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work will affect client benefits. 1 SSA has taken and continues to take other actions that are
designed to improve access to information on work issues. It has provided extensive training
of field office staff; developing work incentive specialist positions in each SSA area; training
a liaison to the area specialist in each field office to support beneficiary access to work
information; and collaborating with the U.S. Department of Labor to establish disability
program navigators at One-Stop Career centers.
SSA has also made improvements to its basic systems that seem likely to facilitate
beneficiaries’ return-to-work efforts. Some of these improvements address long-standing
issues, and it is possible that, even without TTW, the changes would have improved
beneficiary employment outcomes and reduced dependence on benefits. New software, new
data systems, and other enhancements in SSA procedures should help reduce overpayments
and retroactive terminations, speed Ticket eligibility verification, provide timely information
about use of the Trial Work Period, and speed payments to providers. SSA administrators
have recently accorded high priority to process such post-entitlement work and have
budgeted more resources to that effort.
The various changes extend beyond the walls of SSA, most obviously to SVRAs. Ticket
implementation has clearly focused SVRA attention on disability beneficiaries, made the
agencies aware of SSA’s desire to reduce dependence on benefits through increased earnings,
and motivated the agencies to pay more attention to the consequences of increased earnings
for benefits. A few SVRAs have even taken what can be viewed as positive steps to promote
the development of the EN market.
B. TICKET USE AND PROVIDER PARTICIPATION IS LOWER THAN
MANY HOPED
Reliance on TTW is lower than hoped for at this stage. The best evidence comes from
Phase 1 states, where rollout was completed in November 2002 (see Chapter IV). Nine
months later (August 2003), the assignment rate was only 0.74 percent, although it continues
to rise. In addition, 91 percent of Tickets were assigned to SVRAs and the share of Tickets
assigned under the new payment systems was particularly low (3 percent for outcomes-only
and 11 percent for milestone-outcome system) and declining (see Chapter IV). The
experience in Phase 2 states, where rollout ended in September 2003, appears to be similar to
the experience of Phase 1 states in the comparable period.
Provider participation in TTW has also been much lower than predicted. Although
over 700 providers have signed up to be ENs in the Phase 1 and 2 states, only about 250
have accepted Ticket assignments (Chapter III). Payments to ENs with Tickets are thus far
1 This statement is based on the impressions left by several interviews of staff at SSA, the
state VR agencies, and ENs. Conducting a rigorous evaluation of changes in beneficiary and
provider knowledge and access to information will require the more detailed survey data that
will be available in 2005.
VII: Conclusions and Implications