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Disability Action Center NW

‘Ticket to Work’ Plagued By Real-World Problems

By Brenda Brown-Grooms
The Ticket to Work Program was designed to give Social Security Disability Insurance (SSDI) and blind Supplemental Security Income (SSI) beneficiaries an opportunity to receive employment, vocational and other support services for help obtaining, regaining and, ultimately, maintaining self-supporting permanent employment.
In a case in which the ticket holder (beneficiary) “achieves specified work outcomes” the Social Security Administration (SSA) will pay an employment network (EN) or state vocational rehabilitation (VR) agency. Employment networks work with individuals to create a work plan.
According to a Wikipedia article (April 8th, 2011), entities eligible to become ENs include one-stops, independent living centers, United Cerebral Palsy, Arc of the United States, Easter Seals (U.S.), mental health organizations, Goodwill Industries International, faith-based organizations, colleges and universities, high school and youth transition organizations, employment agencies, state independent living councils, employers and other service providers.
Wikipedia reported in that same article that, “to date, SSA has mailed more than 17 million tickets to eligible beneficiaries. Today, approximately 12.5 million beneficiaries are eligible to participate in the Ticket to Work Program, and on average, 89,000 new SSDI or SSI tickets are mailed to new SSA beneficiaries each month.” Those figures, however, do not indicate how many beneficiaries are actually enrolled in the program or have successfully achieved the specified work outcomes that result in ENs or state VR agencies being paid. In southwest Virginia (and most probably in other areas of the country as well), the primary concern should be that what the program was designed to do and what beneficiaries hope and perceive that it will do are not the same.
The Ticket to Work Program was designed to get people off disability rolls. But those who study the issue say that the ultimate goal of most people on disability is to earn enough money to get off the poverty rolls without losing their benefits and health insurance.
The program sounds good. It is supposed to help people with disabilities or chronic conditions work to the extent that they can without forfeiting SSDI and SSI benefits. The program receives funding from the SSA and, in some cases, state rehab agencies, to pay for the employment, rehabilitation and other support services accrued by a contracted agency without charge to the person with the ticket to work. But does – or can – the program work?
The Ticket to Work Program, developed and proposed by Rutgers University economics professor Monroe Berkowitz, was created by the 1999 Ticket to Work and Work Incentive Act.
When the Ticket to Work Program was being created, Congress envisioned that initial implementation of this new approach to service delivery would generate valuable lessons that SSA could use to refine and improve its programs. Based upon the lessons learned, SSA issued notices of proposed rule making (NPRM) in September 2005 and August 2007 that put forth changes to the program’s regulations designed to improve the employment network (EN) payment process and provide greater financial incentives and flexibility. The goal was to make the program more attractive to providers, thereby encouraging them to become employment networks.
The two major problems with the Ticket to Work Program are the low numbers, both of ENs and eligible people willing to participate.
Prospective ENs need to decide if the program will generate enough revenue to make it worthwhile to work with beneficiaries to achieve the goal of self-sufficiency.
There are several major problems for beneficiaries:
Their goals are different from that of the SSA.
There are not enough ENs available across the country.
They fear that, in the end, working will cause the loss of their disability benefits and health insurance.
Large pockets of the U.S. population have never seen the program work.
Disability advocates and those who develop programs to increase and deliver services for the disabled know that there are just not enough providers.
Almost without fail, government funding streams now require that the winning bidders for those monies create or locate networks (organizations allied with each other) to administer programs to particular populations for the services their money will pay for. Employment networks were designed to administer the Ticket to Work Program.
The problem is that organizations are in the process of becoming networks that meet the Social Security Agency’s guidelines to be an employment network at the same time as ENs need to be up and running for beneficiaries who need their services. (That does not even address the problem prospective participants have trying to navigate through the Ticket to Work Program maze).
Getting an individual from the start of the process to a point at which he or she “achieves specified work outcomes” is the more problematic because whether the EN gets paid is dependent upon beneficiaries achieving those goals.
Although many people on disability are eligible to participate in the Ticket to Work Program, many do not.
How the program is explained to beneficiaries in the face of continued and repeated Social Security disability reviews is problematic. No one gets disability funding without a major struggle. The words “disability review” appear to people with disabilities like an engagement in the same struggle they had to become “disabled certified” in the first place. This remains true, even though the Ticket to Work Program was designed to protect beneficiaries from Social Security’s continuing disability reviews. In the end, potential ticket holders in southwest Virginia do not believe that they will be protected.
Added to the fear that ticket holders will lose their benefits and health insurance is the fact that none of them have ever seen the Ticket to Work Program work. Until they do, they will not risk participating in the program.
Brenda Brown-Grooms, a stroke survivor, is a writer and ordained Baptist minister who lives in Roanoke, Va.