TN 1 (10-02)

A. Policy – overview of work incentive policies

The Ticket to Work is part of a comprehensive work incentive package. Every SSA employee with public contact responsibilities must be prepared to offer accurate information to individuals so that they can make sound decisions about work activity. The work incentives other than the Ticket to Work are described below.

When conducting an interview, be alert to opportunities to encourage and inform SSA beneficiaries who are working, or who are considering working, of all employment support policies.

B. Policy – relationship of the Ticket To Work provision to other work–incentive provisions

A beneficiary can use the Ticket to Work in conjunction with other work incentives. For example, the EN and beneficiary can agree on an IWP that calls for the EN to provide some services (like vocational evaluation) and the beneficiary to use a Plan for Achieving Self-Support to pay for other expenses necessary to become self-supporting. Of course, using available work incentives will affect when the beneficiary's SSDI and/or SSI benefits terminate and, therefore, payment to the EN.

For more information on SSA work incentives , especially Medicaid, go to http://ssa.gov/work

1. Impairment-related expenses

In SGA determinations, we can deduct from earned income the cost of certain items and services that a person with a disability needs to work. The expenses must be related to the person's disability. For SSI beneficiaries, the impairment-related work expense (IRWE) provision also allows for the exclusion of earned income used to pay for these work expenses. (See DI 10520.001 and SI 00820.540 for more information on IRWE.)

2. Subsidies and special conditions

When making an SGA determination, we use only earnings that represent the real value of the work performed. When someone's earnings are subsidized, he/she is receiving more pay than the actual value of the services he/she performed. (For more information on subsidies, see DI 10505.010)

3. Unincurred business expenses (self-employed only)

We deduct the value of self-employment business support that someone gives a beneficiary without cost, when making an SGA determination. (See DI 10510.015B.2.a(3) on unincurred business expenses.)

4. Unsuccessful work attempts

We do not count earnings during an unsuccessful work attempt when making an SGA determination. An unsuccessful work attempt is an effort to do substantial work, which the beneficiary stopped or reduced to below the SGA level after a short time (6 months or less) because of his/her disability, or removal of special conditions related to the disability. (See DI 11010.145 for more information on unsuccessful work attempts.)

5. Expedited reinstatement of benefits

Effective January 1, 2001, individuals whose disability benefits were terminated because of work activity can request reinstatement of his/her benefits. The beneficiary must be unable to work because of the original medical condition. Also, he/she must file the request for reinstatement within 60 months from the month of termination. We may make provisional payments to the individual while we are deciding on whether he/she meets the reinstatement requirements. (See DI 13050.000 for more information on expedited reinstatement.)

6. Changes to the medical CDR process (Sections 1148( i ) of the Social Security Act and section 221(m) of the Social Security Act (added by section 111 of P.L. 106-170)

Effective January 1, 2002, we will not conduct a continuing disability review of a disabled beneficiary based on work activity alone. This provision applies to beneficiaries who have received Social Security disability benefits for at least 24 months. We will still conduct regularly scheduled CDRs, unless the beneficiary is using a Ticket to Work. (See DI 13010.012 for information on Section 111 of P.L. 106-170 and DI 55025.010 for CDR policies on ticket holders.)

7. Continued payment under a vocational rehabilitation program

If a beneficiary medically recovers while participating in a vocational rehabilitation program that is likely to lead to becoming self-supporting, benefits may continue until the program ends. (See DI 14505.010 for more information.)

8. Trial work period

The TWP allows a Title II disability beneficiary to test his/her ability to work for at least nine months. The TWP continues until the beneficiary accumulates 9 months (not necessarily consecutive) of services that he/she performed within a rolling 60-consecutive-month period. During this period of time, the beneficiary receives the Title II disability benefits regardless of the amount of earnings. SSA decides if the earnings represent SGA after the TWP to determine if benefits should cease. (See DI 24001.005 and DI 13010.035 for more information on TWP.)

9. Extended period of eligibility

The EPE is a 36 consecutive month period following the end of the TWP. During the EPE, we can reinstate a person's benefits without a new application and/or disability determination for people who meet certain conditions. (See DI 13010.210 for more information on EPE.)

10. Continuation of Medicare

Title II beneficiaries with disabilities can receive at least 93 consecutive months of hospital and medical insurance after the Trial Work Period, effective 10/1/2000. This is true even if the beneficiary is working at the SGA level. Prior to 10/1/2000, Medicare coverage continued for at least 39 months after the TWP. After the extended period of Medicare coverage, an individual can buy Medicare coverage by paying a monthly premium. (For more information on Medicare continuation, see HI 00801.146, HI 00801.170 and HI 00820.025)

11. Student earned income exclusion

We exclude a certain amount of earned income for SSI child beneficiaries who regularly attend school. We adjust the annual and monthly limits on this exclusion each year. (See SI 00820.510 and SI 01320.185 for more information on SEIE.)

12. Plan for achieving self-support

A PASS allows a SSI beneficiary with a disability to set aside income and/or resources for a specified time for a work goal. We do not count the income or resources set aside when determining SSI eligibility or payment amount. (See SI 00870.001 and SI 01320.140 for more information on PASS.)

13. Blind work expenses

The BWE provision allows SSA to exclude from the earnings of a SSI beneficiary who is statutorily blind, earned income used to pay for work- related expenses. These expenses do not have to be related to the individual's disability. (See SI 00820.535 for more information on BWE.)

14. Property essential to self-support

The property essential to self-support (PESS) provision provides for the total or partial exclusion of property needed for self-support under certain conditions. (See SI 01130.500 for more information on PESS.)

15. Sections 1619(a) and (b)

SSI beneficiaries with disabilities can continue to receive cash payments even when the earned income is at the SGA level, if they are still disabled and meet all other eligibility rules, including income and resources tests. If the State in which the beneficiary lives provides Medicaid to people on SSI, Medicaid eligibility also continues. Once the earnings and other income are too high for a SSI cash payment, Medicaid coverage continues if certain conditions are met. (For more information about section 1619, see SI 02302.001)