BASIC (02-02)

A. Policy – limited appeal rights

A determination SSA makes about an individual's eligibility for a ticket is a made under the Ticket to Work and Self-Sufficiency program, i.e., section 1148 (title XI) of the Social Security Act (the Act). It is not a determination about an individual's rights under title II or title XVI of the Act. Therefore, a ticket eligibility determination is not an action that constitutes an initial determination under title II or title XVI of the Act. As a result, an individual may request SSA to review a determination that he or she is not eligible for a ticket. However, that determination is not subject to the administrative and judicial review processes that apply to initial determinations under the title II or title XVI program.

NOTE: While the ticket eligibility determination made under title XI of the Act, most underlining factors that affect ticket eligibility are made under title II and title XVI of the Act. Thus, determinations about such underlining factors (e.g., determinations about whether an individual can receive a Federal cash disability/blindness-based benefit from SSA) may be appealed or reopened, subject to the rules on administrative finality.

B. Procedure – FO and PC action when individual requests an explanation for not getting a ticket

1. Step 1 -- determine reason(s) and explain it to the individual

When the system did not select an individual for a ticket and the individual wants to know why, FOs and PCs should:

• follow the procedures in DI 55002.035 to determine why a ticket was not issued, and

• explain the reason(s) to the individual.

EXCEPTIONS: If unable to determine why the individual is not ticket-eligible, see DI 55002.040. If the coding on the MBR/SSR/CDRCF is incorrect or needs updating, see DI 55002.045.

2. Step 2 -- individual wants a formal determination

If the individual wants a formal determination, FOs and PCs should:

• record the beneficiary/recipient contact and the reasons the FO/PC gave the individual for why he/she is not eligible for a ticket on a Form SSA-5002;

• take a statement from the beneficiary/recipient that he/she wants a formal determination; and

• hold the Form SSA-5002, the request for a formal determination, and any obtained query(ies) for 60 days.

NOTE: Approved, cleared language for the Document Processing System (DPS) will be forthcoming. It will be released as an Emergency Message and followed by an amendment to these POMS.