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210.00 Serving Individuals who are SSDI/SSI Participants Policy

(February 2003)

See corresponding procedure: 210.00 Social Security and Ticket Procedure

 

Table of Contents

Description

As VESID works with individuals who are on Social Security Disability Insurance (SSDI - Title II) or SSI (SSI - Title XVI), it is important to recognize the employment supports and options available to them. VESID can receive payments from the Social Security Administration (SSA) for those individuals who achieve employment with earnings at a substantial level as defined by SSA. Specific policy provisions for SSDI/SSI participants, benefits counseling, the Ticket to Work Program and other strategies can be coordinated to improve employment outcomes.

Definitions

Social Security Disability Insurance (SSDI)
SSDI provides benefits to disabled or blind individuals who are "insured" by workers' contributions to the Social Security trust fund. These contributions are the Federal Insurance Contributions Act (FICA) social security tax paid on their earnings or those of their spouses or parents. Title II of the Social Security Act authorizes SSDI benefits.

Supplemental Security Income Program (SSI)
SSI makes cash assistance payments to aged, blind and disabled people (including children under age 18) who have limited income and resources. The Federal government funds SSI from general tax revenues. Some States, like New York State,  pay benefits to some individuals to supplement their Federal benefits.  In New York State, the Social Security Administration combines the state supplementary payment with the Federal payment into one monthly check. Title XVI of the Social Security Act authorizes SSI benefits.

Ticket to Work Program
Most working age individuals with disabilities who receive benefits from the Social Security Administration are eligible to participate in an initiative from the Social Security Administration called the Ticket to Work and Self-Sufficiency Program. The "Ticket to Work Program" allows SSDI and SSI beneficiaries to seek the employment services, vocational rehabilitation services and other support services needed to obtain, regain or maintain employment and reduce their dependence on cash benefit programs.

Employment Network (EN)
Any qualified entity that has entered into an agreement with SSA to deliver employment, vocational rehabilitation and support services to beneficiaries of SSI and/or SSDI who have assigned their Tickets to them.

Benefits Counseling
Benefits counseling is a resource for an individual to obtain benefits and/or to understand and use work incentives available through the Social Security Administration and other public or private programs. Benefits counseling provides reliable information on the impact of earned income on cash benefits and entitlement programs that the person may depend on for overall income, including:

  1. SSI,
  2. SSDI,
  3. Medicaid and Medicare, and other health care benefits,
  4. housing subsidies, and
  5. other public assistance.

Benefits counseling can help the individual to make informed choices regarding working and earnings; apply work incentives to manage benefits and the costs associated with going to work; and develop a plan that leads to greater economic self-sufficiency. It reduces the risk of losing essential entitlements and helps the person establish a secure financial situation.

Informed Choice

Individuals are active participants in making informed choices throughout the VESID program. VESID staff will provide:

  1. information regarding a range of vocational rehabilitation options that will allow individuals on SSDI/SSI to make informed choices to find work;
  2. benefits counseling, directly or through community resources, to enable SSA's beneficiaries with disabilities to make informed choices about work; and,
  3. VESID’s "Basic Facts about the Ticket to Work Program" will be provided by VESID staff and reviewed with the individuals on SSDI/SSI.

Referral

VESID staff will work with referral sources and SSDI/SSI participants to encourage the use of benefits counseling prior to a referral to VESID or another EN so that the individual is able to make an informed choice about work and the effect on benefits

Orientation/Intake

At orientation/intake, VESID staff will describe the availability of benefits counseling and the options available to the individuals who receive Tickets. VESID staff will also describe the services available through VESID for individuals pursuing an employment outcome.

For individuals on SSDI/SSI only interested in extended employment, VESID staff will refer the individual to the Social Security Administration (SSA) and/or to the SSA-funded Benefits Planning Assistance and Outreach program, consistent with the policy and procedures related to Eligibility. These programs can provide the individual with information about work incentives available through SSA.

Significant Disability and Most Significant Disability

Individuals on SSI and/or SSDI are considered to have at least a significant disability. Further review may result in a determination that the individual meets the criteria established by VESID for most significant disability.

Eligibility

Any applicant who has been determined eligible for SSDI or SSI is presumed eligible for  VESID services.

The only exception to this presumption of eligibility is if the VESID counselor demonstrates with clear and convincing evidence that the person cannot benefit from VR services, in terms of employment, because of the severity of the individual's disability.  See VESID VR Policy 202.00 Eligibility for Services for more information on Trial Work Experience/Extended Evaluation.

VESID staff may require additional assessment information for vocational planning purposes and the development of the Individualized Plan for Employment. Gathering assessment information does not delay the eligibility decision.

Verification of SSDI/SSI Benefits

The applicant should provide appropriate documentation to verify that he or she is a recipient of SSDI or SSI benefits. 

If the applicant is unable to provide verification, VESID staff, with appropriate releases available, must verify the applicant's eligibility for SSDI/SSI.   This verification must be made within a reasonable period of time to determine the applicant's eligibility. 

A current Ticket to Work is evidence that the ticket holder is receiving SSDI/SSI benefits for the purpose of determining eligibility.

