TN 1 (10-02)

DI 55099.110 SSA-L1370 (Beneficiary/Recipient Notice Review of Ticket Eligibility Explanation Prior Explanation Incorrect Individual Was Eligible For A Ticket)

 

Social Security Administration

Important Information

 

Social Security Administration

(1)

(2)

Date: (3)

Social Security Number: (4)

 

(5)

(6)

(7)

 

This is a notice about whether you are eligible to receive a Ticket to participate in the Ticket to Work program. Please read it carefully.

Our Prior Explanation Was Incorrect –You Were Eligible for a Ticket

You asked us to review our explanation of (8) about whether you are eligible to get a Ticket, stating that the reason(s) we gave you was incorrect. We have reviewed our records and prior explanation. We find that our prior explanation was incorrect and that you were eligible to receive a Ticket. We have taken the action necessary to send you a Ticket.

You Can Start Now to Look for an Organization to Provide You Services

You can get started now by choosing an organization to provide you with services under the Ticket to Work program. The organization can be an Employment Network or your State Vocational Rehabilitation (VR) agency.

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  You do not have to wait to receive your Ticket in the mail in order to contact an Employment Network or your State VR agency to talk about getting services under the program.

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  Employment Networks are public or private organizations that have agreed to work with us under the program. An Employment Network or State VR agency can offer employment, vocational and other services to help you go to work or earn more money from your work.

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  We have hired a company called MAXIMUS to help us manage the Ticket to Work program. We call MAXIMUS the Program Manager for the program.

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  If you want to get started, you can get a list of Employment Networks or find the State VR agency in your area by calling MAXIMUS. Their toll-free numbers are 1-866-968-7842 (1-866-YOUR TICKET) and 1-866-833-2967 (1-866-TDD 2 WORK) (TTY/TDD). If you use the Internet, you can find a list of Employment Networks or information about the State VR agency in your area at www.yourtickettowork.com.

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  You must meet certain requirements in order to assign your Ticket to an Employment Network or State VR agency to begin participating in the Ticket to Work program.

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.ssa.gov/work for specific information on employment supports for people with disabilities. If you have specific questions, you may call us toll-free at 1-800-772-1213, or call your local Social Security office at (9). 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:

(10)

(11)

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) Date of explanation notice

(9) Phone number of resident FO

(10) Street address of resident FO

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