Federal Register: December 28, 2000 (Volume 65, Number 250)
DOCID: FR Doc 00-32924
SOCIAL SECURITY ADMINISTRATION
Uniformed Services University of the Health Sciences
CFR Citation: 20 CFR Part 411
RIN ID: RIN 0960-AF-11
NOTICE: Part IV
DOCUMENT ACTION: Notice of proposed rulemaking.
SUBJECT CATEGORY:
The Ticket to Work and Self-Sufficiency Program
DATES: To be sure that your comments are considered, we must receive them no later than February 26, 2001.
DOCUMENT SUMMARY:
We are proposing rules to implement the new ``Ticket to Work and SelfSufficiency Program'' (Ticket to Work program) authorized by the Ticket to Work and Work Incentives Improvement Act of 1999. The Ticket to Work program will provide disabled beneficiaries with expanded access to employment services, vocational rehabilitation services, or other support services. We will pay the providers of those services after the beneficiaries achieve certain levels of work.
SUMMARY:
Social Security Administration,
SUPPLEMENTAL INFORMATION
Background
The National Organization on Disability/Harris Survey of 1998 found that only 29 percent of individuals with disabilities were working full or parttime. From 1986 to 1999, the number of individuals receiving disability benefits rose 80 percent, with about half receiving Social Security disability benefits and half Supplemental Security Income (SSI) benefits. Among the factors contributing to this increase were expanded eligibility for benefits, SSA's outreach efforts, the recession of the late 1980's and early 1990's, greater demand for benefits due to the lack of adequate, affordable health care insurance, and the aging of the work force. The Federal government spent $51.3 billion on Social Security disability benefits in 1999, and $22.9 billion in SSI. Many States use State funds to supplement the benefits of SSI beneficiaries.
According to the U.S. General Accounting Office, less than 1 percent of Social Security disability and SSI beneficiaries leave the Social Security and SSI rolls each year as a result of paid employment. Of those who leave, about onethird return within 3 years. If just one half of one percent of the current Social Security disability and SSI recipients were to cease receiving benefits as a result of engaging in selfsupporting employment, savings in cash assistance would total $3.5 billion over the worklife of those individuals.
These proposed rules are intended to expand the options available for Social Security disability beneficiaries and disabled or blind SSI beneficiaries to access vocational rehabilitation services, employment services, and other support services that are necessary for such beneficiaries to obtain, regain or maintain employment that reduces their dependency on cash assistance. We expect that the expansion of these options and the creation of new work incentives in the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA) will remove some of the disincentives that many beneficiaries with disabilities face when they attempt to work or, if already working, continue working or increase their work effort. If more beneficiaries with disabilities engage in selfsupporting employment, the net result will be a reduction in the Social Security and SSI disability rolls and savings to the Social Security Trust Fund and general revenues.
Ticket to Work and Work Incentives Improvement Act of 1999
On December 17, 1999, President Clinton signed into law the Ticket to Work and Work Incentives Improvement Act of 1999 (Public Law 106 170).
In section 2(b) of TWWIIA, the Congress states that TWWIIA has four basic purposes. In general, these are:
To provide health care and employment preparation and placement
services to individuals with disabilities that will enable those
individuals to reduce their dependence on cash benefit programs.
To encourage States to adopt the option of allowing individuals with
disabilities to purchase Medicaid coverage that is necessary to enable such individuals to maintain employment.
To provide individuals with disabilities the option of maintaining Medicare coverage while working.
To establish a ``Ticket to Work and SelfSufficiency Program'' that allows Social Security disability and disabled or blind SSI recipients to seek the employment services, vocational rehabilitation services, and other support services needed to obtain, regain, or maintain employment and reduce their dependence on cash benefit programs.
