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Ticket To Work: TWWIIA

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The Ticket to Work / Work Incentives Improvement Act of 1999 is generally referred to as TWWIIA, pronounced "Twee -- uh".

TWWIIA is intended to help people receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits return to work or increase current earnings by:

  • Providing a ticket which can be exchanged for vocational training by certified organizations. Vocational training can include career counseling, job placement services, job coaching/training, job accommodation, continuing employment support and transportation assistance.
  • Extending Medicare and Medicaid medical benefits that can be cut off when people return to work or even prepare to return to work.
  • Providing an expedited reinstatement of income benefits if the return to work isn't successful.

If you qualify for SSDI or SSI, you will receive a letter from the Social Security Administration giving you a ticket number as well as contact information for a private company that will help you find an Employment Network that is right for you.

TWWIIA's Objectives

  • TWWIIA helps people who are collecting either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) because of disability to get back to work.
  • TWWIIA:
    • Increases beneficiary choice in obtaining rehabilitation and vocational services.
    • Removes barriers that require people with disabilities to choose between health care coverage and work.
    • Assures that more Americans with disabilities have the opportunity to participate in the workforce and lessen their dependence on public benefits

Help With Returning To Work: The Ticket To Work And Self-Sufficiency Program

  • TWWIIA establishes a "Ticket-to-Work" program for all Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) beneficiaries who are not working because of a disability.
  • The idea of the program is to provide free preparation for returning to work. Depending on the person's needs, the program may include updating skills and information, or it may include analyzing capabilities and teaching new skills. It does not include employment search services.
  • The free preparation is provided by "rehabilitation providers" who have incentive to provide practical preparation because they don't get paid until Social Security payments stop and the beneficiary returns to work.
  • The program allows the beneficiary to choose a "rehabilitation provider," and to change providers without having to provide a reason.
  • Social Security provides a list of participating rehabilitation providers from which to choose.
  • The Ticket program is completely voluntary for Social Security beneficiaries. Choosing whether or not to participate has no bearing on continued benefits.
  • While participating in the Ticket To Work program, a freeze is put on review of SSDI status. This means that while you are under the Ticket to Work Program, Social Security cannot stop your benefits on the grounds that you are no longer disabled. See Continuing Disability Reviews below. According to the Social Security Administration, continuing disability reviews are also not triggered by the attempt to return to work.
  • Since Continuing Disability Reviews are prohibited with respect to beneficiaries while they are using a Ticket, people whose health is improving and who may have problems with such a review in the future may want to take advantage of the program. The program postpones reviews while you are preparing to reenter the workforce.

How the TWWIIA Ticket Works

SSDI and SSI beneficiaries receive a "no-cost" ticket in the mail with their name and Social Security number on it. Individuals have the choice whether to use the ticket to obtain vocational rehabilitation services from an approved provider.

People "assign" a ticket to a certified provider. If the individual isn't happy, the ticket may be retrieved and reassigned to another provider.

As noted above, continuing disability reviews stop while a person is using a ticket. 

TWWIIA Puts Continuing Disability Reviews On Hold

Thanks to TWWIIA, Social Security cannot initiate a continuing disability medical review while a SSDI or SSI disability beneficiary is using a Ticket To Work. It's important to note that this doesn't leave you off the hook completely however, because:

  • Any Continuing Disability Reviews that are scheduled prior to your enrolling in the Ticket to Work may be continued. 
  • After you have been using a Ticket To Work for two years, you are expected to be doing some kind of work, either part-time or on-the-job. If you don't work for a period of at least three months in each twelve month period after the first two years, your "ticket" is no long considered active and you may be subject to a Continuing Disability Reviews.

If you're on your way to being able to return to work, consider not waiting until you get a notice of a Continuing Disability Review to enroll in the Ticket to Work Program. You run the risk of the review being continued and your benefits stopped if you are determined to be no longer disabled. 

Effect Of Return To Work On Cash Benefits

Cash benefits may be subject to termination if earnings are substantial, as defined by the particular program. See Social Security Disability Insurance (SSDI): Return to Workand Supplemental Security Income (SSI) -- Return to Work.

Expedited Reinstatement Of Benefits

  • If you return to work without a Ticket To Work program, and find you are unable to continue to work, your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) payments will be reinstated, but only if Social Security agrees with your medical proof of disability.  On the other hand, thanks to TWWIIA, if you return to work through a Ticket To Work program and your SSDI or SSI disability benefits end because of the amount of earnings from work, Social Security will start the payments immediately, then ask for medical documentation.  Beneficiaries must file the request for reinstatement with Social Security within 60 months from the month of termination of the Social Security benefit.
  • While Social Security is making a new determination about whether the former beneficiary is disabled again, beneficiaries may receive up to six months of provisional benefits, including Medicare and Medicaid, as appropriate.
  • Provisional payments will not be considered an overpayment that has to be returned to Social Security even if Social Security decides that the individual is not disabled again or that the medical condition no longer prevents the individual from working. (For information on overpayments, see Social Security Disability Insurance (SSDI): OverPayments.) 

People With Medicare

  • For people with disabilities who return to work, TWWIIA extends Medicare beyond the trial work period of nine months to at least 93 months more for a total of 102 months or 9.5 years. The 93 months begin after the last month of the trial work period.
  • Medicare Part A (hospitalization) is provided during the extended period premium-free. Individuals must pay the regular premium for Part B (medical insurance) and Part D (Drugs).
  • The Part B premium is typically deducted from the person's SSDI check.
  • Individuals have the option of buying Medicare once the extended coverage is exhausted, if they have low income, limited resources, and large medical expenses. To learn more, see Social Security Disability Insurance - Return to Work.
  • TWWIIA also requires, at a policyholder's request, suspension of Medigap coverage and premiums for people entitled to Medicare Part A, if the disabled individual is covered under certain group health plans. TWWIIA also requires reinstatement of a Medigap policy if group coverage is lost provided that the policyholder gives notice of loss of employer coverage within 90 days.

People With Medicaid  TWWIIA gives states the option to expand eligibility requirements for Medicaid under the following circumstances:

  • States have the option to provide Medicaid coverage to more people with disabilities who work who are in the age range: 16-64.
  • States have the option to permit working individuals with incomes above 250 percent of the federal poverty level to buy-in to Medicaid to cover medical costs.
  • A buy-in project to provide medical assistance to workers with impairments before they become too disabled to stop work. For example, people who are HIV positive may be permitted to obtain Medicaid coverage to help prevent them from progressing to full blown AIDS and becoming too sick to work.

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