FINAL TICKET REGULATIONS ARE OUT!
December 28, 2001, the final ticket regulations were published in the Federal
Register. You can get the entire
text of the regulations at
were not significant changes in the final regulations.
SSA clarified some of the regulations in response to comments.
Here are some highlights of the final regulations:
SSA did not change the eligibility guidelines for the ticket.
Although SSA received many comments requesting that transition age
youth and beneficiaries with a medical diary designation of medical
improvement expected, be eligible for tickets, SSA did not change the rules to
allow these groups to automatically receive a ticket.
SSA is asking the public for suggestions on how to better serve
transition age youth. You can
submit your comments to SSA by February 26, 2022 at TTWWIIA@ssa.gov,
or directly on the SSA website at http://policy.ssa.gov/si/ttwwiia.nsf
SSA clarified that a beneficiary is only entitled to one ticket per
period of disability, but if a beneficiary loses entitlement to
benefits and is later reinstated to benefits under expedited reinstatement,
the beneficiary is entitled to another ticket in the first month they are
entitled to reinstated benefits.
SSA also clarified that both SSDI and SSI beneficiaries must be
receiving cash benefits in order to receive a ticket.
SSA clarified that only an individual eligible for VR services may
assign the ticket to a VR agency, and that a VR agency must cease providing
services to individuals who are no longer for VR services.
The timely progress guidelines for using a ticket are only used by SSA
to determine whether a beneficiary is using a ticket for purposes of
protection against initiation of a medical continuing disability review (CDR).
Beneficiaries who do not meet the timely progress guidelines may
still participate in the Ticket to Work program, receive services and generate
outcome and milestone payments to Employment Networks (ENs).
However, these beneficiaries may be subject to CDRs.
SSA modified its
regulation to allow a beneficiary who has worked in months during the initial
24 month period to use those months of work to meet the work requirements of
the first 12 month progress review period if the work was done at the
SSA made changes to indicate that a State VR agency which selects the
cost reimbursement payment system may be eligible for payment under that
system even though the beneficiary is determined to be no longer using a
ticket. SSA also made changes to
indicate that an EN or State VR agency serving a beneficiary as an EN may
receive milestone or outcome payments for which it is eligible even though the
beneficiary is considered to be no longer using a ticket.
Beneficiaries who do not meet the timely progress guidelines may
continue to receive services from their service providers.
This appears to be a fairly significant change, since it means that
if the beneficiary cannot meet the timely progress guidelines, there is still
an incentive for the EN or State VR agency to continue to provide services as
SSA will still be able to make milestone or outcome payments.
SSA will provide the Program Manager – Maximus – with a list of all
ticket-eligible beneficiaries by geographic area and disability impairment.
Maximus will provide, within the limitations of the Privacy Act, the
ENs, with information from this list for beneficiaries eligible to receive
tickets in their area. Maximus
will encourage ENs to use the lists to market their services with the
- Maximus will be responsible for making determinations regarding the
allocation of outcome or milestone payments when the beneficiary has been
served by more than one EN.
- SSA clarified that friends or family who meet the qualifications to be
an EN can apply to be an EN, but an individual cannot serve as his or her
own EN. SSA noted that the
legislation requires some level of education, experience, or expertise in
providing employment related services, and does not permit SSA to use, as an
EN, providers with no demonstrated qualifications or experience in providing
or arranging for these types of services.
- Potential ENs must comply with all relevant State laws that govern
entities that provide employment services, vocational rehabilitation services
and other support services.
- A State VR agency is precluded from being paid under the cost
reimbursement payment system if an EN or a State VR agency serving a
beneficiary as an EN has been paid by SSA under one of the EN payment systems
with respect to the same ticket. Likewise,
if a State VR agency has been paid by SSA under the cost reimbursement system
with respect to a ticket, such payment precludes any subsequent payment by SSA
under one of the EN payment systems based on the same ticket.
- A beneficiary who is receiving services from a State VR agency
under an existing IPE when he or she receives their ticket should have the
opportunity to make an informed choice regarding their decision to assign
their ticket to the VR agency. Thus
the State VR agency cannot require a beneficiary to assign their ticket to the
- SSA clarified that although the agreements that State VR agencies must
sign with ENs regarding referrals should be broad-based, a State VR agency may
enter into an individualized agreement with an EN to meet the needs of a
single beneficiary if both wish to do so.
SSA does not have the authority to require an EN to enter into an
agreement with a State VR agency unless the EN is going to make a referral of
beneficiaries to a State VR agency for services.
- Payment systems – In response to the number of comments on
this section, SSA made four changes.
SSA can pay an EN for services it rendered after a beneficiary
reassigns the ticket to another EN. Maximus
will determine the allocation of payment to more than one EN.
ENs may receive funding from other sources.
This clarification may be helpful for ENs who have other local, state
or federal contracts to provide employment services.
SSA did not make any changes in the dispute resolution section of the
- First, SSA added two milestones.
The first additional milestone is met when the beneficiary works for
one calendar month and gross earnings for that month over the SGA threshold
amount. The other additional
milestone, which is actually the fourth milestone, is met when the beneficiary
works for 12 calendar months within a 15 month period and has gross earnings
for each of those 12 months that are more than SGA.
- Second, they doubled the total value of the potential milestone
payments. The total value of the
milestone payments is approximately 20 percent of the potential payments
possible under the milestone-outcome payment system.
In terms of the 2001 payment amounts this would be approximately $3,096
for SSDI beneficiaries and $1,874 for SSI beneficiaries.
- Third, SSA spread, over 60 months, as opposed to 12, the outcome
payments reductions made on account of the milestone payments received.
- Fourth, SSA substituted a flat outcome payment rate of 34
percent for the graduated monthly outcome payments proposed.
final regulations are effective January 28, 2002.
If you have any comments on these regulations, you can e-mail them to firstname.lastname@example.org.
expect that SSA will begin mailing tickets at the end of January.
of the SSA Field Offices
will receive a Ticket package that will contain a brief explanation of the
Ticket program, and instructions to call the toll-free number at Maximus for
more information. Beneficiaries
who call SSA local offices or the 800 number at SSA will be referred to
Maximus. The toll free number at
Maximus is 1-866-968-7842 (V); 1-866-833-2967 (TTY).
Work Incentive provision effective on January 1, 2022
Ticket legislation created a work incentive protection to encourage SSDI
beneficiaries who have been entitled to disability benefits for at least 24
months to return to work. Under
this new provision, SSA will not initiate a continuing disability review
solely because of work activity, or completion of a Trial Work Period.
This also applies to concurrent beneficiaries.
NEW ADJUSTMENTS EFFECTIVE January 1, 2022