Section 101(a) of TWWIIA amends part A of title XI of the Social Security Act (the Act) by adding a new section 1148, The Ticket to Work and SelfSufficiency Program (Ticket to Work program). The purpose of the Ticket to Work program is to expand the universe of service providers available to beneficiaries with disabilities who are seeking employment services, vocational rehabilitation services, and other support services to assist them in obtaining, regaining and maintaining selfsupporting employment.
The Social Security Administration is required to develop the regulations necessary to implement TWWIIA and to provide details regarding the Ticket to Work program. Section 1148(l) of the Act requires the Commissioner to prescribe such regulations as are necessary to carry out the provisions of section 1148 of the Act. In addition, section 101(e) of TWWIIA requires the Commissioner of Social Security to prescribe such regulations as are necessary to implement the amendments made by section 101. We are proposing these regulations to address a number of areas where specific policy decisions were left to the discretion of the Commissioner.
Under the Ticket to Work program, the Commissioner may issue
tickets to Social Security disability beneficiaries and disabled and
blind SSI beneficiaries. Each beneficiary will have the option of using
his or her ticket to obtain services from a provider known as an
employment network (EN). The beneficiary will choose the EN, and the EN
will provide employment services, vocational rehabilitation services,
and other support services to assist the beneficiary in obtaining, regaining and maintaining selfsupporting
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employment. ENs will also be able to choose who they serve.
The Commissioner's intent in developing the proposed rules for the Ticket to Work program is to allow service providers that have traditionally provided employment services, vocational rehabilitation services and other support services, as well as other types of entities, to qualify as ENs and serve beneficiaries with disabilities under the program. The expansion of options available to obtain these services will provide beneficiaries with real choices in getting the services they need to obtain, regain, or maintain employment. Public Education Forums and Conferences
Immediately following passage of TWWIIA, we began working with the U.S. Departments of Health and Human Services, Education, and Labor, as well as the Presidential Task Force on the Employment of Adults with Disabilities, the President's Committee on Employment of People with Disabilities, and the National Council on Disability. These Federal partners joined together to plan and conduct a series of public education forums. The purpose of the forums was to increase the awareness of public disability programs among individuals with disabilities, their families and representatives, and service providers. The forums focused on Federal and State employmentrelated policies and programs for people with disabilities.
Forums were scheduled in eleven major cities across the country. Those cities were Baltimore, MD (December 12, 1999); Kansas City, MO (February 2, 2000); Durham, NC (March 9, 2000); Phoenix, AZ (March 30, 2000); New York, NY (April 6, 2000); Austin, TX (May 17, 2000); Seattle, WA (June 13, 2000), Worcester, MA (June 26, 2000); Chicago, IL (August 1, 2000); Harrisburg, PA (August 15, 2000); and Denver, CO (September 1314, 2000).
Representatives from many national and communitybased organizations (e.g., the SSI Coalition, Virginia Commonwealth University, Disability Rights Education and Defense Fund, the National Brain Injury Association, Consortium for Citizens with Disabilities, Robert Wood Johnson Foundation, National Council on Independent Living, Capstone Group, and State representatives from the Developmental Disabilities Councils, the State Independent Living Councils, and the Governors' Committees on Employment of People with Disabilities) participated in these forums.
The forums provided participants with both information and an opportunity for discussion. Topics included: SSA customer services and work incentives; State health care systems and models; and employment initiatives of the Departments of Education, Labor, and Health and Human Services.
The forums were also used as an opportunity to share information about TWWIIA and conduct exploratory discussions about policy issues relating to the implementation of the provisions in TWWIIA that were left to the Commissioner to interpret. New models where State and local systems are working together to serve their common customers with disabilities were highlighted.
SSA representatives have also been involved in meetings and
conferences on the national, regional, State, and local levels. These
included SSAsponsored forums in Chicago, San Francisco, Dallas,
Denver, and Philadelphia conducted in January and February 2000, which
focused on the Ticket to Work program. At these meetings and
conferences, SSA representatives made presentations on TWWIIA,
facilitating discussion and obtaining recommendations that were
considered in developing the provisions of the Ticket to Work program that are being addressed in these proposed rules.
