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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 was 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 will be 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.ssa.gov/work/Ticket/ticket_info.html

For the latest information about implementation of the act, go to this SSA web page on the OESP web site:
http://www.ssa.gov/work/ResourcesToolkit/legisregfact.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

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.

SSA has a multimedia presentation that provides a brief overview of the Ticket Program using animation, sound, and captioning. You can download it to your computer, and then double-click it from Windows Explorer to start the executable file. It requires the free Flash Player, and is available for download (note the file size is approximately 7 MB) from the SSA website at:
http://www.ssa.gov/work/Ticket/Flash12_24_03/fsTicket2Work.exe

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:

· increases beneficiary choice in obtaining rehabilitation and vocational services;

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

· assures 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 become 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 will receive 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 expands 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. However, benefits can still be terminated if earnings are above the limits. Effective January 1, 2002, Social Security disability beneficiaries who have been receiving benefits for at least 24 months will not be medically reviewed solely because of work activity. However, regularly scheduled medical reviews can still be performed and, again, benefits terminated if earnings are above the limits.

Work Incentives Advisory Panel

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

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.

The law also directs Social Security to establish a corps of work incentives specialists within Social Security offices. These specialists, who SSA calls Employment Support Representatives or ESRs, 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.

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 extends Social Security disability insurance demonstration authority for five years. 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 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 recruit 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