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Ticket to Work and Work Incentives Improvement Act of 1999

Logo of the Ticket to Work and Work Incentives Improvement Act. The Ticket to Work and Work Incentives Improvement Act of 1999, also referred to as Public Law 106-170, or by its acronym TWWIIA, was designed to increase beneficiary choice, remove barriers, and provide greater opportunities for people with disabilities to participate in the workforce and lessen their dependence on public benefits.

The summary below is based in part on information published on the Social Security Administration's Office of Employment Support Programs (OESP) web site at:
http://www.ssa.gov/work/

There are many provisions of the Act that were phased in over the course of several years, sometimes in just a particular group of states. To find out more about the Act, go to this SSA web page on the OESP web site:
http://www.socialsecurity.gov/work/aboutticket.html

To see the complete TWWIIA final regulations, go to the SSA website at:
http://www.ssa.gov/OP_Home/cfr20/411/411-0000.htm

NOTE: After proposing changes for several years, in May 2008 SSA published new regulations for the Ticket program, which became effective on July 21, 2008. To see the new Ticket to Work regulations, go to:
http://edocket.access.gpo.gov/2008/E8-10879.htm

You can also read a summary of the 2008 regulation changes in the Ticket to Work Regulation Changes - 2008 topic.

Click here to read a summary of the Ticket Program. Also, additional summary information in the form of a slide show may be found in the Ticket to Work and Self-Sufficiency Program - Summary Presentation topic.

Click here to read the note at the end of this page for toll-free telephone numbers to get more information about the Ticket Program.

Summary of TWWIIA Provisions

Former President Clinton signed the Ticket to Work and Work Incentives Improvement Act of 1999 on Dec. 17, 1999. This law:

· increased beneficiary choice in obtaining rehabilitation and vocational services;

· removed barriers that require people with disabilities to choose between health care coverage and work; and

· assured that more Americans with disabilities have the opportunity to participate in the workforce and lessen their dependence on public benefits.

The provisions of the law became effective at various times, generally beginning one year after enactment. They are described below.

Ticket To Work And Self-Sufficiency Program

Starting in 2002, most Social Security and Supplemental Security Income (SSI) disability beneficiaries received a "ticket" they may use to obtain vocational rehabilitation, employment or other support services from an approved provider (Employment Network) of their choice.

The Ticket Program is voluntary.

The program was phased in nationally over a three-year period. During the first phase, in early 2002, SSA distributed tickets in the following 13 states: Arizona, Colorado, Delaware, Florida, Illinois, Iowa, Massachusetts, New York, Oklahoma, Oregon, South Carolina, Vermont and Wisconsin.

During the second phase, SSA distributed tickets in the following 20 states: Alaska, Arkansas, Connecticut, Georgia, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Dakota, South Dakota, Tennessee, Virginia and in the District of Columbia. SSA began implementation of this phase in November 2002.

During the third phase, SSA distributed tickets in the following 17 states: Alabama, California, Hawaii, Idaho, Maine, Maryland, Minnesota, Nebraska, North Carolina, Ohio, Pennsylvania, Rhode Island, Texas, Utah, Washington, West Virginia, Wyoming, as well as in American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the Virgin Islands. SSA began implementation of this phase in November 2003.

Expanded Availability of Health Care Services

Starting Oct. 1, 2000, the law expanded Medicaid and Medicare coverage to more people with disabilities who work.

States may provide Medicaid coverage to more people ages 16-64 with disabilities who are still working. States also may permit working individuals with income above 250 percent of the federal poverty level to purchase Medicaid coverage. This provision creates an experiment in which medical assistance will be provided to workers with impairments who are not yet too disabled to work. In addition, a Medicaid Infrastructure Grant program is available to support State efforts to increase employment options for people with disabilities.

To find out if these provisions are available in your state, call the state Medicaid office in your area. A list of each State's toll-free Medicaid contact numbers is available on the Centers for Medicare and Medicaid Services website at:
http://www.cms.hhs.gov/TWWIA/

The law also expands Medicare coverage to people with disabilities who work. It extends Medicare Part A (HI) premium-free coverage for four and one-half years beyond the current limit (39 months) for most Social Security disability beneficiaries who work. To apply for the expanded coverage, you must have exceeded the current limit.