SSA's Programs for Rehabilitation Services Prior to Implementation of the Ticket to Work Program
In titles II and XVI of the Social Security Act, Congress provided
that we promptly refer individuals applying for or determined eligible
for Social Security disability benefits or SSI benefits based on
disability or blindness to State vocational rehabilitation (VR)
agencies for necessary rehabilitation services. Under the statute and
by regulations, if a State VR agency does not serve a beneficiary whom we referred, we may use other public or private agencies,
organizations, institutions or individuals to provide services. Under
our regulations, these other providers of services are known as
alternate participants. We are authorized under the Act to pay State VR
agencies and alternate participants for the reasonable and necessary
costs of services provided to Social Security disability beneficiaries
and disabled and blind SSI beneficiaries under specific circumstances.
The most frequent circumstance permitting payment under the Act is when
the services provided result in the beneficiary performing substantial
gainful activity (SGA) for a period of at least 9 continuous months.
These programs for referral and reimbursement for VR services are
provided for in sections 222(a) and (d), and sections 1615(a), (d), and (e) of the Act.
Section 101(b) of TWWIIA makes a number of conforming amendments to the Act, which require amendments to existing regulations that implement these statutory provisions. As we gradually implement the Ticket to Work program in States selected by the Commissioner, the provisions of the Act for referring beneficiaries to State VR agencies will cease to be in effect in those States as provided in sections 101(b), (c) and (d) of TWWIIA. Additionally, the use of alternate participants under the title II and title XVI vocational rehabilitation reimbursement programs will be phased out in the States as the Ticket to Work program is implemented, as authorized under section 101(d)(5) of TWWIIA.
Under sections 222 and 1615 of the Act, the Commissioner is authorized to impose sanctions (i.e., make deductions from Social Security disability benefits or suspend SSI benefits) with respect to any beneficiary who refused, without good cause, to accept rehabilitation services made available by a State VR agency or an alternate participant.
The proposed rules to implement these statutory changes will be published in the Federal Register at a later date.
Section 101(b) of TWWIIA also amends sections 225(b)(1) and 1631(a)(6)(A) of the Act by striking ``a program of vocational rehabilitation services'' and inserting ``a program consisting of the Ticket to Work and SelfSufficiency Program under section 1148 or another program of vocational rehabilitation services, employment services, or other support services''. Under existing law, SSA continues to pay disability benefits to individuals who recover medically while participating in an approved program of vocational rehabilitation services if the Commissioner determines that continuation in or completion of the program will increase the likelihood that the individual will be permanently removed from the disability rolls. The proposed rules to implement the expanded definition discussed above will be published in the Federal Register at a later date.
We will also publish at a later date in the Federal Register the
rules for implementing section 112 of the TWWIIA, Expedited Reinstatement of Disability Benefits.
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General Goals of the Ticket to Work Program
The Ticket to Work program will enhance the range of choices available to Social Security disability and disabled and blind SSI beneficiaries when they are seeking employment services, VR services and other support services to obtain, regain or maintain self supporting employment. The coordinated and interrelated public policy embodied in various provisions of TWWIIA will remove several disincentives to employment faced by beneficiaries with disabilities. The Ticket to Work program will increase beneficiaries' access to public and private providers to obtain employment services, VR services, and other support services. As a result, the Ticket to Work program, together with other provisions of TWWIIA, should substantially increase the number of beneficiaries who increase their work effort and leave the Social Security or SSI disability rolls due to income from employment.
In addition to providing the increased opportunity for these beneficiaries to obtain services when they seek employment, TWWIIA may result in substantial savings for the Federal government and State governments. Not only should there be an increase in the number of beneficiaries leaving the Social Security and SSI disability rolls due to work or earnings, some individuals will secure work with employers who offer group health coverage, thereby reducing Medicaid and Medicare expenses. Earned income should also yield tax receipts while reducing expenses in Social Security disability and disabled and blind SSI benefits, food stamps, HUD rent subsidies, and veterans benefits. Improved employment rates of individuals with disabilities should increase the independence of such individuals and strengthen our communities and workforce.
