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Ticket to Work Program

Ticket to Work Program. All About Payments. Expectations. I want to know how to fill out a payment request form what steps do I take if payment was denied Why was my payment denied Steps to take for Universal Auto pay

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Ticket to Work Program

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  1. Ticket to Work Program All About Payments

  2. Expectations • I want to know how to fill out a payment request form • what steps do I take if payment was denied • Why was my payment denied • Steps to take for Universal Auto pay • Need more in depth info on EN Split Payment Request Form and 18 Month Lookback Form

  3. Course Objectives • Describe the Payments Process • Differentiate between Outcome-only and Milestone/Outcome payment methods • Identify available Phase I Milestone payments using the 18-Month Lookback Tool • Define exclusions, transitions and reconciliation

  4. Payment Process Get Beneficiary to Trial Work Level (TWL) or Substantial Gainful Activity (SGA) Check Ticket Assignability Complete Individual Work Plan (IWP) Be sure to include Certification of Services Submit Payment Request Form Consider Universal Auto Pay

  5. Progress Check #1 Payment Process step #3 is missing from the list below. Choose the correct step. • Check ticket assignability • Complete an IWP • ? • Submit a payment request • Be sure to include COS • Consider Universal Auto Pay

  6. Payment Methods Outcome Only Milestone/Outcome EN provides the services needed Beneficiary reaches certain Trial Work Level (TWL) earnings with Federal cash benefits Milestone payments while beneficiary receives benefits EN can receive Outcome payments • EN provides the services needed • Beneficiary must reach a consistent earnings level of Substantial Gainful Activity (SGA) and stop receiving Federal cash benefits • EN can receive Outcome payments

  7. Definition of Terms Trial Work Level • Incentive to work while receiving benefits 2013 $750/month Substantial Gainful Activity • Substantial – significant mental or physical activity • Gainful – performed for pay or profit 2013 $1,040/month non-blind $1,740 if blind

  8. Pause for Understanding George TicketHolder Pizza restaurant employee SSI recipient Physical disability Average earnings $900/month

  9. Outcome-Only Payment Method • No payments until • Beneficiary reaches gross SGA ($1,040/month non-blind; $1,740 blind or visually impaired for 2013) • Beneficiary stops receiving Federal cash benefits

  10. Business Plan Considerations Outcome Only Milestone/Outcome

  11. Milestone/Outcome Payment Method • Payments can occur while beneficiary continues to receive Federal cash benefits • Payment types • Phase I Milestone • Phase II Milestone • Outcome

  12. Phase I Milestones

  13. Phase II Milestones • Ticket Holder reaches SGA but still receives Federal cash benefits • Based on single calendar months

  14. Outcome Payments • Zero Federal cash benefit status

  15. Milestone/Outcome Payments

  16. Progress Check If a beneficiary is working at Trial Work Level and is receiving monthly Federal cash benefits due to a disability, then what payment method could that EN be receiving?

  17. Prior Earnings Rule

  18. Prior Earnings Rule Conditions • TWL or above • Between Date of Disability Onset and Ticket Assignment date • Maximum 18 month period

  19. Phase 1 Milestone 1 Payment Earnings month Ticket Assignment Month EN cannot receive Phase 1 Milestone 1 payment

  20. Phase 1 Milestone 2 Payment Earnings months Ticket Assignment Month EN cannot receive Phase 1 Milestone 2 payment

  21. Phase 1 Milestone 3 Payment 6 Earnings months 12 months Ticket Assignment Month EN cannot receive Phase 1 Milestone 3 payment

  22. Phase 1 Milestone 4 Payment 9 Earnings months 18 months Ticket Assignment Month EN cannot receive Phase 1 Milestone 4 payment

  23. Criterion are applied independently Ticket Assignment Month Milestone 1 is available Milestone 2 is not

  24. 18 Month Lookback Tool

  25. Enter the Ticket Assignment Date

  26. Enter an X for every month TWL or above was earned

  27. Available Milestone payments are shown

  28. 18 Month Lookback Tool • Ticket assignment date: January 2013 • Above TWL: August, October, and December 2012

  29. Guided Practice X X X Ticket assignment date: January 2013

  30. What other Milestone is unavailable? X X X X X X

  31. Phase 1 Milestones 1, 2 and 3 are unavailable

  32. 18-Month Lookback Tool • TWL: September – December 2011; May, June 2012; July, October, November 2012

  33. Exclusions Other Phase 1 Denial reasons • State VR agency • Cost Reimbursement method • Reimbursement for costs incurred • Received after SGA level – 9 months in a 12 month period

  34. Previous VR involvement? • Cost Reimbursement • Case closed successfully No Phase 1 Milestone Payments

  35. Purpose for the Exclusion

  36. Transitions

  37. Transitions • Caused by changes in regulation • Prevents duplicate payments • Rules • Phase I Milestones not available if State VR agency closed case successfully in 2002 or later • Phase I Milestones are available if State VR agency closed case successfully before 2002 • Phase I Milestones are available if State VR agency closed case unsuccessfully

  38. Reconciliation Payment • Reconciles available milestone payments • Milestone/Outcome method only • Total amount skipped at the year rate Specific rules available at www.yourtickettowork.com More details on next week’s Ticket Training Tuesday

  39. Questions? Please call in on Tuesday, November 12th for the topic “Payment Request Form”

  40. This Completes the Ticket to Work All About Payments training Please fill out our brief evaluation of this training which you will receive in an email

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