The Centers for Medicare and Medicaid Services (CMS) maintains an informational website on the "Ticket to Work and Work Incentives Improvement Act of 1999" that will provide information to States, beneficiaries and advocacy groups on an ongoing basis concerning implementation of this legislation. The website URL is:
http://www.cms.hhs.gov/TWWIA/

Expedited Reinstatement of Benefits

Effective January 1, 2001, when a person's Social Security or SSI disability benefits have ended because of earnings from work, he or she can request reinstatement of benefits, including Medicare and Medicaid, if applicable, without filing a new application.

Beneficiaries must be unable to work because of their medical condition, and it must be the same as or related to the condition they had when SSA first decided that they should receive disability benefits. They must file the request for reinstatement with Social Security within 60 months from the month their benefits are terminated. In addition, they may receive temporary benefits - as well as Medicare or Medicaid - for up to six months while their case is being reviewed. If they are found not disabled, these benefits would not be considered an overpayment.

Disability Reviews Postponed

Effective January 1, 2001, an individual using a "ticket" will not need to undergo the regularly scheduled disability reviews. The beneficiary will not be subjected to a medical Continuing Disability Review by Social Security a long as the beneficiary’s Ticket is assigned or "in-use," and the beneficiary is making timely progress towards self-supporting employment.

Work Incentives Advisory Panel

The law established a Work Incentives Advisory Panel within Social Security, composed of 12 members appointed by the President and Congress. The panel advised the Commissioner and reported to Congress on implementation of the ticket program. At least one-half of the panel members were required to be individuals with disabilities or representatives of individuals with disabilities, with consideration given to current or former Social Security disability beneficiaries.

After eight years, the panel completed its work and issued a final report in December 2007.

Additional information, copies of reports, meeting information, and a calendar of activities for the panel may be found on the Internet at:
http://www.ssa.gov/work/panel/index.html

Work Incentives Outreach Program

The law directs Social Security to establish a community-based work incentives planning and assistance program to disseminate accurate information about work incentives and to give beneficiaries more choice. Social Security has established a program of cooperative agreements and contracts to provide free benefits planning and assistance to all Social Security disability beneficiaries, including information about the availability of protection and advocacy services. See the Benefits Planning, Assistance, and Outreach Program (BPAO) topic for more information about the original implementation of these activities.

Because of an increased emphasis on work incentives, return to work supports and jobs for beneficiaries, in 2006 the Program was renamed the Work Incentives Planning and Assistance (WIPA) Program.

The law also directed Social Security to establish a corps of work incentives specialists within Social Security offices. These specialists, who SSA called Employment Support Representatives or ESRs, were to provide timely and accurate information about SSA's employment support programs for beneficiaries with disabilities who want to work. See the Employment Support Representative (ESR) topic for more information about this short-lived program.

There are now designated Work Incentive Liasons (WIL) in each local SSA office.

Protection and Advocacy

The law authorizes Social Security to make payments to protection and advocacy systems established in each state to provide information, advice and other services to disability beneficiaries. See the Protection and Advocacy for Beneficiaries of Social Security (PABSS) Program topic for more information.

Demonstration Projects and Studies

The law extended Social Security disability insurance demonstration authority. Under the law, Social Security is required to conduct a demonstration project to test reducing Social Security disability insurance benefits by $1 for each $2 that a beneficiary earns over a certain amount.

The implementation date for this Benefit Offset National Demonstration will be announced.

For More Information About the Ticket Program

Social Security has contracted with MAXIMUS, Inc., which will serve as the Program Manager for the Ticket Program. MAXIMUS is a private organization that will help Social Security manage the program. Some of their main duties will be to provide information to beneficiaries and the general public about the Ticket Program, as well as helping to enroll and train agencies to serve as Employment Networks for the Ticket Program.

MAXIMUS has toll-free telephone numbers for the Ticket Program. These numbers are:

1-866-968-7842 (1-866-YOURTICKET)
TTY (1-866-833-2967) (1-866-TDD 2 WORK)

MAXIMUS has trained staff at these phone numbers that can answer all questions related to the Ticket Program.

Additional information is also available on MAXIMUS' web site:
http://www.yourtickettowork.com

CESSI, a division of Axiom Resource Management, Inc. was awarded a Program Manager for Recruitment and Outreach (PMRO) contract to provide marketing services for SSA's work incentives programs, including the Ticket to Work Program. Application assistance for becoming an Employment Network is provided by CESSI by phone at 1-877-743-8237 and on their website at:
http://www.cessi.net/contracts/pm/ssa_pmro.html