Ticket to Work Program
Section 1148 of the Act, which was added by section 101(a) of TWWIIA, directs the Commissioner of Social Security (the Commissioner) to establish a Ticket to Work and SelfSufficiency Program. Section 1148(b) of the Act authorizes the Commissioner to issue tickets to disabled beneficiaries. Beneficiaries may choose among public or private service providers that have been approved by SSA to function as ENs under the program to obtain employment services, vocational rehabilitation services, or other support services to assist them in obtaining, regaining or maintaining employment that will reduce their dependence on cash benefits. Beneficiaries will also have the option of choosing to obtain services from their State VR agency. The overall purpose of the Ticket to Work program is to expand the universe of options available to beneficiaries with disabilities for obtaining such services.
Section 1148(d)(1) of the Act authorizes the Commissioner to conduct a competitive bidding process and enter into an agreement with one or more organizations to serve as a Program Manager (PM) to assist SSA in administering the Ticket to Work program.
The PM will recruit and recommend for selection by the Commissioner ENs for service under the program; monitor all ENs serving in the geographic areas covered under the PM's agreement to ensure that adequate choices of services are made available to beneficiaries; assure that payment by the Commissioner to ENs is warranted; facilitate access by beneficiaries to ENs; ensure the availability of adequate services; and ensure that sufficient ENs are available and that each beneficiary receiving services under the program has reasonable access to employment services, vocational rehabilitation services, and other support services. Section 1148(d)(4) of the Act directs the Commissioner to select and enter into agreements with service providers that are willing to function as ENs and assume responsibility for the coordination and delivery of employment services, vocational rehabilitation services, and other support services to beneficiaries with disabilities under the Ticket to Work program. A beneficiary with a ticket may assign his or her ticket to any provider that is serving as an EN under the Ticket to Work program and is willing to take the assignment.
Section 1148(l) of the Act requires the Commissioner to prescribe such regulations as are necessary to carry out the provisions of section 1148. In addition, section 101(e) of TWWIIA requires the Commissioner to prescribe such regulations as are necessary to implement the amendments made by section 101 of TWWIIA. The regulations proposed in this notice address those areas which must be regulated in order to begin implementing the Ticket to Work program. Additional regulations necessary for the ongoing implementation of the program will be issued in the Federal Register at a later date. For example, proposed performance measures to be used in conducting periodic reviews as necessary to provide for effective quality assurance in the provision of services by ENs will need to be developed and published in the Federal Register for comment. Refer to the section near the end of this Supplementary Information, titled ``Additional Matters for Comment,'' for more information on provisions that will be addressed in future regulations.
Proposed Regulations
We are proposing to add a new part 411 to chapter III of title 20 of the Code of Federal Regulations to provide the rules for the Ticket to Work program. The new part 411 is divided into the following subparts.
Subpart AIntroduction
Subpart A of these proposed rules provides an introduction to the rules in the new part 411. Proposed Sec. 411.100 provides an overview of the proposed rules in part 411. Proposed Sec. 411.105 describes the purpose of the Ticket to Work program. Proposed Sec. 411.110 explains that the Ticket to Work program will be implemented in graduated phases in sites around the country as required by section 101(d) of TWWIIA. Proposed Sec. 411.115 provides definitions of terms used in part 411. Subpart BTickets Under the Ticket to Work Program
Subpart B of these proposed rules describes what a ticket is and explains who is eligible to receive a ticket.
