Evaluation of the Ticket to Work Program Initial Evaluation Report

C HAPTER I
O VERVIEW OF THE T ICKET TO W ORK
P ROGRAM AND I TS E VALUATION
T
he Ticket to Work and Work Incentives Improvement Act of 1999 (Ticket Act)
established the Ticket to Work 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 who become economically selfsufficient.
Currently, very few beneficiaries leave the rolls due to work. TTW tries to help
more beneficiaries exit due to work by changing the way the Social Security Administration
(SSA) pays for employment services. It also changes some program rules in order to let
beneficiaries explore work opportunities without jeopardizing their benefit status.
The TTW program operates with the apparent paradox of trying to promote work
among a group of individuals judged incapable of substantial work. 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 vast majority of beneficiaries will not attempt any
work once they are on the rolls. Only about 2.5 percent of any enrollment cohort will
ultimately leave the rolls due to work and less than 0.5 percent of all beneficiaries on the rolls
at a point in time eventually leave due to work (Newcomb et al. 2003; Berkowitz 2003).
The low employment rates among disability beneficiaries have proven difficult to
increase substantially. There is no evidence that the many work incentives that SSA has
instituted prior to TTW have increased work-related program exits (Newcomb et al. 2003).
Furthermore, two prior SSA demonstrations to test employment support programs, Project
Network and the Transitional Employment Training Demonstration, had low participation
rates: about 6 percent of eligibles participated (Kornfeld et al. 1999; and Decker and
Thornton 1995). In addition, while both demonstrations’ interventions generated a large
proportional increase in participant earnings, those increases were small in absolute terms.
These small absolute increases translated into negligible reductions in benefit payment as
most working participants had earnings below the thresholds that would result in losing their
benefits.
Nevertheless, it is well-known that 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