (or a 
combination of anticipated and actual gross earnings, as appropriate) 
for the 12-month period beginning with the month for which your special 
SSI eligibility status is being determined to a threshold amount for 
your State of residence. This threshold amount consists of the sum for a 
12-month period of two items, as follows:
    (1) The amount of gross earnings including amounts excluded under 
Sec.  416.1112(c) (4), (5) and (7) that would reduce to zero the Federal 
SSI benefit and the optional State supplementary payment for an 
individual with no other income living in his or her own household in 
the State where you reside. This amount will vary from State to State 
depending on the amount of the State supplementary payment; and
    (2) The average expenditures for Medicaid benefits for disabled and 
blind

[[Page 848]]

SSI cash recipients, including recipients of federally administered 
State supplementary payments only, in your State of residence.
    (c) How the eligibility requirements are met. (1) You meet the 
requirements in Sec.  416.265(d) if the comparison shows that your gross 
earnings are equal to or less than the applicable threshold amount for 
your State, as determined under paragraphs (b) (1) and (2) of this 
section. However, if the comparison shows that these earnings exceed the 
applicable threshold amount for your State, we will establish (and use 
in a second comparison) an individualized threshold taking into account 
the total amount of:
    (i) The amount determined under paragraph (b)(1) of this section 
that would reduce to zero the Federal SSI benefit and State 
supplementary payment for your actual living arrangement;
    (ii) The average Medicaid expenditures for your State of residence 
under paragraph (b)(2) of this section or, if higher, your actual 
medical expenditures in the appropriate 12-month period;
    (iii) Any amounts excluded from your income as impairment-related 
work expenses (see Sec.  416.1112(c)(6)), work expenses of the blind 
(see Sec.  416.1112(c)(8)), and income used or set aside for use under 
an approved plan for achieving self support (see Sec.  416.1112(c)(9)); 
and
    (iv) the value of any publicly-funded attendant care services as 
described in paragraph (d) of this section (including personal care 
assistance).
    (2) If you have already completed the 12-month period for which we 
are determining your eligibility, we will consider only the expenditures 
made in that period.
    (d) Attendant care services. Expenditures for attendant care 
services (including personal care assistance) which would be available 
to you in the absence of earnings that make you ineligible for SSI cash 
benefits will be considered in the individualized threshold (as 
described in paragraph (c)(1) of this section) if we establish that they 
are:
    (1) Provided by a paid attendant;
    (2) Needed to assist with work-related and/or personal functions; 
and
    (3) Paid from Federal, State, or local funds.
    (e) Annual update of information. The threshold amounts used in 
determinations of sufficiency of earnings will be based on information 
and data updated no less frequently than annually.

[59 FR 41404, Aug. 12, 1994; 59 FR 49291, Sept. 27, 1994]