TN 3 (02-14)
DI 55030.020 Guidance on the Roles and Responsibilities of Field Offices (FOs) Regarding the Ticket to Work Program Earnings Process and Employment Network (EN) Payment
There are currently two Ticket-to-Work (TTW) program processes that require FO assistance:
the earnings report and verification process (see DI 55030.010E.2. and DI 55030.010F.2.), and
the employment network (EN) payment process.
B. The earnings report and verification process for the Ticket to Work program
1. Program Manager (PM) role
The TTW program requires that ENs and State vocational rehabilitation (VR) agencies serving as ENs submit evidence of a beneficiary/recipient’s earnings to the PM. The PM, using SSA approved authority, evaluates the reported earnings it receives from ENs and State VR agencies as evidence. The PM, following Social Security guidelines, electronically records the evidence of earnings into the shared process (located on the SSA menu, #4). Once this is completed, the PM then accesses the DCF and records the associated monthly gross earnings as “alleged” on the verify/update earnings (VERN) screen.
Once the PM enters the alleged earnings information into the DCF, certain tolerance conditions are conducted that may trigger a request for verification or generate verify earnings (VY) issues to the FO. VY issues are systems-generated issues created when the alleged gross earnings posted by the PM exceed the earnings tolerance levels. Generally, the reasons for the VY issues are posted earnings that exceed the tolerance for:
a trial work period (TWP),
a substantial gainful activity (SGA) determination, and
a title XVI payment determination.
The FO then verifies the earnings, thereby closing the VY issue.
NOTE: The PM can also post manual earnings (ERNGS) issues related to the areas above that provide additional information (e.g., T2EARN, T16EARN, or CONCEARN) and that will require FO action. (See DI 55030.010E.)
2. FO role in providing assistance
FOs will follow the procedures on processing reported earnings information as outlined in DI 55030.015. This will also “close” any VY issues generated to the FO.
NOTE: If the PM finds that the earnings submitted differ from what is already posted to the DCF, and the difference could affect TWP, SGA, EPE, or title XVI payment determinations, then the PM will create a T2EARN, T16EARN, or CONCEARN issue on the DCF, requiring FO action to resolve.
The EN or beneficiary/recipient may submit earnings evidence directly to the FO. In these situations, the FO should conduct normal earnings process actions by accepting the report of earnings as mentioned in DI 55030.001C and DI 55030.001D.
C. PM role in the EN payment process
1. PM processes and triggers the EN outcome or milestone payment
After the PM receives an outcome or milestone payment request from an EN or a State VR agency acting as an EN, the PM queries the DCF to ensure that the monthly posted earnings are verified as part of its case review process. If the posted earnings for the requested payment month are verified, the PM processes and triggers the EN outcome or milestone payment through the system.
2. PM creates an “OPAYMENT” issue
The “OPAYMENT” issue is defined as an “other” EN payment related issue(s) that requires FO assistance to resolve. These issues are not overpayment for DI or SSI payment and only relate to other ticket payment such as:
a. Posted earnings are not verified
When the monthly posted earnings associated with the EN’s outcome or milestone payment requests are not verified, the EN payment request cannot be processed until the PM takes an additional step by posting an OPAYMENT issue to the DCF, thereby requesting that the FO verify the earnings as a priority.
b. EN unable to obtain earnings information from beneficiary/recipient
When the PM receives an EN payment request and is unable to generate a VY issue to the FO because the EN is unable to obtain wage information from the beneficiary/recipient, the PM will create an OPAYMENT issue on the DCF.
For information on the FO's role in providing assistance in the EN payment process, see DI 55060.010.