Development of the Individualized Plan for Employment

When the IPE is being developed, it should be determined if the SSDI/SSI beneficiary has a Ticket to Work. Use of a Ticket by beneficiaries is voluntary and SSA does not require beneficiaries to participate in the program.  However, SSA has made it clear that when beneficiaries who receive Tickets develop a plan to go to work with either VESID or an Employment Network, they are participating in the Ticket Program. Not all beneficiaries will receive or be eligible to receive the Ticket to Work.

At the time the IPE is prepared, the Ticket to Work Program Manager, Maximus, must be contacted to clarify Ticket status.

If the Ticket is available to be assigned, the individual assigns his/her Ticket to Work to VESID when the IPE is prepared. The individual should sign the Ticket assignment form when he/she signs the IPE. In situations where the individual receives a Ticket after an IPE has been developed by VESID, the Ticket can then be assigned after the IPE has been signed.

When an individual assigns his or her Ticket to VESID, VESID staff selects the payment system for payments from SSA.  VESID can then receive funds from SSA for those individuals who become employed at levels established by SSA.  VESID selects, on the SSA-1365 for each individual, to be paid under the "cost reimbursement" payment system (an option available only to State VR agencies) or under the employment network payment system.

Development of an IPE when an Individual Work Plan (IWP) Exists

When an individual has assigned the Ticket to an Employment Network (EN) and is referred to and/or applies for VESID services, VESID can proceed with the vocational rehabilitation process if there is a written agreement between VESID and the EN.  The Individual Work Plan (IWP) should be obtained from the individual and the EN. The VESID counselor will review the plan, and if approved, will incorporate appropriate sections into the IPE.

Those services provided by the EN, as listed in the IWP, are considered as comparable services provided at no cost to VESID.  VESID will provide those services that are not available through the EN and are necessary to reach the employment outcome. This will be done in accordance with the agreement.

VESID and the EN are required to establish an agreement. The individual also has the option to reassign the Ticket to VESID. If no agreement exists between VESID and the EN, VESID and the EN must establish an agreement for VESID services to be provided. If the delay of service provision while agreement issues are resolved would interrupt the individual's progress toward an employment outcome, delay an immediate job placement, or create a serious hardship to the individual, then services will be initiated, in accordance with the above process for IPE development, with the approval of the District Office Manager.

Provision of Benefits Counseling

All Social Security recipients will be offered benefits counseling during the vocational rehabilitation process. Benefits counseling can be provided at any point in the rehabilitation process.  If VESID staff does not provide this service, it may be obtained through the Social Security Administration-funded Benefits Planning, Assistance and Outreach (BPA&O) program or authorized from an approved vendor.

Participation in the Cost of Services based on Financial Need

Federal regulation prohibits requiring the financial participation of the individual who is an SSDI/SSI participant.

Comparable Benefits and Services

  1. An SSA-approved Plan for Achieving Self-Support (PASS) does not constitute a comparable benefit or service. A PASS is a Social Security work incentive that allows an SSI recipient to set aside income and/or resources for a specified time in order to achieve an employment goal. While funds from a PASS cannot be considered a comparable benefit, PASS resources can complement VR services, particularly to cover additional costs of services, such as vehicle modifications, college study and self-employment.
  2. A Ticket to Work that is assigned to an employment network other than VESID is considered a comparable service for those services provided by the Employment Network (EN) identified in the consumer's Individualized Work Plan (IWP) with the EN. VR funds should not be used for those services that the individual can receive through the employment network.
  3. Benefits counseling is exempt from a consideration of comparable benefits and services. 

The Two Disability Programs

Social Security Disability Supplemental Security Income
Also known as SSD, SSDI - Social Security Disability Insurance, Title II or simply "Social Security". Also known as SSI or Title XVI.
Wage earner must have accrued sufficient "quarters of coverage". No work history is required.
Benefits to worker's (wage earner) family:
Spouses:  If at least age 62, or if caring for either a child under 16 or a disabled child of the worker.
Divorced Spouses:  If the marriage lasted at least 10 years, and the person is age 62 years old or older and remains unmarried.
Child: If under age 18 (or under19 if a full-time high school or elementary student) and dependent unmarried child of an insured eligible worker.
Disabled Adult Child:  Adult Children (18 or older) of a retired, disabled or deceased worker, if the disability began before the age of 22.

 No family member of the SSI recipient will be eligible for SSI benefits unless the family member independently establishes eligibility for SSI.
From the date one becomes disabled, there is a five-month waiting period prior to the receipt of benefits. No waiting period.  An individual may receive benefits from the date of application of benefits.
Provision for payment up to 12 months before the date of application. Only paid the first day of the month following month of application.
Only Worker's Compensation or other Federal or State disability payments may affect payment level. Any income (earned or unearned) can affect benefit (after applying income disregard and exclusion).
No resource limits. Resources must be below $2,000 for an individual and $3,000 for an eligible couple.
Checks are paid one month behind, i.e. check received on May 3 is recipient's April check. Checks are paid for the month in which they are received.

Reference:

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Policy: