Ticket to Work FAQ’s
The Frequently Asked Questions (FAQ’s) included in this document have
been collected from a variety of individuals involved in assisting One-Stop
Career Centers through the Disability Employment Initiative (DEI).
Additionally, these FAQ’s represent questions that the National Technical
Assistance Provider to the DEI projects, the National Disability institute,
have identified in order to assist you in better understanding the Ticket to
Work Program.
These questions have been developed in cooperation with CESSI, and are
intended to augment FAQ’s that they have already developed, which can be
found at: http://www.cessi.net/ttw/faqs/index.asp.
Additional FAQs regarding the Ticket to Work program that have been
developed by SSA can be located at: http://www.ssa.gov/work/faqs.html.
Question: Are all Milestone payments determined by Ticket Holders’
gross earnings?
Answer:
For all Milestones, MAXIMUS will determine whether you are
eligible for payment based on gross earnings. The only exception
to this rule is for self-employment. In cases where a Ticket Holder
is engaged in self-employment, MAXIMUS will look at Net Earnings
from Self-Employment (NESE), just as Social Security would in
determining earnings.
Question: How long can an EN provide services to a Ticket Holder?
Answer:
An EN can provide services to a Ticket Holder as long as they
choose, however, payments are only generated to ENs when the
Ticket Holder achieves Trial Work level earnings ($720/month in
2010) for Milestones, and Substantial Gainful Activity (SGA) level
earnings ($1000/month non-blind rate and $1640/month blind rate
for 2010) for Phase 2 Milestones and Outcome payments in order
to be paid for services they provide. Additionally, based on all
available payments an EN can secure under the
Milestone/Outcome billing option, total payments can be made for
up to 56 months of supports to SSDI beneficiaries and up to 87
months for SSI recipients that meet billing requirements.
Question: What is Timely Progress?
Answer:
Timely Progress is a measure of a Ticket Holder’s progress in the
Ticket to Work program toward achieving sequential steps that lead
to self-sufficiency. Timely Progress must be met for Ticket Holders
to continue to receive protections from medical Continuing
Disability Reviews (CDR), which are used by Social Security
Administration (SSA) to determine whether individuals continue to
be disabled under Federal guidelines for disability benefits. Having
protection from CDR’s can be an advantage to Ticket Holders
which they can receive by assigning a Ticket to an Employment
Network for employment supports. The chart below shows the
progression a Ticket Holder must achieve in order to make Timely
Progress.
Note: Ticket Holders that DO NOT achieve Timely Progress can
still be assisted by EN’s, additionally, Ticket assignment status to
the EN does not change, however, SSA may reinstate scheduled
CDR’s for that Ticket Holder.
12Month
Review
Period
1st
2nd
3rd
4th
5th
6th
Work Requirement
3 out of 12 months with
Trial Work Period level
earnings.
6 out of 12 months with
Trial Work Period level
earnings.
9 out of 12 months with
Substantial Gainful
Activity level earnings.
9 out of 12 months with
Substantial Gainful
Activity level earnings.
6 out of 12 months at
level precluding Social
Security and Federal SSI
cash benefits
Work criteria are same
for both 5th and
subsequent 12-month
periods.
High School
diploma or GED
Degree or certification
program
Technical, trade, or
vocational program
Obtained high school
diploma or GED
certificate.
Completed 60 percent of full time
course load for 1 year.
Completed 60 percent
of full time course load
for 1 year.
Completed 75 percent
of full time course load
for 1 year.
Completed the
program.
Completed 75 percent of full time
course load for 1 year.
Completed a 2 –year program or,
for a 4-year program, completed
an additional academic year of
full time study.
Completed an additional
academic year of full time study.
Completed an additional
academic year of full time study
or completed 4-year degree
program.
Completed 4-year degree
program.
From 20 CFR Part 411, Amendments to the Ticket to Work and Self-Sufficiency Program: Final Rule (final Sec. 411.180)
Question: How will One-Stop ENs check on whether a Ticket is
available for assignment since many SSA beneficiaries
may not know whether they have an available Ticket?
Answer:
One-Stops that become ENs can easily determine if someone has
a Ticket available for assignment by calling their Point of Contact at
MAXIMUS. MAXIMUS, the Ticket to Work Operations Support
Manager, can provide information about whether the Ticket is
available and if it has had any previous history. If there is previous
history on a Ticket, this indicates that it is likely the person has had
this Ticket assigned with State VR, or another EN. If previous
history is with State VR, you would need to determine if the case
was closed successfully, thereby indicating which Milestones are
left for you to bill under.
