In 1999, Congress passed and the President signed the Ticket to Work and Work Incentives Improvement Act. Through this Act, the Social Security Administration (SSA) created a new system of vocational rehabilitation services for beneficiaries of Social Security. This new system is called the Ticket to Work Program. In order to access this new system in a meaningful way, it is important for beneficiaries of Social Security to understand the purposes of this new system, how this system works, and a beneficiary's rights under the system. This article will spell out this important information so that any Social Security beneficiary, including those living with HIV/AIDS, interested in working can make an informed choice about participating in this new program.
The purpose of the Ticket to Work Program is not to force individuals receiving Social Security into the workforce. Rather, this program represents a serious attempt by the Social Security Administration to provide meaningful assistance to those beneficiaries interested in finding employment. This is one of the main reasons why individuals who identify with the disability rights community (including individuals from the HIV/AIDS service community) have supported this legislation and have been heavily involved in its implementation.
Another purpose of this legislation is to save the federal government money. According to the U.S. General Accounting Office, less than one percent of Social Security beneficiaries leave the rolls each year as a result of employment. If another one-half of one percent of those receiving Social Security were to leave the rolls, as a result of paid employment, the federal government would save $3.5 billion over the work-life of those individuals. Through the successful employment placement of beneficiaries utilizing this new Ticket Program, the federal government hopes to realize these savings.
Under the Ticket to Work Program, most beneficiaries of Social Security will receive a document in the mail called a "ticket." This ticket enables the beneficiary to seek employment services from entities designated by Social Security as Employment Networks (EN). The medical conditions of all beneficiaries of Social Security are given the designation of medical improvement expected, medical improvement possible, or medical improvement not expected. Beneficiaries whose condition is designated as medical improvement expected will only receive a ticket after they have had a continuing disability review (CDR) and been determined still disabled. Most, if not all, individuals receiving Social Security due to HIV-related illness have had their conditions designated as medical improvement not expected and will receive tickets.
If an EN accepts a beneficiary's ticket, the EN will assist that individual in finding employment. This program is entirely voluntary. A beneficiary can choose whether or not to participate in this program. This is not an attempt by the Social Security Administration to force beneficiaries to work. At the same time, an EN network can choose whether or not it wants to work with a beneficiary on finding employment. An EN cannot be forced to assist a beneficiary who requests services. (The one exception to this rule involves the state vocational rehabilitation agency. These agencies must make eligibility determinations under the rules established by the Rehabilitation Act. )
The Social Security Administration has contracted with a private company, Maximus, to administer the Ticket to Work Program. Among other things, Maximus distributes the tickets, recruits employment networks, tracks the assignment of tickets, and provides referrals to beneficiaries with questions about the program. To contact Maximus, call their toll free number at (866) 968-7842.
The Ticket to Work Program is being implemented throughout the country in three phases (contact Maximus to determine which phase for your state). Those Social Security beneficiaries living in "first phase" states should have already received their tickets in the mail. For those living in "second phase" states, distribution of tickets should begin in November of this year. In third phase states, beneficiaries should receive their tickets in 2003. Tickets are distributed over a four-month period, based upon the last digit of a beneficiary's Social Security number. However, if tickets are being distributed in a particular beneficiary's state, that beneficiary can request his or her ticket at any time during the distribution. Maximus has been very good at responding to the requests in phase 1 states.
For a beneficiary of Social Security, making the decision to become employed is a difficult one. The rules on how employment income will affect public benefits are complicated and confusing. However, no beneficiary of Social Security should accept a job without understanding exactly how the income from that job will impact his or her Social Security cash benefits, Medicare, Medicaid, any housing subsidy, and state benefits, such as Food Stamps.
Fortunately, SSA has funded projects throughout the United States and its territories whose main purpose is to assist beneficiaries in understanding the impact of employment income on their public benefits. These projects are called Benefits Planning, Assistance, and Outreach projects. Trained benefits planners, who provide written benefits analysis reports to individuals, staff these projects. These written reports provide an individualized assessment of how employment income will affect the public benefits of the beneficiary. No beneficiary of Social Security should begin working without first obtaining this information from a benefits planner. A list of benefits planners throughout the United States and its territories is listed at www.ssa.gov/work/ServiceProviders/statebystate.html and with the local Social Security office.
ENs (except the state vocational rehabilitation agency) involved in the Ticket to Work program only get paid for working with a beneficiary if that beneficiary works at an income level that eventually disqualifies him or her from receiving cash benefits from SSA. Therefore, before deciding to use a ticket, a beneficiary must decide if he or she is willing to stop receiving cash benefits from Social Security. An EN will not be interested in assisting beneficiaries who want to continue receiving any level of cash benefits from Social Security because they won't receive compensation for working with such individuals. If a beneficiary decides that they do not want to work at a level that disqualifies them from benefits, that beneficiary should not participate in this new program. However, beneficiaries can still participate in the state vocational rehabilitation programs, which do not require that a person work at a level that disqualifies them from receiving Social Security benefits.
