Evaluation of the Ticket to Work Program Initial Evaluation Report

milestone payment is equal to 34 percent of the PCB, as defined above. The second
milestone payment is equal to 68 percent of the PCB for the calendar year in which the
month of milestone attainment occurs. The third milestone payment is equal to 136 percent
of the PCB for the calendar year in which the month of milestone attainment occurs. The
fourth milestone payment is equal to 170 percent of the PCB for the calendar year in which
the month of milestone attainment occurs. Monthly outcome payments under the
milestone-outcome system are equal to 34 percent of the PCB for the calendar year in which
the month occurs.
To obtain either an outcome or milestone payment, an EN must submit a request and
proper documentation of the beneficiary’s earnings to the Program Manager. Detailed rules
govern the type of earnings evidence that will be accepted and how it will be evaluated.
Evidence is categorized as primary or secondary, reflecting the degree to which it can be
relied upon as an accurate and complete record of earnings. Primary evidence consists of
employer records—for example, pay stubs, employer wage statements, or oral statements by
employers. Secondary evidence comes from other (third-party) sources such as state
unemployment insurance, tax returns, employee business records, or employee statements of
earnings. If the EN is unable or unwilling to submit the primary earnings evidence, it must
wait until SSA investigates the reported earnings and develops the evidence necessary to
process the claim. This can take substantial time, depending on field office workloads and
beneficiary and employer cooperation. The EN can expedite the process by providing the
primary earnings evidence up front.
The Program Manager encourages ENs to meet the requirements for primary evidence,
as this will expedite the payment process. Evidence that does not meet the standards for
acceptance (original, legible, unaltered, clearly identifying the beneficiary, and so on) must be
further investigated by the Program Manager (by contacting the EN, beneficiary, or
employer) or referred to the relevant SSA field office for continued development; both of
these processes could substantially delay payment. The high standards placed on the
evidence reflect its use as a key determinant of a beneficiary’s continued eligibility for
benefits. With respect to primary earnings evidence, one issue that often must be addressed
is that pay stubs may not contain all of the information that SSA needs to process the claim.
The evidentiary requirements also differ depending on the program(s) from which the
beneficiary is receiving benefits (DI and/or SSI) and the type of payment claim. 7 As
discussed in Chapter III, SSA is in the process of implementing changes intended to reduce
the burden of collecting evidence after the third Ticket payment for a beneficiary has been
made.
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7 For DI beneficiaries, SSA requires information on the period in which the wages were
earned. For SSI beneficiaries, SSA requires information on the date that the wages were paid.
Also, for all milestone payments and for outcome payments after benefits terminate for
work or earnings, SSA requires information on the date that the wages were earned.
II: Structure and Background of the Ticket to Work Program