PART 411—THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM

Table of Contents

Subpart A—Introduction

411.100Scope.
411.105What is the purpose of the Ticket to Work program?
411.115Definitions of terms used in this part.

Subpart B—Tickets Under the Ticket to Work Program

411.120What is a ticket under the Ticket to Work program?
411.125Who is eligible to receive a ticket under the Ticket to Work program?
411.130How will we distribute tickets under the Ticket to Work program?
411.135What do I do when I receive a ticket?
411.140When may I assign my ticket and how?
411.145When can my ticket be taken out of assignment?
411.150Can I reassign my ticket?
411.155When does my ticket terminate?

Subpart C—Suspension of Continuing Disability Reviews for Beneficiaries Who are Using a Ticket

Introduction

411.160What does this subpart do?
411.165How does using a ticket under the Ticket to Work program affect my continuing disability reviews?
411.166Glossary of terms used in this subpart.
411.167What is an educational institution or a technical, trade or vocational school?
411.170When does the period of using a ticket begin?
411.171When does the period of using a ticket end?
411.175What if a continuing disability review is begun before my ticket is in use?
411.180What is timely progress toward self-supporting employment?
411.192What choices do I have if I am unable to make timely progress toward self-supporting employment?
411.200How will the PM conduct my progress reviews?
411.205What if I disagree with the PM's decision about whether I am making timely progress toward self-supporting employment?

Failure To Make Timely Progress

411.210What happens if I do not make timely progress toward self-supporting employment?

The Extension Period

411.220What if my ticket is no longer assigned to an EN or State VR agency?
411.225What if I reassign my ticket after the end of the extension period?
411.226How will SSA determine if I am meeting the timely progress guidelines if I assign my ticket prior to July 21, 2008?

Subpart D—Use of One or More Program Managers To Assist in Administration of the Ticket to Work Program

411.230What is a PM?
411.235What qualifications are required of a PM?
411.240What limitations are placed on a PM?
411.245What are a PM's responsibilities under the Ticket to Work program?

Evaluation of Program Manager Performance

411.250How will SSA evaluate a PM?

Subpart E—Employment Networks

411.300What is an EN?
411.305Who is eligible to be an EN?
411.310How 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?
411.315What are the minimum qualifications necessary to be an EN?
411.320What are an EN's responsibilities as a participant in the Ticket to Work program?
411.321Under what conditions will SSA terminate an agreement with an EN due to inadequate performance?
411.325What reporting requirements are placed on an EN as a participant in the Ticket to Work program?
411.330How will SSA evaluate an EN's performance?

Subpart F—State Vocational Rehabilitation Agencies' Participation

Participation in the Ticket to Work Program

411.350Must a State VR agency participate in the Ticket to Work program?
411.355What payment options does a State VR agency have?
411.365How does a State VR agency notify us about its choice of a payment system for use when functioning as an EN?
411.375Does 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 et seq.), when functioning as an EN?

Ticket Status

411.380What does a State VR agency do if the State VR agency wants to determine whether a person seeking services has a ticket?
411.385What 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?
411.390What does a State VR agency do if a beneficiary to whom it is already providing services has a ticket that is available for assignment?
411.395Is a State VR agency required to provide periodic reports?

Referrals by Employment Networks to State VR Agencies

411.400Can an EN to which a beneficiary's ticket is assigned refer the beneficiary to a State VR agency for services?

Agreements Between Employment Networks and State VR Agencies

411.405When does an agreement between an EN and the State VR agency have to be in place?
411.410Does each referral from an EN to a State VR agency require its own agreement?
411.415Who will verify the establishment of agreements between ENs and State VR agencies?
411.420What information should be included in an agreement between an EN and a State VR agency?
411.425What 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?
411.430What 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?

Resolving Disputes Arising Under Agreements Between Employment Networks and State VR Agencies

411.435How will disputes arising under the agreements between ENs and State VR agencies be resolved?

Subpart G—Requirements for Individual Work Plans

411.450What is an Individual Work Plan?
411.455What is the purpose of an IWP?
411.460Who is responsible for determining what information is contained in the IWP?
411.465What are the minimum requirements for an IWP?
411.470When does an IWP become effective?

