Impairment-Related Work Expenses: What Qualifies and How to Claim

Impairment-related work expenses are out-of-pocket costs a person with a disability pays specifically so they can do their job, and common examples include sign language interpreters, screen readers and voice recognition software, hand controls installed in a commuting vehicle, wages for an on-site aide, and prescription medications that keep a disabling condition controlled well enough to work. These costs get unusually favorable treatment. They’re fully deductible without the percentage-of-income floor that limits ordinary medical expenses, and they can also reduce your countable earnings for Social Security disability purposes.

The tax code limits the deduction to a person with a physical or mental disability that creates a functional limitation to employment, or an impairment that substantially limits one or more major life activities such as walking, speaking, breathing, or learning.¹ Beyond the disability itself, each expense has to be necessary for you to work (not just helpful) and has to be an ordinary and necessary business expense under Section 162.² And the cost cannot be reimbursed by an employer, insurer, or any other source.

Attendant Care and Human Assistance at Work

Paying someone to help you perform your job or get through the workday is the clearest category. IRS Publication 529 specifically identifies attendant care at your place of employment as a qualifying expense.³ Concrete examples:

Sign language interpreters hired for meetings, training, and workplace interactions.
Readers who vocalize documents, emails, and correspondence for a visually impaired employee. Publication 529 gives the example of a blind taxpayer whose reader works both during and outside regular hours; the entire reader cost qualifies as long as the services are only for work.³
Job coaches and aides who help you perform essential functions your impairment otherwise prevents.⁴
Personal care attendants at the workplace who help with physical tasks during working hours.

The services have to be tied to earning income. Paying someone to cook and clean at your home doesn’t qualify, even with the same underlying disability.

Adaptive Equipment and Technology

Devices, software, and tools you buy or rent to work around your impairment on the job can qualify. Examples:

Screen readers, voice recognition software, magnification devices, and keyboards or input devices designed for limited mobility or vision.
Modified workstations such as a height-adjustable desk for a wheelchair user, an ergonomic setup prescribed for a musculoskeletal condition, or custom lighting for a visual impairment.
Specialized professional tools like a Braille embosser used to produce work documents or a modified microscope.
Costs for a service animal you need to perform your job, including food, veterinary care, and training.⁵
Prosthetic devices, wheelchairs, and disposable medical supplies like bandages or syringes that you need in order to work.⁵

Something that also serves personal life isn’t disqualified. The SSA has stated that a wheelchair’s cost is generally deductible even though it’s used for daily living, as long as it’s also necessary for work.⁵

Transportation and Vehicle Modifications

Ordinary commuting doesn’t count for anyone. But when your disability is the reason you can’t use the cheaper option, transportation becomes deductible. The SSA’s Program Operations Manual sets out the qualifying scenarios:⁴

Vehicle modifications required by your impairment, such as hand controls, a hydraulic wheelchair lift, or specialized seating. The modification cost is deductible, along with maintenance and repair of the modification and a mileage allowance for driving to and from work. The vehicle’s purchase price and general maintenance are not.
Mileage for driving an unmodified vehicle when your impairment prevents you from using available public transportation, with medical verification from a physician or vocational rehabilitation counselor.
Amounts paid to taxi services or personal drivers when you can neither use public transit nor drive yourself, again with medical verification.

If public transportation exists in your community and you can physically use it, choosing to drive doesn’t create an IRWE.⁴

Workplace and Home Office Modifications

Modifications you pay for out of pocket to make your workspace usable can qualify. In an employer’s facility, that might mean installing a ramp to reach your workspace, widening a doorway for wheelchair access, or adjusting counter or desk heights. Your employer must not have reimbursed you.

Self-employed individuals who work from home can deduct modification costs for the business portion of the home: grab bars in a home office bathroom, a widened doorway to a dedicated workspace, or an accessible workstation configuration. Only the share attributable to the business space counts. The Section 190 deduction for architectural barrier removal is capped at $15,000 per year for business property.¹

Medications and Ongoing Medical Care That Keep You Working

This is the category that surprises most people. Prescription drugs and routine medical services needed to control a disabling condition while you work can be IRWEs, not just ordinary medical expenses.⁵ The test is whether you need the medication or care to keep working: seizure medication, drugs that manage a psychiatric condition, or treatment that prevents flare-ups of a chronic illness so you can stay on the job. Doctor visits to monitor and adjust that treatment can count on the same principle.

Treating the cost as an IRWE is almost always better than treating it as a medical expense, because medical expenses on Schedule A are only deductible above 7.5% of adjusted gross income, while IRWEs face no such floor.

