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Ticket to Work Program. All About Payments. Expectations. I want to know how to fill out a payment request form what steps do I take if payment was denied Why was my payment denied Steps to take for Universal Auto pay

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Presentation Transcript
ticket to work program

Ticket to Work Program

All About Payments

expectations
Expectations
  • I want to know how to fill out a payment request form
  • what steps do I take if payment was denied
  • Why was my payment denied
  • Steps to take for Universal Auto pay
  • Need more in depth info on EN Split Payment Request Form and 18 Month Lookback Form
course objectives
Course Objectives
  • Describe the Payments Process
  • Differentiate between Outcome-only and Milestone/Outcome payment methods
  • Identify available Phase I Milestone payments using the 18-Month Lookback Tool
  • Define exclusions, transitions and reconciliation
payment process
Payment Process

Get Beneficiary to Trial Work Level (TWL) or Substantial Gainful Activity (SGA)

Check Ticket Assignability

Complete Individual Work Plan (IWP)

Be sure to include Certification of Services

Submit Payment Request Form

Consider Universal Auto Pay

progress check 1
Progress Check #1

Payment Process step #3 is missing from the list below. Choose the correct step.

  • Check ticket assignability
  • Complete an IWP
  • ?
  • Submit a payment request
  • Be sure to include COS
  • Consider Universal Auto Pay
payment methods
Payment Methods

Outcome Only

Milestone/Outcome

EN provides the services needed

Beneficiary reaches certain Trial Work Level (TWL) earnings with Federal cash benefits

Milestone payments while beneficiary receives benefits

EN can receive Outcome payments

  • EN provides the services needed
  • Beneficiary must reach a consistent earnings level of Substantial Gainful Activity (SGA) and stop receiving Federal cash benefits
  • EN can receive Outcome payments
definition of terms
Definition of Terms

Trial Work Level

  • Incentive to work while receiving benefits

2013

$750/month

Substantial Gainful Activity

  • Substantial – significant mental or physical activity
  • Gainful – performed for pay or profit

2013

$1,040/month non-blind

$1,740 if blind

pause for understanding
Pause for Understanding

George TicketHolder

Pizza restaurant employee

SSI recipient

Physical disability

Average earnings $900/month

outcome only payment method
Outcome-Only Payment Method
  • No payments until
    • Beneficiary reaches gross SGA ($1,040/month non-blind; $1,740 blind or visually impaired for 2013)
    • Beneficiary stops receiving Federal cash benefits
business plan considerations
Business Plan Considerations

Outcome Only Milestone/Outcome

milestone outcome payment method
Milestone/Outcome Payment Method
  • Payments can occur while beneficiary continues to receive Federal cash benefits
  • Payment types
    • Phase I Milestone
    • Phase II Milestone
    • Outcome
phase ii milestones
Phase II Milestones
  • Ticket Holder reaches SGA but still receives Federal cash benefits
  • Based on single calendar months
outcome payments
Outcome Payments
  • Zero Federal cash benefit status
progress check
Progress Check

If a beneficiary is working at Trial Work Level and is receiving monthly Federal cash benefits due to a disability, then what payment method could that EN be receiving?

slide18
Prior Earnings Rule Conditions
  • TWL or above
  • Between Date of Disability Onset and Ticket Assignment date
  • Maximum 18 month period
phase 1 milestone 1 payment
Phase 1 Milestone 1 Payment

Earnings month

Ticket Assignment Month

EN cannot receive Phase 1 Milestone 1 payment

phase 1 milestone 2 payment
Phase 1 Milestone 2 Payment

Earnings months

Ticket Assignment Month

EN cannot receive Phase 1 Milestone 2 payment

phase 1 milestone 3 payment
Phase 1 Milestone 3 Payment

6

Earnings months

12 months

Ticket Assignment Month

EN cannot receive Phase 1 Milestone 3 payment

phase 1 milestone 4 payment
Phase 1 Milestone 4 Payment

9

Earnings months

18 months

Ticket Assignment Month

EN cannot receive Phase 1 Milestone 4 payment

criterion are applied independently
Criterion are applied independently

Ticket Assignment Month

Milestone 1 is available Milestone 2 is not

18 month lookback tool1
18 Month Lookback Tool
  • Ticket assignment date: January 2013
  • Above TWL: August, October, and December 2012
guided practice
Guided Practice

X

X

X

Ticket assignment date: January 2013

18 month lookback tool2
18-Month Lookback Tool
  • TWL: September – December 2011; May, June 2012; July, October, November 2012
exclusions
Exclusions

Other Phase 1 Denial reasons

  • State VR agency
    • Cost Reimbursement method
      • Reimbursement for costs incurred
      • Received after SGA level – 9 months in a 12 month period
previous vr involvement
Previous VR involvement?
  • Cost Reimbursement
  • Case closed successfully

No

Phase 1

Milestone

Payments

transitions1
Transitions
  • Caused by changes in regulation
  • Prevents duplicate payments
  • Rules
    • Phase I Milestones not available if State VR agency closed case successfully in 2002 or later
    • Phase I Milestones are available if State VR agency closed case successfully before 2002
    • Phase I Milestones are available if State VR agency closed case unsuccessfully
reconciliation payment
Reconciliation Payment
  • Reconciles available milestone payments
  • Milestone/Outcome method only
  • Total amount skipped at the year rate

Specific rules available at www.yourtickettowork.com

More details on next week’s Ticket Training Tuesday

questions
Questions?

Please call in on Tuesday, November 12th for the topic “Payment Request Form”

slide40
This Completes the Ticket to Work All About Payments training

Please fill out our brief evaluation of this training which you will receive in an email

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