DI 55002.005:
Who Is Eligible For A Ticket?
Effective Dates: 05/07/2013 - Present- Effective Dates: 11/08/2017 - Present
- BASIC (02-02)
- DI 55002.005 Who Is Eligible For A Ticket?
- A. Policy – ticket eligibility requirements and exceptions
- An individual who meets the two general ticket eligibility requirements in DI 55002.005B is eligible for a ticket unless one or more of the nine exceptions in DI 55002.005C apply.
- NOTE: A concurrent beneficiary, eligible for a ticket on either record (i.e., the title II or the title XVI record), will get a ticket. Such an individual does not have to be ticket eligible on both records.
- B. Policy – two general ticket eligibility requirements
- 1. Age 18 through 64
- Only an individual who is age 18 or older and has not attained age 65 is eligible for a ticket.
- 2. Entitled to or eligible for a disability/blindness-based benefit
- Also, the individual must be either:
- * a title II disability beneficiary (i.e., a disabled worker, a disabled widow(er), a disabled surviving divorced spouse, or a childhood disability beneficiary); or
- * a title XVI recipient eligible for SSI benefits based on disability or blindness.
- C. Policy – nine exceptions to the general ticket eligibility requirements
- 1. Not receiving federal cash disability/blindness-based benefits or payments from SSA
- An individual must be receiving a Federal cash disability/blindness-based benefit from SSA to be eligible for a ticket. If no Federal cash disability/blindness-based benefits from SSA are payable (e.g., benefits are in suspense or deferred status; individual receives only a State supplementation), then the individual who meets all other criteria will not get a ticket until these Federal cash disability/blindness-based benefits resume.
- 2. Receiving section 301 payments
- An individual who has medically recovered while participating in a VR program and receives section 301 payments is not eligible for a ticket.
- 3. Receiving benefit continuation payments during a medical cessation appeal
- An individual receiving benefit continuation payments during an appeal of a medical cessation determination is not eligible for a ticket. However, the individual will get a ticket later, if disability continues based on a successful appeal and all other criteria are met.
4. Some medical improvement expected (MIE) diary casesa. General ruleGenerally, an individual with a MIE diary who has not had at least one continuing disability review (CDR) is not eligible for a ticket. However, the individual will get a ticket later, if disability continues after SSA conducts a medical CDR and all other criteria are met.b. Exception 1 — MIE diary is at least 3 years oldFor systems selection purposes, anyone with a MIE diary who has been on the disability benefit rolls for at least 3 years will be presumed to have had a medical CDR.c. Exception 2 – MIE diary is set for an expedited reinstatement (EXR) medical determinationThe setting of a MIE diary in connection with a favorable medical determination on an EXR case will not preclude the EXR beneficiary/recipient from getting a ticket (see DI 55002.010B.3.), as the EXR medical determination utilizes the Medical Improvement Review Standard (MIRS), the same medical criteria used in CDR determinations.5. Receiving SSI benefits based on the childhood standard- 4. Receiving SSI benefits based on the childhood standard
- An individual who attains age 18 on or after August 22, 1996, and receives SSI benefits based on the childhood standard (see DI 23570.001) is not eligible for a ticket. However, the individual will get a ticket later, if SSA finds the individual disabled based on the adult standard after conducting an age-18 disability redetermination and all other criteria are met.
- NOTE: Those born after August 22, 1978, attain age 18 on or after August 22, 1996.
6. Receiving provisional (temporary) cash benefits under the EXR provisions- 5. Receiving provisional (temporary) cash benefits under the EXR provisions
- An individual who receives provisional (temporary) cash benefits under the EXR provisions (see DI 13050.001) is not eligible for a ticket. However, the individual will get a ticket later, if entitlement to or eligibility for benefits is reinstated after SSA makes a favorable medical determination with regard to an EXR request and all other criteria are met.
7. Receiving presumptive disability/blindness payments- 6. Receiving presumptive disability/blindness payments
- An individual who receives presumptive disability/blindness payments (see DI 11055.230) is not eligible for a ticket. However, the individual will get a ticket later, if SSA makes a favorable determination of disability or blindness and all other criteria are met.
8. Living in a non-ticket location- 7. Living in a non-ticket location
- SSA is distributing tickets to eligible beneficiaries/recipients in three phases, based on available residence or mailing address information (see DI 55001.001A.1.). During the phase-in period only eligible individuals identified as living in locations where SSA has phased-in the Ticket to Work program will get tickets. The chart below gives these locations, by phase. Note that individuals residing in foreign countries will not get tickets. Also note that DI 55002.045B.1. provides guidance on what to do should a title II beneficiary live in a ticket location but the mail goes to a non-ticket location (e.g., the beneficiary and his/her representative payee or legal guardian live in different States).
- Phase 1 Locations
- Phase 2 Locations
- Phase 3 Locations
- Arizona
- Alaska
- Alabama
- Colorado
- Arkansas
- American Samoa
- Delaware
- Connecticut
- California
- Florida
- District of Columbia
- Guam
- Illinois
- Georgia
- Hawaii
- Iowa
- Indiana
- Idaho
- Massachusetts
- Kansas
- Maine
- New York
- Kentucky
- Maryland
- Oklahoma
- Louisiana
- Minnesota
- Oregon
- Michigan
- Nebraska
- South Carolina
- Mississippi
- North Carolina
- Vermont
- Missouri
- Northern Mariana Islands
- Wisconsin
- Montana
- Ohio
-
- Nevada
- Pennsylvania
-
- New Hampshire
- Puerto Rico
-
- New Jersey
- Rhode Island
-
- New Mexico
- Texas
-
- North Dakota
- Utah
-
- South Dakota
- Virgin Islands
-
- Tennessee
- Washington
-
- Virginia
- West Virginia
-
-
- Wyoming
9. Title II beneficiary does not have an SSN- 8. Title II beneficiary does not have an SSN
- Tickets are issued under each beneficiary's/recipient's own SSN (see DI 55002.020B.1.a.). Thus, if the record of a disabled widow(er), disabled surviving divorced spouse, or a childhood beneficiary does not reflect the beneficiary's own account number (BOAN), the system will not select the title II record.
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was removed and
was added – in other words, the "Effective Dates" line at the top of the document has been updated to reflect that the new version is effective as of the date the change was made.