Evaluation of the Ticket to Work Program Initial Evaluation Report

E XECUTIVE S UMMARY
T
he Ticket to Work and Work Incentives Improvement Act of 1999 (Ticket Act)
established the Ticket to Work and Self Sufficiency program (TTW) to increase
access to, and the quality of, rehabilitation and employment services available to
Social Security disability beneficiaries and ultimately to increase the number of such
beneficiaries who become economically self-sufficient. Very few beneficiaries now leave the
rolls as a result of having found work, and TTW tries to help more beneficiaries do this by
changing the way the Social Security Administration (SSA) pays for employment services.
The Ticket Act also creates some new rules that let beneficiaries explore work opportunities
without jeopardizing their benefit status.
Somewhat paradoxically, the goal of the TTW program is to promote work among a
group of individuals judged to be incapable of working in any substantial way. People who
receive disability benefits from either SSA’s Disability Insurance (DI) or Supplemental
Security Income (SSI) programs have been judged to have a medically determinable
impairment that is expected to last at least 12 months or result in death, and that renders
them unable to engage in substantial gainful activity. The majority of these beneficiaries do
not attempt to engage in any work once they are on the rolls. Only about 2.5 percent of any
enrollment cohort will ultimately leave the rolls because of having found work, and less than
0.5 percent of all beneficiaries on the rolls at a point in time eventually leave because of
work.
It has proven difficult to raise the low employment rates among disability beneficiaries.
Nevertheless, many people with medical conditions that would make them eligible for
disability benefits do in fact work, and advances in technology and rehabilitation techniques
make it feasible for many people with very severe disabilities to obtain and hold jobs. This
has generated a continuing interest in promoting employment among DI and SSI
beneficiaries, which in turn has led to a consensus that no person with a disability should be
denied the right to participate fully in society, including work, because of external barriers
that can be removed with a reasonable effort.
The TTW program and other elements of the Ticket Act provide new means to help
beneficiaries become employed and financially self-sufficient. In particular, it introduces a
new financing system for providers and gives beneficiaries a choice in which provider to use.
The new financing system adds two payment options to the traditional system that SSA has
used to pay state vocational rehabilitation agencies (SVRAs) for rehabilitation services
provided to beneficiaries. The traditional system reimburses an agency’s costs, up to a limit,