SSDI Benefits Now Can Bridge Between Illness
The New Ticket to Work and Work Incentives Improvement Act
Many Social Security disability beneficiaries want to work, but in the past many had to choose between employment and continuing to have access to healthcare through Social Security. They asked Congress for help, and Congress responded with a new law, the Ticket to Work and Work Incentives Improvement Act of 1999 (Public Law 106-170). Its improved work incentives started taking effect in October 2000, as described below.
The Social Security Administration (SSA), has primary responsibility for administering the new law, and says that over the next few years the TWWIIA will: (1) Increase beneficiary choice in obtaining rehabilitation and vocational services; (2) Remove barriers requiring people with disabilities to choose between healthcare coverage and work; (3) Assure that more Americans with disabilities have the opportunity to participate in the work force and lessen their dependence on public benefits.
To monitor implementation of the TWWIIA, the President and Congress have established a Work Incentives Advisory Panel within SSA. The group will advise the SSA commissioner and Congress on work incentives, including implementation of the Ticket to Work and Self-Sufficiency program. The panel has 12 members appointed by the President and Congress. At least half must be people with disabilities or their representatives, and current or former disability beneficiaries must be considered for membership. After convening in 2000, the panel will have a life span of eight years.
In coming months, SSA will prepare regulations that clarify how beneficiaries may take advantage of the new work incentives, The law's provisions become effective at different times. Therefore we offer the following time line of key dates and a brief description of the significant things that will occur:
October 1, 2000 - Medicare and Medicaid coverage improvements become effective on this date; provisions that: o Extend Part A Medicare for Social Security Disability Insurance (SSDI) beneficiaries who work despite their disabilities to a potential total 8 ¸ years of coverage after the beneficiary resumes work (which adds 4-1/4 years of coverage to that authorized by previous law). SSA and the Health Care Financing Administration (HCFA) are identifying those who will be eligible for the extension of Medicare entitlement as of October, to notify them of their right to this extended entitlement. o Allow Medicare-covered workers with disabilities to suspend Medicare supplemental policies while they are in group health-insurance plans provided by their employers, and regain coverage under their Medicare supplemental policies if they lose coverage under the group health plans. o Expand state options and funding for Medicaid. These options will permit states to liberalize the limits on resources and income for Medicaid eligibility for people with disabilities. They will also allow states to permit employed individuals with disabilities to buy into Medicaid, even though they are no longer eligible for Social Security or SSI benefits because their medical condition has improved. SSA is working with HCFA to help develop policies and grants to the states for increased Medicaid entitlement for people with disabilities who work.
December 2000 - SSA is to publish final regulations to implement the Ticket program.
January 1, 2001 - The Ticket to Work vocational rehabilitation program begins to phase in on this date. The TWWIIA establishes a Ticket to Work and Self-sufficiency program. The Ticket program is to be phased in over a three-year period beginning on January 1, 2001. SSDI and Supplemental Security Income (SSI) disability beneficiaries will receive "tickets" they may use to obtain vocational rehabilitation (VR), employment, or other support services from an approved provider of their choice. The program is voluntary. During the first year, it will be available to beneficiaries in some states (to be determined). SSA will continue expanding the program to other parts of the country over the next three years. By January 1, 2004, SSA, expects that the Ticket program will be operating nationally. (1) Once the Ticket to Work program begins, SSA is not to conduct medical continuing disability reviews (CDRs) of Social Security or SSI beneficiaries while the beneficiaries are using "tickets." (2) On and after January 1, 2001, SSDI and SSI disability beneficiaries will be able to request reinstatement of their benefits that SSA terminated because they went to work. For reinstatement, individuals must be unable to continue working because of medical condition, and must request reinstatement within 60 months from the month in which the previous benefits were terminated. Beneficiaries who request reinstatement can receive provisional payments for up to six months while SSA decides whether they are still "disabled" under SSA rules. These individuals will not have to repay the provisional payments if SSA decides their medical condition no longer meets the SSA definition of "disability."
FISCAL YEAR (FY) 2001 - The Department of Health and Human Services is to make grants to states to develop and operate programs supporting working people with disabilities and to let people know about these new programs. Funding of $150 million is to be available over the first five years, with additional funding for another six years.
FY 2001 & 2002 - SSA will publish proposed and final rules to implement the legislation's other provisions as they become effective.
January 1, 2002 - Beginning on this date, SSA is not to conduct continuing disability reviews of beneficiaries' medical conditions solely because these individuals are working (work issue reviews), if the individuals have received Social Security disability benefits for at least 24 months. However, SSA will perform regularly scheduled medical reviews (periodic reviews) unless the beneficiaries are using the Ticket to Work and Self Sufficiency program.
FUTURE - The TWWIIA authorizes SSA to conduct demonstration projects for five years to improve Title II work incentives. In particular, the law requires SSA to do a demonstration to evaluate effects of withholding $1 of Social Security disability benefits for every $2 a beneficiary earns over a specified level. SSA is also authorized to conduct other demonstrations or studies of work incentives for beneficiaries. The TWWIIA requires SSA to submit periodic reports to Congress regarding progress and effectiveness of the projects.
The author, Douglas M. Smith, an attorney, publishes the quarterly Pds Disability Facts newsletter, which reports on trends affecting Social Security Disability applicants.
Disability Notes, Social Security Administration Office of Disability Pub. No. 64-040 Special Edition 2000
Pds Disability Facts newsletter
Redbook on Work Incentives: A Summary Guide to Social Security and Supplemental Security Income Work Incentives for People With Disabilities, SSA Pub. No. 64-030, ICN 436900 (January 2000); free on the SSA Web site:. www.ssa.gov Note: This book lays out the work incentives program structure, but does not reflect changes made by the TWWIIA.
"SSA Fact Sheet: Ticket to Work and Work Incentives Improvement Act of 1999" (December 1999)
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