Title 20, Part 411 — The Ticket to Work and Self-sufficiency Program

Scope.

What is the purpose of the Ticket to Work program?

Definitions of terms used in this part.

What is a ticket under the Ticket to Work program?

Who is eligible to receive a ticket under the Ticket to Work program?

How will we distribute tickets under the Ticket to Work program?

What do I do when I receive a ticket?

When may I assign my ticket and how?

When can my ticket be taken out of assignment?

Can I reassign my ticket?

When does my ticket terminate?

What does this subpart do?

How does using a ticket under the Ticket to Work program affect my continuing disability reviews?

Glossary of terms used in this subpart.

What is an educational institution or a technical, trade or vocational school?

When does the period of using a ticket begin?

When does the period of using a ticket end?

What if a continuing disability review is begun before my ticket is in use?

What is timely progress toward self-supporting employment?

What choices do I have if I am unable to make timely progress toward self-supporting employment?

How will the PM conduct my progress reviews?

What if I disagree with the PM's decision about whether I am making timely progress toward self-supporting employment?

What happens if I do not make timely progress toward self-supporting employment?

What if my ticket is no longer assigned to an EN or State VR agency?

What if I reassign my ticket after the end of the extension period?

How will SSA determine if I am meeting the timely progress guidelines if I assign my ticket prior to July 21, 2008?

What is a PM?

What qualifications are required of a PM?

What limitations are placed on a PM?

What are a PM's responsibilities under the Ticket to Work program?

How will SSA evaluate a PM?

What is an EN?

Who is eligible to be an EN?

How does an entity other than a State VR agency apply to be an EN and who will determine whether an entity qualifies as an EN?

What are the minimum qualifications necessary to be an EN?

What are an EN's responsibilities as a participant in the Ticket to Work program?

Under what conditions will SSA terminate an agreement with an EN due to inadequate performance?

What reporting requirements are placed on an EN as a participant in the Ticket to Work program?

How will SSA evaluate an EN's performance?

Must a State VR agency participate in the Ticket to Work program?

What payment options does a State VR agency have?

How does a State VR agency notify us about its choice of a payment system for use when functioning as an EN?

Does a State VR agency continue to provide services under the requirements of the State plan approved under title I of the Rehabilitation Act of 1973, as amended (29 U.S.C. 720 ), when functioning as an EN?

What does a State VR agency do if the State VR agency wants to determine whether a person seeking services has a ticket?

What does a State VR agency do if a beneficiary who is eligible for VR services has a ticket that is available for assignment or reassignment?

What does a State VR agency do if a beneficiary to whom it is already providing services has a ticket that is available for assignment?

Is a State VR agency required to provide periodic reports?

Can an EN to which a beneficiary's ticket is assigned refer the beneficiary to a State VR agency for services?

When does an agreement between an EN and the State VR agency have to be in place?

Does each referral from an EN to a State VR agency require its own agreement?

Who will verify the establishment of agreements between ENs and State VR agencies?

What information should be included in an agreement between an EN and a State VR agency?

What should a State VR agency do if it gets an attempted referral from an EN and no agreement has been established between the EN and the State VR agency?

What should the PM do when it is informed that an EN has attempted to make a referral to a State VR agency without an agreement being in place?

How will disputes arising under the agreements between ENs and State VR agencies be resolved?

What is an Individual Work Plan?

What is the purpose of an IWP?

Who is responsible for determining what information is contained in the IWP?

What are the minimum requirements for an IWP?

When does an IWP become effective?

Definitions of terms used in this subpart.

How is an EN paid?

How is the State VR agency paid under the Ticket to Work program?

Can the EN change its elected payment system?

How are beneficiaries whose tickets are assigned to an EN affected by a change in that EN's elected payment system?

What payments are available under each of the EN payment systems?

Under what circumstances will milestones be paid?

Under what circumstances can we make a reconciliation payment under the outcome-milestone payment system?

How are the payment amounts calculated for each of the milestones?

How are the outcome payments calculated under the outcome-milestone payment system?

How are the outcome payments calculated under the outcome payment system?

How are EN payments calculated for transition cases pending on July 21, 2008?

What effect will the subsequent entitlement to title II benefits have on EN payments for title XVI beneficiaries after they assign their ticket?

Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all outcome months?

Is it possible to pay a milestone or outcome payment to more than one EN?

What happens if two or more ENs qualify for payment on the same ticket but have elected different EN payment systems?

May an EN use outcome or milestone payments to make payments to the beneficiary?

Can an EN request payment from the beneficiary who assigned a ticket to the EN?

How does the EN request payment for milestones or outcome payment months achieved by a beneficiary who assigned a ticket to the EN?

Can an EN receive payments for milestones or outcome payment months that occur before the beneficiary assigns a ticket to the EN?

Can an EN receive milestone and outcome payments for months after a beneficiary takes his or her ticket out of assignment?

Can a State VR agency receive payment under the cost reimbursement payment system if a continuous 9-month period of substantial gainful activity is completed after the ticket is assigned to an EN?

Can a State VR agency and an EN both receive payment for serving the same beneficiary?

What can an EN do if the EN disagrees with our decision on a payment request?

What oversight procedures are planned for the EN payment systems?

Will SSA periodically review the outcome payment system and the outcome-milestone payment system for possible modifications?

Is there a process for resolving disputes between beneficiaries and ENs that are not State VR agencies?

What are the responsibilities of the EN that is not a State VR agency regarding the dispute resolution process?

When should a beneficiary receive information on the procedures for resolving disputes?

How will a disputed issue be referred to the PM?

How long does the PM have to recommend a resolution to the dispute?

Can the beneficiary or the EN that is not a State VR agency request a review of the PM's recommendation?

Is SSA's decision final?

Can a beneficiary be represented in the dispute resolution process under the Ticket to Work program?

Do the dispute resolution procedures of the Rehabilitation Act of 1973, as amended (29 U.S.C. 720 ), apply to beneficiaries seeking services from the State VR agency?

Is there a process for resolving disputes between ENs that are not State VR agencies and PMs, other than disputes on a payment request?

How will the PM refer the dispute to us?

Is SSA's decision final?