Proposed Sec. 411.120 explains that a ticket is a document that provides evidence of the Commissioner's agreement to pay an EN milestone or outcome payments for services to beneficiaries under the Ticket to Work program. Proposed Sec. 411.125 states the following requirements, among others, for eligibility to receive a ticket: a title II beneficiary must be age 18 to 64, and a title XVI beneficiary must be age 18 to 64 and be eligible for disability payments under the disability standard for adults; a beneficiary must be in current pay status for monthly cash benefits based on disability under title II of the Act or monthly Federal cash benefits based on disability or blindness under title XVI of the Act; and a beneficiary must either: (1) Have a permanent impairment or a nonpermanent impairment (i.e., an impairment for which medical improvement is possible but cannot be predicted), or (2) have an impairment that is expected to improve and have undergone at least one continuing disability review.
In developing requirements for ticket eligibility under the proposed rules, we considered, but decided not to propose,
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extending eligibility for a ticket to two additional groups of individuals.
The first group consists of beneficiaries who have impairments that are expected to improve and for whom we have not yet conducted at least one continuing disability review. Because these beneficiaries have conditions that are expected to medically improve in a relatively short period of time, they could be expected to return to work without the need for services under the Ticket to Work program. Continuing disability reviews for this category of beneficiaries are scheduled for six to eighteen months after the initial disability determination. Under the proposed rules, if we determine in the first continuing disability review that the beneficiary remains disabled, we would then issue a ticket, provided that the beneficiary met the other ticket eligibility criteria. This approach would ensure that beneficiaries whose conditions do not improve as anticipated have the opportunity to benefit from services under the Ticket to Work program within a relatively short period of time after the initial determination.
The second group consists of those who received title XVI payments prior to attaining age 18 (i.e., under the disability standard for children) and have since attained age 18, but for whom we have not yet conducted a redetermination of their eligibility under the disability standard for adults. Because ongoing eligibility has not yet been determined for these beneficiaries, we believe that it is premature to issue a ticket to them immediately. Under the proposed rules, if we establish in the redetermination that a beneficiary in this group is eligible for disability payments under the disability standard for adults, we would then issue a ticket, provided that the beneficiary met the other ticket eligibility criteria. We plan to review periodically our policy regarding ticket eligibility, including whether it would be prudent to extend eligibility to the groups discussed above.
Proposed Sec. 411.130 explains that SSA will distribute tickets in graduated phases. Proposed Sec. 411.135 explains that participation in the Ticket to Work program is voluntary. This proposed section explains that if beneficiaries want to participate in the program they can take their tickets to any entity serving under the program. Proposed Sec. 411.140 explains that a beneficiary may assign his or her ticket to any EN or State VR agency that is willing to provide services, and that the beneficiary may discuss his or her rehabilitation and employment plans with as many entities as he or she wishes. This proposed section explains that the beneficiary can obtain a list of the approved ENs in his or her area. This section also explains certain requirements a beneficiary must meet in order to assign a ticket. This section provides that beneficiaries and ENs must agree to and sign an individual work plan (IWP) (or, in the case of a State VR agency, an individualized plan for employment (IPE)) before a ticket can be assigned. This provision requires that a copy of the plan be submitted to the PM to facilitate the assignment of the ticket. Proposed Sec. 411.145 describes the conditions under which a beneficiary may take a ticket back after it has been assigned to an EN or State VR agency. It also describes other conditions under which a ticket that is assigned can be taken out of assignment. Proposed Sec. 411.150 explains the beneficiary's right to reassign a ticket, if the beneficiary chooses.
Proposed Sec. 411.155 explains when a beneficiary's ticket
terminates and eligibility for participation in the Ticket to Work
program ends. Once a ticket terminates, a beneficiary may not assign or
reassign it to an EN or State VR agency. Under the proposed rules, a
ticket will terminate when entitlement to Social Security disability
benefits ends or eligibility for SSI benefits based on disability or
blindness terminates (whichever is later) for reasons other than the
individual's work activity or earnings; when a Social Security disabled
widow(er) beneficiary attains age 65; when a disabled or blind SSI
beneficiary reaches age 65 and may qualify for SSI benefits based on
age; or after the 60th month for which an outcome payment is made based on that ticket.
