TN 2 (04-13)

A. Overview of timely progress requirements

IMPORTANT: This section does not cover every policy and procedure applicable to progress reviews. Since a contracted Program Manager (PM) is responsible for conducting this review, we are only providing a brief description of the criteria for field office use. For more information, you can visit the PM’s Choose Work website.

We describe the use of a ticket in DI 55025.001. This section briefly outlines the requirements necessary to suspend medical continuing disability reviews (CDR) while a ticket is “In Use.” Timely progress requires ticket users to make progress toward self-supporting employment. We designed the timely progress requirements:

• to encourage beneficiaries to actively seek self-supporting employment; and

• to protect the integrity of the Ticket to Work program.

B. Policy for timely progress toward self-supporting employment

1. Definition of timely progress

Timely progress is the standard we use to determine if a beneficiary is successfully participating in the Ticket to Work program. If the beneficiary is making timely progress as defined in Regulations, Section CFR 20 411.180, we will not initiate a medical CDR. Timely progress means the beneficiary passes a periodic review by demonstrating he or she has completed at least a certain amount of work or educational activity, or a combination of both, during a 12-month period.

An example of this is the first 12-month progress review, where we expect the beneficiary to meet one of the following goals:

• Worked three months at the trial work period (TWP) amount. (For current TWP amounts, see DI 13010.060);

• Obtained a general education diploma certificate or high-school diploma;

• Completed 60 percent of a full-time course load for an academic year in a college or technical, trade, or vocational training plan; or

• Completed a combination of the work and education requirements so that the 2 percentages equal 100 percent or more.

2. PMs conduct the timely progress review

We have a contract with a PM to conduct timely progress reviews. Beneficiaries respond to a letter they receive mailer to indicate their accomplishments. Click here to see a sample Q2 notice.

An Employment Network (EN) or State Vocational Rehabilitation (VR) Agency acting as an EN may notify the PM if the beneficiary is not actively following the rehabilitation plan. If the beneficiary does not make timely progress, we change the beneficiary’s ticket status from “In Use” to “Not In Use.” The beneficiary may appeal timely progress decisions with us, or reactivate his or her participation in the Ticket to Work program; however, he or she must be working or going to school sufficiently to meet the timely progress requirements that applied when he or she failed the progress review. The failed progress review notice provides instructions on where to send appeal letters.

3. Beneficiary cannot meet the ticket requirements

If the beneficiary cannot work or attend school, and is unable to meet the ticket guidelines, he or she may inactivate his or her ticket. In evaluating the timely progress requirements, we will not count months that the ticket was unassigned nor any month that the ticket is in inactive status, as defined in DI 55025.001B.6. The beneficiary has the choice during a review period to:

• place his or her ticket into inactive status;

• take the ticket out of assignment; or

• establish that he or she meets the timely progress requirements.

4. Identifying the review certification periods

The first 12-month progress review certification period begins with either the month following the:

• month that we assign the ticket; or

• date the beneficiary has an assignable ticket and receives VR services under an Individual Plan for Employment (IPE) from a state VR agency that chose the VR cost-reimbursement option.

Any subsequent 12-month progress review certification period begins with the month following the end of the previous 12-month progress review certification period. In computing certification periods, we do not count any month that the ticket is:

• not assigned to an EN or state VR agency acting as an EN and not in VR cost-reimbursement status (the status will show In-Use SVR); or

• in inactive status.

C. Policy for progress review criteria

The following chart shows the guidelines that the PM uses when conducting a progress review: