TN 1 (10-02)
DI 55002.055 Policies Related to Ticket Terminations
A. Policy — events that terminate a ticket
1. General rule — entitlement/eligibility based on disability or blindness terminated for reasons other than work or earnings
Generally, an individual's ticket will terminate in the earliest of the following months:
the month in which entitlement to title II benefits based on disability ends for reasons other than work activity or earnings (e.g., death, a medical cessation, a DIB to RIB conversion), or the month in which eligibility for benefits under title XVI based on disability or blindness terminates for reasons other than work activity or earnings (e.g., death, an excess resources termination), whichever is later;
the month in which a disabled widow(er) or a disabled surviving divorced spouse attains full retirement age;
the month following the month in which a title XVI disabled or blind recipient attains age 65, or
the month after the month in which your outcome payment period ends.
NOTE: The mere suspension of benefits/payments (e.g., a title XVI suspension for excess resources) will of will not cause a ticket to terminate).
2. Special rules — entitlement/eligibility based on disability or blindness terminated because of work or earnings
a. When the special rules apply
Special ticket termination rules apply after an individual's entitlement to or eligibility for benefits based on disability or blindness terminate because of work or earnings. In concurrent cases, these rules apply only when entitlement and eligibility under both titles have terminated and the reason for the termination under at least one of the titles is the beneficiary's/recipient's work or earnings.
b. Ticket-Terminating events under the special rules
After entitlement/eligibility terminates for work or earnings (except where a former concurrent beneficiary continues to be entitled/eligible under the other program), an individual's ticket will terminate in the earliest of the following months:
NOTE: This is not the determination that SSA makes about provisional (temporary) cash benefits. It is the EXR entitlement/eligibility determination requiring a favorable medical decision.
the month SSA makes a final determination/decision to deny the individual's new claim for title II/title XVI disability/blindness benefits based on the filing of an application;
the month the individual attains full retirement age (see RS 00615.004);
the month the individual dies;
the month the individual becomes entitled to a title II benefit that is not based on disability or eligible for a title XVI benefit that is not based on disability or blindness;
the month the individual again becomes entitled to or eligible for disability/blindness-based benefits under title II or title XVI based on a new application; or
the month in which the individual is eligible to receive another ticket because SSA reinstates entitlement to or eligibility for title II/XVI benefits under the EXR provisions (see DI 55002.010B.3.).
NOTE: Reinstatement of entitlement/eligibility requires a favorable medical decision. It does not mean that SSA has decided to pay provisional (temporary) cash benefits.
B. Policy – effect of a ticket terminating
1. General effect of a ticket terminating
Generally, once a ticket terminates, a disability/blindness beneficiary/recipient can no longer participate in the Ticket to Work program. In practical terms this means that:
a beneficiary/recipient may no longer use the ticket to obtain services from an EN or a State VR agency after the ticket termination date (see DI 55002.001A); and
SSA will not pay an EN for milestones or outcomes that a beneficiary/recipient achieves in or after the month in which a ticket terminates (see DI 55060.005).
2. Exception – new ticket issued
If a new ticket is issued, then the beneficiary/recipient will be able to participate again in the Ticket to Work program. This can occur in connection with:
benefit entitlement/eligibility reinstatement under the EXR provisions (see DI 55002.010B.3.), or
the approval of a new application for disability/blindness-based benefits.
C. Policy – limited appeal rights
As with the ticket-eligibility determinations (see DI 55002.050A), SSA makes ticket-termination determinations in accordance with title XI of the Act. Therefore, ticket-termination determinations are not actions that constitute initial determinations under title II or title XVI of the Act. As a result, an individual may request SSA to review a determination that his/her ticket has terminated. However, that determination is not subject to the administrative and judicial review processes that apply to initial determinations under the title II or title XVI program.
NOTE: The underlining factors that cause a ticket to terminate may be based on determinations made under title II and title XVI of the Act. Thus, such determinations (e.g., determinations about whether disability/blindness has medically ceased, determinations about whether title XVI payments should terminate for excess resources) may be appealed or reopened, subject to the rules on administrative finality.