Subpart CSuspension of Continuing Disability Reviews for
Beneficiaries Who Are Using a Ticket
Under section 221(i) of the Act and under the authority granted by sections 1631 and 1633 of the Act, we conduct periodic reviews to ensure that beneficiaries continue to meet the definition of disability under sections 223(d) and 1614(a) of the Act. These reviews are called continuing disability reviews. TWWIIA amends the Act to add section 1148(i), which states that SSA may not initiate a continuing disability review during any period in which a beneficiary is using a ticket.
The statute states:
``During any period for which an individual is using, as defined by
the Commissioner, a ticket to work and selfsufficiency issued under
this section, the Commissioner (and any applicable State agency) may
not initiate a continuing disability review or other review under
section 221 of whether the individual is or is not under a disability
or a review under title XVI similar to any such review under section 221.''
The definition of using a ticket is to be determined by the Commissioner of Social Security. Subpart C outlines our proposed definition of using a ticket.
In developing our proposed definition of using a ticket, we considered two key factors. First, the intent of the Ticket to Work program is to allow beneficiaries with disabilities to seek the services they need to work and to reduce or eliminate dependence on Social Security disability and SSI benefits. However, anecdotal evidence suggests that some beneficiaries are afraid that working, or even receiving vocational rehabilitation services, may increase the likelihood that their benefits will be terminated in a continuing disability review. Therefore, using a ticket should be defined in a way that minimizes this employment disincentive for beneficiaries participating in the Ticket to Work program. However, in order to maintain the integrity of the disability programs, it is also important that beneficiaries who have medically improved and who no longer meet the definition of disability under sections 223(d) and 1614(a)(3) of the Act do not continue to receive disability benefits for an undue length of time.
Our proposed definition seeks to balance these concerns by ensuring that continuing disability reviews are suspended only during the period in which beneficiaries are making meaningful progress toward reducing or eliminating dependence on Social Security disability or SSI benefits, while at the same time recognizing that such progress may not always be rapid or continuous.
Under our proposed definition of using a ticket, a beneficiary would be considered to be using a ticket during the period in which he or she was making progress toward the goal of reducing or eliminating dependence on disability benefits within reasonable timeframes. Under this approach, beneficiaries would be allowed a limited period to prepare for work. At the end of this period, they would need to show that they were progressing toward selfsufficiency by demonstrating increasing levels of employment.
An important advantage of this definition of using a ticket is that
it increases employment incentives by ``rewarding'' beneficiaries who
work and progress toward selfsufficiency with continued deferral of continuing
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disability reviews. However, requiring beneficiaries to demonstrate
increasing levels of employment within a defined timeframe results in a
fairly complex regulation. The complexity arises from our attempt to
balance the concerns discussed above and, to the extent possible, to
accommodate the diverse employment needs of a wide range of
beneficiaries. While some level of complexity is unavoidable, we have
attempted wherever possible to simplify the regulation and to make it straightforward to implement.
The following analysis discusses the major provisions of subpart C.
Proposed Secs. 411.170 and 411.171 describe when the period of using a ticket begins and ends. We propose that the period of using a ticket begin when the ticket is first assigned to an EN or State VR agency. The primary purpose of the suspension of continuing disability reviews is to ensure that Ticket to Work program participants are not inhibited in their attempts to work or pursue an employment plan by the fear that such activities will increase the likelihood that their benefits will be terminated in a medical review. Prior to the assignment of the ticket, a beneficiary is not participating in these activities under the Ticket to Work program.
Under our proposed definition, the period of using a ticket ends with the earliest of the following:
(1) The completion of the 60month outcome payment period;
(2) When the beneficiary is no longer making timely progress toward
selfsupporting employment according to our guidelines (see Secs. 411.180 through 411.225);
(3) Three months after the ticket is no longer assigned, if the
beneficiary fails to reassign the ticket during this 3month period; or
(4) When the beneficiary's entitlement to or eligibility for disability benefits terminates.
Proposed Secs. 411.180, 411.185, and 411.220 describe our guidelines for timely progress toward selfsupporting employment. We propose that after assigning a ticket, beneficiaries be allowed up to two years to prepare for employment. Under the current VR system, the average time to attain employment with substantial earnings is approximately 2 years.
After 2 years, beneficiaries would be required to meet progressively higher levels of employment to continue to be considered to be using a ticket in order to receive the protection in 1148(i) of the Act regarding noninitiation of continuing disability reviews. Such a progression would allow beneficiaries time to improve their employment capacities. Under our proposed definition, in the third year of Ticket to Work program participation, beneficiaries would be required to work at least 3 months at the SGA level. In the fourth year of the program, they would be required to work at least 6 months at the SGA level. In the fifth and succeeding years, in order to be considered to be using a ticket they would be required to work at least 6 months in each year and have earnings in each such month that were sufficient to eliminate the payment of Social Security disability benefits and Federal SSI benefits.
In developing these guidelines, we recognized that progress toward selfsufficiency is not always continuous and that for some, full self sufficiency may not be attained. Many beneficiaries have disabilities with cycles of relapse and remission. In addition, some beneficiaries may need to try more than one job before finding a situation that suits their abilities and needs. The requirement that beneficiaries need only work 3 months out of 12 in the third year and 6 months out of 12 in succeeding years recognizes that some beneficiaries may not be able to work on a continuous basis.
In addition, since beneficiaries would be required to work for only 3 months in the third year of their participation in the program, beneficiaries would actually have a total of 2 years and 9 months to prepare for employment. This should allow beneficiaries sufficient preparation time even if they are incapacitated for some portion of that time due to the disabling impairment.
Beneficiaries would also have the option of placing their ticket in inactive status during the initial 24month period following assignment of a ticket if they expected to be unable to participate in their employment plan for a significant period of time due to a relapse, or if they simply chose to stop participating in the plan temporarily. Any period in which the ticket was inactive would not count toward the time limitations under the timely progress guidelines. However, since the ticket would not be in use during this period, the beneficiary would be subject to a continuing disability review should one become due.
In Sec. 411.185, we propose levels of earnings that an individual must have in order to be considered to be using a ticket. Under the proposed definition, the required earnings level would increase over time. In the third and fourth years, both Social Security disability beneficiaries and disabled and blind SSI beneficiaries would be required to work at the SGA level applicable to nonblind beneficiaries for the specified number of months. This level is set by regulation under 20 CFR 404.1574 and is currently $700 a month for nonblind beneficiaries. SSI disability and blindness beneficiaries, Social Security disability beneficiaries who are in a trial work period, and Social Security disability beneficiaries who are statutorily blind would be deemed to have met the requirement to work at the SGA level applicable to nonblind beneficiaries if their gross earnings from employment, before any exclusions, were at or above the dollar amount of the nonblind SGA level, or if their net earnings from self employment, before any exclusions, were at the SGA level applicable to nonblind beneficiaries.
Earnings at the SGA level applicable to nonblind beneficiaries may
not be sufficient to eliminate the payment of all disability benefits,
since the amount of earnings needed to eliminate the payment of
disability benefits depends on a variety of factors, including whether
the beneficiary receives Social Security or SSI benefits, or both,
whether the beneficiary is blind, and whether the beneficiary has
impairment related work expenses or is eligible for other income
exclusions. We are proposing that the earnings requirement for the
third and fourth years be at the SGA level for nonblind beneficiaries to establish an initial earnings level that:
(1) Is consistent across different categories of beneficiaries, increasing simplicity; and
(2) Allows beneficiaries time to work toward the higher levels of
earnings that may be required to eliminate the payment of disability benefits for the required months.
