TN 1 (10-02)

DI 55099.080 SSA-L1365 (Beneficiary/Recipient Notice Ticket Eligibility Explanation)

 

 

Social Security Administration

Important Information

 

Social Security Administration

(1)

(2)

Date: (3)

Social Security Number: (4)

 

(5)

(6)

(7)

 

This is a notice that explains why you are not eligible to get a Ticket to participate in the Ticket to Work program. Please read it carefully.

Why You Are Not Eligible for a Ticket

You asked us to explain why you are not eligible for a Ticket under the Ticket to Work program. The (8) you are not eligible for a Ticket (9): (10)

You May Be Eligible for a Ticket at a Later Date

On a regular basis, we identify individuals who become eligible to receive a Ticket. If your situation changes and the reason(s) listed above no longer exists, and you meet all of the other requirements for getting a Ticket, we will identify your record automatically and send you a Ticket in the mail. For this reason, you should report any changes that might mean you could become eligible for a Ticket.

If You Disagree with this Explanation

If you disagree with our explanation of why you are not currently eligible to receive a Ticket, you may ask us to review this explanation. We will consider any new facts you have and send you another notice.

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  You have 30 days to ask for a review.

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  The 30 days start the day after you receive this notice. We assume you got this notice 5 days after the date on it unless you show us that you did not get it within the 5-day period.

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  You must have a good reason for waiting more than 30 days to ask for a review.

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  You may request a review in person at any Social Security office or by letter.

 

If You Have Any Questions

We invite you to visit our website at www.ssa.gov on the Internet to find general information about the programs of the Social Security Administration. Also, you may wish to go directly to www.sssa.gov/work for specific information on employment supports available to people with disabilities. If you have specific questions or you want to let us know about a change that affects your eligibility for a Ticket, you may call us toll-free at 1-800-772-1213, or call your local Social Security office at (11). We can answer most questions over the phone. If you have difficulty hearing or talking on a telephone, you may call our TTY/TDD number, 1-800-325-0778. You can also write or visit any Social Security office. The office that serves your area is located at:

(12)

(13).

 

If you do call or visit an office, please have this notice with you. It will help us answer your questions. You may call before you visit an office to make an appointment. This will help us serve you more quickly when you arrive.

 

 

 

Deputy Commissioner

for Operations

 

Fill-ins

(1) Street address of FO/PC

(2) City, State, and zip code of FO/PC

(3) Date

(4) Social Security Number

(5) Name of beneficiary/recipient

(6) Address

(7) City, State, and zip code

(8) (a) reason
     (b) reasons

(9) (a) is
     (b) are

(10)

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  You are under age 18.

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  You are age 65 or older.

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  You are not eligible for benefits under the Social Security or Supplemental Security Income disability program.

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  You are not receiving a Federal cash disability-based benefit from us.

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  We previously decided you recovered enough to work and are now paying you benefits under special rules while you participate in an approved vocational rehabilitation program.

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  We are not issuing Tickets to individuals who are receiving benefits under these special rules.

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  We previously decided you recovered enough to work and are now paying you benefits under special rules while you appeal that decision. We are not issuing Tickets to individuals who are receiving benefits under these special rules.

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  We are not issuing Tickets to individuals whose health is expected to improve until we review their cases at least once. The notice that we sent you when you were first awarded disability benefits told you your health was expected to improve. That notice also told you when we will review your case and that we will send you a notice before we start this review.

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  We are not issuing Tickets to individuals receiving disability benefits who turn age 18 unless we find them disabled based on the rules we use for adults filing new disability claims. You became eligible for Supplemental Security Income benefits prior to your 18^th birthday based on special rules we have for children. We have not yet decided if you are eligible for benefits based on the rules we use for adults.

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  We are not issuing Tickets to individuals who are getting provisional benefits. You now get these temporary benefits because special rules allow us to pay you for up to six months while we decide if we can reinstate your disability or blindness benefits.

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  We are not issuing Tickets to individuals who are getting Supplemental Security Income benefits while we are making a final determination about whether they are disabled or blind.
  You now get these benefits because special rules allow us to pay you for up to 6 months while we decide whether you are disabled or blind.

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  At the present time, the Ticket to Work program is not available to individuals living in your area.

  (11) Phone number of resident FO

  (12) Street address of resident FO

  (13) City, State, and zip code of resident FO