I have a Dallas bankruptcy law client that needs to have major dental work done that she’s been putting off for 2 years. Now she has to have them done and she needs to have 6 implants and other work at a tune of $20k. She went in early May and started her treatment – out of pocket cost $1200. The treatment will continue for the next 5 months. She’s had ongoing problems with her teeth and gum most of her life and I can document this. She doesn’t pass the bankruptcy Means Test – unless I can include approximately $700 in medical expenses. IMHO, line 31 is looking at the medical expenses averaged over the six months. HOWEVER, this case is exactly what Congress meant by special circumstances on the bankruptcy means test – such as a serious medical condition. Get documents from the dentists that these procedures are medically necessary – show that there are no reasonable alternatives – and show how these additional expenses required by the special circumstance reduces DMI to less than the presumptive amount. Indicate these expenses on line 56. She is planning to pay for all of her dental expenses regardless of discharge because it’s a dentist she’s had a long standing relationship with and wants to continue to be under her care. Also, she would have to be current on her bills before the dentist performs the next phrase of the treatment.