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by John Coburn
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 Purposes Behind the
Ticket to Work 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.
How the Ticket to Work
Program Works
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.
Using the Ticket to Secure
Meaningful Employment
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.
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...this program represents
a serious attempt by the Social Security Administration
to provide meaningful assistance to those beneficiaries
interested in finding employment.
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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.
Rights and Responsibilities
of the Beneficiary Under the Ticket to Work Program
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.
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For most individuals
on Social Security, maintaining their health insurance (Medicare
or Medicaid) is their primary or only concern.
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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.
Conclusion
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.
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