Subpart H—Employment Network Payment Systems

411.500Definitions of terms used in this subpart.
411.505How is an EN paid?
411.510How is the State VR agency paid under the Ticket to Work program?
411.515Can the EN change its elected payment system?
411.520How are beneficiaries whose tickets are assigned to an EN affected by a change in that EN's elected payment system?
411.525What payments are available under each of the EN payment systems?
411.535Under what circumstances will milestones be paid?
411.536Under what circumstances can we make a reconciliation payment under the outcome-milestone payment system?
411.540How are the payment amounts calculated for each of the milestones?
411.545How are the outcome payments calculated under the outcome-milestone payment system?
411.550How are the outcome payments calculated under the outcome payment system?
411.551How are EN payments calculated for transition cases pending on July 21, 2008?
411.552What effect will the subsequent entitlement to title II benefits have on EN payments for title XVI beneficiaries after they assign their ticket?
411.555Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all outcome months?
411.560Is it possible to pay a milestone or outcome payment to more than one EN?
411.565What happens if two or more ENs qualify for payment on the same ticket but have elected different EN payment systems?
411.566May an EN use outcome or milestone payments to make payments to the beneficiary?
411.570Can an EN request payment from the beneficiary who assigned a ticket to the EN?
411.575How does the EN request payment for milestones or outcome payment months achieved by a beneficiary who assigned a ticket to the EN?
411.580Can an EN receive payments for milestones or outcome payment months that occur before the beneficiary assigns a ticket to the EN?
411.581Can an EN receive milestone and outcome payments for months after a beneficiary takes his or her ticket out of assignment?
411.582Can 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?
411.585Can a State VR agency and an EN both receive payment for serving the same beneficiary?
411.590What can an EN do if the EN disagrees with our decision on a payment request?
411.595What oversight procedures are planned for the EN payment systems?
411.597Will SSA periodically review the outcome payment system and the outcome-milestone payment system for possible modifications?

Subpart I—Ticket to Work Program Dispute Resolution

Disputes Between Beneficiaries and Employment Networks

411.600Is there a process for resolving disputes between beneficiaries and ENs that are not State VR agencies?
411.605What are the responsibilities of the EN that is not a State VR agency regarding the dispute resolution process?
411.610When should a beneficiary receive information on the procedures for resolving disputes?
411.615How will a disputed issue be referred to the PM?
411.620How long does the PM have to recommend a resolution to the dispute?
411.625Can the beneficiary or the EN that is not a State VR agency request a review of the PM's recommendation?
411.630Is SSA's decision final?
411.635Can a beneficiary be represented in the dispute resolution process under the Ticket to Work program?

Disputes Between Beneficiaries and State VR Agencies

411.640Do the dispute resolution procedures of the Rehabilitation Act of 1973, as amended (29 U.S.C. 720 et seq.), apply to beneficiaries seeking services from the State VR agency?

Disputes Between Employment Networks and Program Managers

411.650Is there a process for resolving disputes between ENs that are not State VR agencies and PMs, other than disputes on a payment request?
411.655How will the PM refer the dispute to us?
411.660Is SSA's decision final?

Subpart J—The Ticket to Work Program and Alternate Participants Under the Programs for Payments for Vocational Rehabilitation Services

411.700What is an alternate participant?
411.705Can an alternate participant become an EN?
411.710How will an alternate participant choose to participate as an EN in the Ticket to Work program?
411.715If an alternate participant becomes an EN, will beneficiaries for whom an employment plan was signed prior to implementation be covered under the Ticket to Work program payment provisions?
411.720If an alternate participant chooses not to become an EN, can it continue to function under the programs for payments for VR services?
411.725If an alternate participant becomes an EN and it has signed employment plans, both as an alternate participant and an EN, how will SSA pay for services provided under each employment plan?
411.730What happens if an alternate participant signed an employment plan with a beneficiary before Ticket to Work program implementation in the State and the required period of substantial gainful activity is not completed by January 1, 2004?

Authority: Secs. 702(a)(5) and 1148 of the Social Security Act (42 U.S.C. 902(a)(5) and 1320b-19); sec. 101(b)-(e), Public Law 106-170, 113 Stat. 1860, 1873 (42 U.S.C. 1320b-19 note).

Source: 66 FR 67420, Dec. 28, 2001, unless otherwise noted.