The filing deadline for the 2025 tax year is April 15, 2026 — and for family caregivers who support disabled relatives, that window represents one of the few moments each year when some of what they’ve quietly spent can be partially recovered. When I sat down with Monique Washington last month at a diner near her home in Baltimore’s Belair-Edison neighborhood, she had just gotten off a ten-hour shift and was still in her brown UPS uniform. She had a folder of receipts on the table. She’d never brought receipts to a tax appointment before.
Monique is 43 years old. She has driven for UPS for fourteen years, earns roughly $78,000 annually with overtime, and belongs to the Teamsters union. By most measures, she is financially stable. By her own accounting, she is one car repair away from not making rent.
A Brother’s Accident, a Family’s Silence, and One Woman Left Holding It All
Monique’s younger brother, Darius, was 25 when a driver ran a red light in 2011 and hit the car he was a passenger in. He sustained a traumatic brain injury and spinal damage that left him with permanent cognitive and mobility limitations. He requires daily assistance with basic tasks. He cannot drive. He cannot hold consistent employment.
Their parents were both alive when the accident happened, and for several years the caregiving was shared. Their mother passed in 2018, their father in 2021. With no other siblings and no extended family nearby, Monique became — in her words — “the plan.”
Darius currently receives Social Security Disability Insurance. Because his work history was limited at the time of his injury — he’d been working part-time and attending community college — his monthly benefit is approximately $1,090, well below the Social Security Administration’s 2025 average SSDI payment of $1,537. He is also enrolled in Maryland Medicaid, which covers his primary physician visits and a portion of his in-home aide hours.
The portion Medicaid doesn’t cover is where Monique’s budget disappears.
Where the Money Goes, Line by Line
Monique tracked her expenses for the first time when she prepared for our conversation. She itemized three categories: supplemental in-home care hours beyond what Maryland Medicaid’s Community First Choice waiver covers, accessible transportation for Darius’s medical appointments and therapy sessions, and medical supplies — adaptive equipment, wound care materials, incontinence products — that Medicaid reimburses inconsistently or not at all.
- Supplemental aide hours: approximately $480/month, covering roughly 30 hours of additional care Medicaid does not authorize
- Accessible transportation: approximately $260/month for medical transport and non-emergency rides Medicaid’s transportation benefit doesn’t reach
- Medical supplies and adaptive equipment: approximately $340/month, including a $1,200 wheelchair cushion she purchased last fall after Medicaid denied the claim twice
- Miscellaneous care-related costs (dietary supplements, home modifications, over-the-counter medications): approximately $180/month
That total — roughly $1,260 to $1,400 per month — comes directly from Monique’s paycheck. Over the course of a year, it approaches $17,000. She hasn’t made a contribution to her Teamsters pension supplement in four years. She cashed out a small 401(k) in 2022 to cover a plumbing emergency and a broken hospital bed motor in the same month.
The Tax Appointment That Changed One Number — Not the Whole Picture
For years, Monique filed her taxes the same way: standard deduction, single filer, done in under an hour. She didn’t think she qualified for anything special. When her coworker mentioned a tax preparer in Towson who specialized in caregiving situations, Monique made an appointment mostly out of curiosity.
What the preparer found shifted her refund significantly — though not enough to resolve the larger problem. Because Monique provides more than half of Darius’s financial support and he meets the IRS’s qualifying relative definition, she was eligible to file as Head of Household and claim the Credit for Other Dependents, worth $500. More importantly, the preparer identified that Monique’s unreimbursed medical expenses paid on Darius’s behalf — totaling approximately $8,400 for 2024 — exceeded the 7.5% of adjusted gross income threshold required to itemize medical deductions under IRS Publication 502.
She also learned about ABLE accounts — tax-advantaged savings accounts for people with disabilities that don’t count against SSI or Medicaid eligibility asset limits. Darius could theoretically hold up to $100,000 in an ABLE account without jeopardizing his benefits. Monique had never heard of them.
What the Numbers Recovered — and What They Couldn’t
The 2024 tax filing ultimately returned Monique approximately $2,800 more than she would have received under her previous approach. It was the largest refund she had seen in a decade. She used $1,400 to pay down a medical credit card she’d opened in 2023 to cover Darius’s adaptive shower chair and grab bar installation. The remaining $1,400 went into a small emergency fund she is trying to rebuild.
She did not put anything toward retirement. She is 43 years old and has, by her own estimate, less than $12,000 in any retirement account.
When I asked Monique whether she resented the position she found herself in, she went quiet for a moment. She picked up her coffee cup, set it back down without drinking from it.
She told me she hasn’t taken a real vacation since 2019, when she and a friend drove to Virginia Beach for three days and she spent most of it on the phone arranging Darius’s temporary care coverage. She said she’s not looking for sympathy. She’s looking for a system that doesn’t require her to choose between his present and her future.
The Larger Gap No Tax Credit Closes
Monique’s situation reflects a structural reality in how disability benefits are designed in the United States. SSDI payments are calculated based on a recipient’s lifetime earnings record — meaning younger people who acquire disabilities before accumulating significant work history receive lower benefits, often far below what independent living actually costs.
Monique told me she plans to file on time this April, using the same preparer from Towson. She’s already collected twelve months of receipts in a folder — the same one she brought to our meeting. She is hoping the deductible medical expenses will again exceed the 7.5% threshold. She is not counting on it.
When I left the diner, Monique was already on her phone — not scrolling, but on a call, her voice dropping to the low, patient register of someone explaining a medication schedule to a home aide. She waved goodbye with one hand without looking up. She had another shift starting at 5 a.m.
The folder of receipts sat on the table until she scooped it up on her way out. She’s keeping it this time.
Related: Claiming Social Security at 62 Feels Smart Until You See What It Actually Costs You Over 20 Years
Related: I Watched My Tax Refund Stay ‘Approved’ for 31 Days — What the IRS Status Screen Isn’t Telling You
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