In the fifth and subsequent years, both Social Security and SSI
beneficiaries would be required to work for at least 6 months with
earnings in each such month that were sufficient to eliminate payment
of Social Security disability and Federal SSI cash benefits in a month.
The requirement that individuals using a ticket eventually attain this
level of earnings is consistent with the payment structure of the
Ticket to Work program, in which ENs receive outcome payments only when
Federal disability benefit payments are eliminated. It also reflects
that one of the purposes of the Ticket to Work program is to produce
savings in benefit payments. Since the suspension of continuing
disability reviews for individuals using a ticket means that it is
possible that some beneficiaries who no longer meet the definition of disability will continue to be eligible for
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benefits, it is important that the suspension of continuing disability
reviews not continue for an undue length of time without a significant reduction in benefit payments due to earnings.
In proposed Sec. 411.210, we discuss beneficiaries who do not meet the timely progress guidelines. Beneficiaries who do not make timely progress toward employment in order to be considered using a ticket would be allowed to continue in the Ticket to Work program, and the beneficiary's EN or State VR agency would still be eligible for any payments that became due. However, these beneficiaries would no longer be considered to be using a ticket as defined by the Commissioner, and therefore would once again be subject to continuing disability reviews.
We also propose that beneficiaries who fail to meet the timely progress guidelines to be considered to be using a ticket have the opportunity to be considered to be using a ticket later. In order to be considered to be using a ticket later, a beneficiary would need to work for a specified number of months. The number of months, and earnings level required, would vary depending on how far the beneficiary had progressed when he or she failed to meet the guidelines.
We propose this method of allowing a beneficiary to once again be considered to be using a ticket because we recognize, as mentioned above, that due to the nature of disability, progress toward increased selfsufficiency is not always direct. Beneficiaries may make unsuccessful attempts before eventually reaching their employment goals, and these unsuccessful attempts should not deprive them of the supports that they need to make renewed efforts.
In proposed Secs. 411.190, 411.195, 411.200, and 411.205, we discuss how it will be determined if a beneficiary is meeting the timely progress guidelines. We are proposing that the PM conduct periodic reviews to ensure that beneficiaries are meeting the timely progress guidelines. The first review would be a progress review 24 months after the assignment of the ticket. This would be followed by annual work reviews. After each successful review, the beneficiary would be considered to be meeting the timely progress guidelines until the next review was completed. If a beneficiary disagreed with the PM's decision in any review, the beneficiary would have the right to ask SSA to review the PM's decision.
The criteria for the 24month progress review and the annual work
reviews are designed to be as clear cut as possible. This feature,
combined with the PM's responsibility for conducting the reviews should
allow for rapid processing of reviews and decrease the administrative burden on both the beneficiary and SSA.
Subpart DUse of One or More Program Managers To Assist in the Administration of the Ticket to Work Program
Section 1148(d)(1) of the Act requires the Commissioner to enter
into an agreement with one or more organizations to serve as a PM to
assist the Commissioner in administering the Ticket to Work program.
Section 101(e)(2)(E) of TWWIIA identifies specific regulations that SSA
must promulgate regarding the terms of the agreements to be entered into with a PM. Three items are specifically required:
(1) The terms by which a PM would be precluded from direct participation in the delivery of services;
(2) Standards which must be met by quality assurance measures and methods of recruitment of ENs; and
(3) The format under which dispute resolution will operate under section 1148(d)(7) of the Act.
Among other things, section 1148(d)(7) requires the Commissioner to provide a mechanism for resolving disputes between PMs and ENs, and between PMs and providers of services.
Subpart D of these proposed rules explains that SSA will contract with one or more organizations to serve as a PM and assist SSA in administering the Ticket to Work program. Proposed Sec. 411.230 explains that SSA will conduct a competitive bidding process to select one or more private organizations to perform the PM's functions. