1099-R. We took out 20,000, My wife had emergency back surgery. She was out of work 15 weeks. Is there any way to show the hardship? Or get some sort of deduction.

It depends.

If your unreimbursed medical expenses were over 7.5% of your adjusted gross income, you may be able to exclude this portion and exclude it from the 10% early distribution penalty.

You should enter your 1099-R information.  TurboTax will ask you questions to determine if any of the distribution can be excluded from the early distribution penalty. 

Exceptions to an early withdrawal penalty

Exceptions to early withdrawal penalty on 401(k)

You should also pick up your wife's medical expenses under the Deductions and Credits section.  If you are able to itemize your deductions, you may be able to take a deduction for the unreimbursed medical expenses.

See the information from the TurboTax FAQ linked below that explains what qualifies for a hardship distribution.  It sure sounds like you'd qualify, but the FAQ does say that your employer and the plan custodian would have to approve of your distribution.

Can I make a hardship withdrawal from my 401-K? 

The early withdrawal penalty, however, is another story.  If you're under 59 1/2, you will be penalized 10% unless you qualify for an exception from the penalty.  See the info linked below.

What are the exceptions to the penalty for an early withdrawal from my 401-K? 

After you enter your 1099-R, the TurboTax program will ask you questions to see if you can avoid the penalty.

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