Question: What is Partnership Plus?
Answer:
Partnership Plus can certainly be a confusing topic to many folks
who are starting work as an Employment Network. The regulations
that dictate payments when there is State VR history, meaning that
State VR has worked with a Ticket holder, are clear in terms of how
this impacts Phase 1 Milestone payments.
If State VR chooses to serve someone under Cost Reimbursement,
the Ticket is "In Use SVR" status...meaning the Ticket is not
available to another EN. If in this situation, State VR closes the
case successfully, meaning the person is employed, the EN that
later works with this Ticket holder would not have any of the Phase
1 Milestones available to them. However, Phase 2 Milestones and
all Outcome payments are still available.
If State VR closes a case unsuccessfully, then all payments are
available on that Ticket.
If State VR chooses to assign a Ticket (which is their option with
each case, rather than serving under Cost Reimbursement), then
when the case is closed, any remaining payments not collected
would then be available to the next EN.
Question: Are there other ways to partner with State VR?
Answer:
Partnership Plus allows ENs to operate with State VR programs
after they have closed the case for services, but there are other
ways that ENs can work with State VR programs. Additional
agreements are required to share payments within the Phase 1
Milestone billing structure. There are states that have additional
agreements with ENs that allow them to share Phase 1 Milestone
payments. This question was brought up with Sallie Rhodes,
CESSI’s Ticket to Work Program Specialist and Partnership Plus
expert, and she had this to share concerning VR agencies that are
operating as an EN (meaning they are taking Ticket assignments):
“Most state VR agencies that are taking Ticket assignments have
written agreements in place with some ENs that spell out exactly
how the Ticket payment would be shared, e.g., WI (Wisconsin VR)
keeps the first 2 Phase 1 milestone payments and lets the EN have
everything else. Some states have agreements where VR and the
EN split the Phase 1 payments 50/50. If a written agreement is not
in place and there are questions about how to split the payments,
MAXIMUS can be consulted. They will look at what services each
entity provided and how those services contributed to the Ticket
Holder’s success, and then make a recommendation on how the
payments should be split. It is much cleaner if an agreement spells
this out up front.”
Question: When State VR chooses to serve a beneficiary under Cost
Reimbursement and the beneficiary is not allowed to assign their
Ticket to another EN, does the consumer have a 'choice' in this? If
this is VR's choice, what is 'in it' for the consumer? Can't a
consumer choose to receive services with VR AND assign their
Ticket elsewhere?
Answer:
When a Ticket Holder is being served by State VR, the Ticket is not
available to assign to another EN. The State VR case would need
to be closed in order for another EN to assign the Ticket. The
Ticket Holder, when open with State VR, would still have protection
from medical “Continuing Disability Reviews”, and would be
receiving the services they need to return to work, which is a choice
they made when opting to work with State VR over a private EN.
There are cases where a Ticket Holder can be served by a private
EN while also receiving services from State VR, but in this situation,
a separate agreement with State VR and the private EN would
need to be in place for the private EN to share payments with State
VR. For more information about split payments, and agreements
separate from Partnership Plus with State VR, you should contact
MAXIMUS, the Ticket to Work Operations Support Manager.
Question: What if the Ticket holder is already working when the One-Stop EN
assigns a Ticket? How will this affect payments available to this
EN?
Answer:
Under the Ticket program this is called the Recent Work Rule. If in
the 18 months prior to the beneficiary first assigning his/her Ticket,
the beneficiary worked and had earnings at a level equal to or
above the amount designated as Trial Work Level (TWL) earnings,
some, or all of, Phase 1 Milestones may not be available to the EN.
This rule addresses the fact that the EN did not incur the cost of
helping the beneficiary achieve that particular level of earnings. The
recent work rule applies only to the Phase 1 Milestone payments.
MAXIMUS has created an electronic tool that can be used to
explore the work and earnings history of a beneficiary in order to
estimate the availability of each of the four Phase 1 Milestone
payments for that particular beneficiary. You can find the 18 Month
Prior Earnings Tool by visiting the Maximus website at:
http://www.yourtickettowork.com/training_2.