Have you ever done the math on someone else’s life and wondered how they keep going? That was the question I kept asking myself when I sat down with Monique Washington, 43, at a diner booth in East Baltimore on a Tuesday afternoon in early March 2026. She had just finished an overnight shift driving for UPS. Her coffee sat untouched for the first ten minutes because she was too busy talking.
Monique is not a person who complains. That much was clear almost immediately. She is the kind of woman who, when you ask how she’s doing, says “fine” and means it — not because things are fine, but because fine is the only gear she has left. What I uncovered over the course of two hours was not a story of crisis in the dramatic sense. It was quieter than that, and in some ways harder to look at.
A Brother, a Crash, and a Life She Didn’t Plan For
When Monique’s younger brother, Darius, was 25, he was hit by a drunk driver on I-695. The accident left him with a traumatic brain injury and significant physical limitations that require daily assistance. That was 18 years ago. Their mother died four years after the accident. Their father followed three years after that. Monique, then in her early thirties and newly settled into her UPS route, became the default caregiver — the only one left.
“Nobody sat me down and said, ‘This is your job now,'” she told me, stirring her coffee slowly. “It just became true. And once it was true, there was no version of my life where it wasn’t.”
Darius receives Social Security Disability Insurance through the Social Security Administration, which provides him approximately $1,340 per month — close to the 2025 national average SSDI payment. He also has Medicaid coverage through Maryland’s managed care program. On paper, that sounds like a foundation. In practice, Monique told me, the gaps are where the money bleeds out.
Medicaid, Monique explained, covers Darius’s physician visits and most prescriptions. What it does not reliably cover: the accessible van transportation he needs for medical appointments outside the standard transit window, the incontinence supplies that exceed the monthly allotment, and the supplemental personal care aide hours when his state-approved home health aide calls out sick. Monique fills those gaps herself — roughly $750 to $850 per month, depending on the season.
What the Numbers Look Like From Inside the Budget
Monique earns a solid income. As a tenured UPS Feeder driver with Teamsters Local 355 representation, she clears approximately $72,000 annually after taxes — a wage that, in many American cities, would signal financial stability. In Baltimore, with a mortgage and a dependent adult to support, it stretches thin in ways the raw number doesn’t reveal.
She walked me through her monthly fixed costs without hesitation, the way someone does when they’ve run the numbers so many times the figures have become reflexive. Mortgage: $1,480. Utilities and internet: $310. Her own car note and insurance: $520. Groceries for two: $650. Darius’s uncovered care costs: $800. That’s $3,760 before she accounts for clothing, her own medical care, or anything resembling a personal expense.
“People hear ‘union wages’ and they think you’re comfortable,” Monique told me flatly. “And I am comfortable — for Darius. My retirement account hasn’t been touched in four years. I haven’t had a real vacation since 2019. I don’t say that looking for pity. I say it because I want people to understand that the math doesn’t lie.”
She has not contributed to her Teamsters pension supplement or her personal IRA since 2021. At 43, she is acutely aware of what that means for her own future — even if she mostly sets that awareness aside to get through the week.
Navigating the Benefits System — What She Found and What She Missed
When I asked Monique what she had done to seek relief through government programs, she paused for a long moment. “I tried,” she said. “I really did. But those websites — I couldn’t tell if I was eligible for anything or if I was just reading in circles.”
This is a pattern I’ve reported on before. The programs that exist for caregivers and their dependents are real — but the eligibility pathways are fragmented across federal, state, and county agencies in ways that make navigation genuinely difficult for working adults without dedicated time to research.
What I found, in reporting around Monique’s situation, is that there were at least two federal tax provisions she had never applied. The first is the Credit for Other Dependents — a non-refundable credit of up to $500 for qualifying dependents who don’t meet the child tax credit criteria, which can include adult siblings with disabilities under certain conditions. The second is the Medical Expense Deduction under IRS Publication 502, which allows taxpayers to deduct qualifying unreimbursed medical and care costs exceeding 7.5% of their adjusted gross income.
Darius’s accident occurred at 25 — one year before the ABLE Act’s onset-before-age-26 threshold. He technically qualifies. Monique had never heard of an ABLE account. When I mentioned it, she set down her coffee and stared at me. “You’re telling me that’s been available this whole time?” she asked. I told her I was telling her what the program exists — but that she would need to speak with a benefits counselor or tax professional about whether and how it applied to her family’s specific situation.
The Turning Point — And What It Actually Changed
In January 2026, Monique was referred by a coworker to a nonprofit benefits navigator at the Baltimore City Department of Social Services. The navigator spent two sessions reviewing her family’s full picture — Darius’s SSDI, Medicaid coverage, her income, and the out-of-pocket costs she had been absorbing for years.
The navigator identified two immediate actions: applying for expanded home care hours through Maryland’s Community First Choice program, and reviewing Monique’s prior three tax years with a volunteer tax preparer through the IRS’s VITA program to assess whether unclaimed deductions had been left on the table.
“She sat there and just laid it out,” Monique told me. “Like, here are the things you might be eligible for, here are the things you definitely aren’t, and here’s what we need to do next. Nobody had ever done that before. I’d always just been on my own with it.”
The Community First Choice application was still pending as of our conversation in early March. The VITA review found that Monique may have been eligible to claim Darius as a qualifying relative dependent for at least two of the past three tax years — which could mean amended returns and a modest recovery. She was waiting on confirmation from the preparer when we spoke.
The outcomes are mixed, as they often are in these situations. There is no program that retroactively gives Monique her vacation years back or restores what she didn’t contribute to retirement. The systems that exist were built with narrower assumptions about who needs help and who is visibly struggling.
What Monique’s Story Reveals About the Caregiver Relief Gap
According to the CDC’s caregiver data, roughly 53 million Americans provide unpaid care to an adult or child with special needs. A significant portion of those caregivers are also full-time wage earners — people like Monique who earn too much to qualify for direct public assistance but not enough to comfortably cover the costs that fall outside what Medicaid and SSDI are designed to handle.
The federal tax code offers some relief in the form of credits and deductions, but claiming them requires knowing they exist, understanding the eligibility rules, and having the time to navigate filings that most working caregivers don’t have. The ABLE Act, passed in 2014, created a meaningful tool — but awareness remains low, particularly in communities where the families who need it most are also the least likely to have access to a financial planner who would mention it.
When I asked Monique what she would tell another caregiver in her position — someone juggling a demanding job and a dependent family member — she didn’t hesitate. “Find a navigator. Don’t try to do it by yourself on a government website at midnight. There are people whose actual job is to help you figure this out. I just wish I’d found one ten years ago.”
I left that diner thinking about the invisible infrastructure of American working life — the millions of people holding up someone else while quietly wondering who is holding them up. Monique Washington drives her route, fills her brother’s prescriptions, pays her mortgage, and goes to bed most nights without complaining to anyone. She didn’t choose this life so much as it chose her. What she’s choosing now, finally, is to stop navigating it alone.
This story is reported for informational purposes. Nothing in this article constitutes financial, legal, or benefits advice. Readers are encouraged to consult a certified benefits planner, licensed tax professional, or their state’s social services agency for guidance specific to their situation.
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