For most individuals on Social Security, maintaining their health insurance (Medicare or Medicaid) is their primary or only concern. There are ways to keep this insurance and work at a level where the cash benefits stop. Therefore, a person can decide to use their ticket, disqualify themselves from cash benefits, and maintain their health insurance. Again, the benefits planners can assist beneficiaries making these important decisions.
Once a beneficiary has decided that they are willing to stop receiving cash benefits and want assistance in finding employment, the beneficiary can begin the process of placing his or her ticket with an EN. The beneficiary should first find the ENs serving his or her area. In order to do this, the beneficiary should contact the Program Manager at Maximus, and request a complete listing of networks in the geographical area. In addition, the Maximus website, www.yourtickettowork.com, lists the ENs by geographical area.
After receiving the list of ENs, the beneficiary should contact all the ENs in his or her area. When calling the EN, the beneficiary should ask to speak to the staff person dealing with the Ticket to Work Program. This staff person will probably ask a series of questions to determine if the services they offer meet the needs of the beneficiary. During this time, the beneficiary should be asking the staff person specific questions about their services to see if these services match the beneficiary's employment goal. Both the beneficiary and the EN will make a decision on whether or not placing the ticket with that agency will benefit the beneficiary and the agency. Remember, both the beneficiary and the EN have the right to choose who they will accept.
If an EN and beneficiary agree to work together, the parties must create an Individualized Work Plan (IWP). The IWP is then submitted to Maximus. The IWP spells out exactly what the EN will do and what the beneficiary will do to reach an employment goal. It is very important that the beneficiary participate in creating this plan. The ticket is not officially placed with the EN until this IWP is submitted to Maximus. Therefore, the beneficiary has the power to reject this IWP and cannot be forced to participate in a plan. If the parties cannot agree on a plan, the beneficiary can simply stop working with that EN and search for a new EN.
Once a beneficiary places their ticket with an EN, he or she should begin working on his or her employment goal by following the directives of the IWP. While this is being done, SSA will measure the beneficiary's progress towards employment. During the first twenty-four months of the plan, there is no work requirement. During months 25-36, the beneficiary should earn a gross income over the substantial gainful activity amount (SGA; $780 per month in 2002) for three months. During months 37-48, the beneficiary should earn a gross income over SGA for six out of twelve months. During months 49-60 of the plan, the beneficiary should earn a gross income that disqualifies him or her from receiving SSDI or SSI.
If a beneficiary meets these goals, he or she is considered to be making "timely progress" under the program. When a beneficiary has placed the ticket and is making timely progress, SSA cannot conduct a Continuing Disability Review (CDR) of the beneficiary's current medical condition. A CDR occurs for most beneficiaries every three or seven years. The CDR involves a request for current documentation of a beneficiary's medical condition. Once this documentation is collected, SSA reviews the documentation to determine if the beneficiary still qualifies for Social Security payments. If a determination is made that the beneficiary is no longer eligible for Social Security, benefits cease. One of the advantages of using a ticket for a beneficiary is that he or she will not be subjected to a CDR while the ticket is in use and timely progress is being made.
If a beneficiary fails to be make "timely progress," it does not mean that he or she will be withdrawn from the Ticket to Work Program or automatically lose benefits. This is very important to understand. The Ticket to Work Program is voluntary and there is no negative consequence to an individual's benefits if he or she tries to participate in the program and is unsuccessful. Rather, the only consequence of failing to make progress under the Ticket Program is the beneficiary will lose the CDR protection explained above. In other words, the beneficiary would be subjected to the CDR that he or she would have had anyway if he or she did not participate in the program.
If a beneficiary is dissatisfied with the services that he or she is receiving from an EN, the beneficiary has two options. First, the beneficiary can choose to utilize the dispute resolution system created by SSA. If the EN is the state vocational rehabilitation agency, the beneficiary can also file an appeal under their pre-existing system. Second, the beneficiary can pull the ticket from the EN and try to place the ticket with another EN. If the beneficiary pulls the ticket, he or she has three months to find a new EN without losing the CDR protection described above.
Any beneficiary who needs more information about this new system or who is dissatisfied with the services provided to him or her by an EN should contact the state PABSS (Protection and Advocacy for Beneficiaries of Social Security) Project. The PABSS Advocates in Illinois can be reached at 1-800-537-2632. All PABSS Projects around the country are listed at www.ssa.gov/work/ServiceProviders/PADirectory.html or can be reached by contacting the local Social Security office.
The SSA Ticket to Work Program represents an important step toward assisting beneficiaries of Social Security in securing and maintaining meaningful employment. In its present form, this system may not work for all beneficiaries of Social Security and many beneficiaries may choose not to participate in this program. However, for HIV/AIDS impacted beneficiaries who are ready to return to the workforce and forego receiving cash benefits, the Ticket Program can be a helpful means for receiving needed support and services to get there.
John Coburn is the PABSS Project Manager and staff attorney for Equip for Equality, Inc of Chicago. This article, his second for Positively Aware, is based upon a document entitled "Checklist for Using Your Ticket to Work," developed by Coburn, Sue Augustus and Marsie Frawley of the SSI Coalition.