What Doesn’t Qualify

Some disability-related costs fail the “necessary for work” test:

Standard prescription eyeglasses or contact lenses, because most people who need them would wear them whether they worked or not.
General physical therapy that improves overall health but isn’t tied to a specific job function.
Home accessibility features outside a home office, such as a ramp at your front door or a stair lift in your personal residence.
Any cost reimbursed by Medicare, Medicaid, private insurance, or your employer. Partial reimbursement means you can only deduct the portion you actually paid.⁶

You also can’t claim the same dollar as both an IRWE and a medical expense on Schedule A.⁷

How to Claim the Deduction

The filing path depends on whether you’re an employee or self-employed. Congress eliminated most unreimbursed employee expense deductions starting in 2018, but IRWEs were never classified as miscellaneous itemized deductions in the first place and survived that change.²

W-2 Employees

Enter your IRWEs on Form 2106, then transfer the impairment-related portion to Schedule A, Line 16, under “Other Itemized Deductions.”³ Any other employee business expenses on that same Form 2106 that aren’t impairment-related are no longer deductible. Because IRWEs go on Schedule A, you have to itemize to get the benefit. For 2026, the standard deduction is $16,100 for single filers, $32,200 for married couples filing jointly, and $24,150 for heads of household.⁸

Self-Employed Taxpayers

Deduct IRWEs as ordinary business expenses on Schedule C (or Schedule E or F, depending on your business).³ This is an above-the-line deduction: it reduces adjusted gross income directly, lowers both income tax and self-employment tax, and doesn’t require itemizing.

How the Same Expenses Help With Social Security Benefits

If you receive SSDI or SSI, IRWEs do double duty. Social Security subtracts them from your gross earnings before deciding whether you’ve hit the substantial gainful activity threshold.⁶ For 2026, the monthly SGA limit is $1,690 for non-blind individuals and $2,830 for those who are statutorily blind.⁹

An example: gross monthly earnings of $1,900 with $300 in monthly IRWEs get counted as $1,600 in earnings, which is below the $1,690 non-blind SGA threshold. Without the deduction, the same earnings would cross SGA and could trigger a review of your continued SSDI eligibility. For SSI recipients, IRWEs reduce the income Social Security uses to calculate your monthly payment.⁶

You report the expense to SSA on Form SSA-821-BK (employees) or SSA-820-BK (self-employed). The field office verifies that the impairment behind the expense matches your established medical basis of disability or another impairment being treated by a healthcare provider, and it may contact your treating physician if the connection to your job isn’t obvious. You’ll need proof of payment and a signed statement confirming no one else reimbursed you.¹⁰

One boundary worth flagging: SSI recipients who are statutorily blind have a separate work incentive called Blind Work Expenses, which doesn’t require the expense to be related to blindness or any specific impairment and will usually deduct more from countable income than IRWEs alone.¹¹

Documentation to Keep

Claims without documentation get denied. Keep:

Receipts, invoices, canceled checks, or bank statements showing the date, amount, and purpose of each expense. For recurring costs like attendant wages, keep a log of dates, hours, and the specific tasks performed.
A written statement from your physician or other qualified provider certifying your impairment and confirming that the expense is necessary for you to perform your job. This is the document that ties the expense to the disability and the disability to work.
Records showing that no employer, insurer, or government program paid for or reimbursed the cost.

The IRS generally requires you to keep tax records for three years from the date you filed or the return’s due date, whichever is later; that window extends to six years if you underreport income by more than 25%.¹² For Social Security purposes, hold IRWE receipts indefinitely. The SSA can request verification of past deductions when reviewing your benefit eligibility, and failing to produce documentation may mean paying back additional SSI benefits you received because of the IRWE reduction.

1
Office of the Law Revision Counsel. 26 U.S. Code 190 – Expenditures to Remove Architectural and Transportation Barriers to the Handicapped and Elderly
2
Office of the Law Revision Counsel. 26 USC 67 – 2-Percent Floor on Miscellaneous Itemized Deductions
3
Internal Revenue Service. Publication 529 – Miscellaneous Deductions
4
Social Security Administration. SSA POMS DI 10520.010 – Definitions
5
Social Security Administration. SSI Spotlight on Impairment-Related Work Expenses
6
Choose Work! (Social Security). Impairment-Related Work Expenses
7
Internal Revenue Service. Publication 502 – Medical and Dental Expenses
8
Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
9
Social Security Administration. Substantial Gainful Activity
10
Social Security Administration. SSA POMS – Verifying and Documenting Issues of IRWE
11
Choose Work! (Social Security). Social Security Work Incentives for People Who Are Blind
12
Internal Revenue Service. Topic No. 305, Recordkeeping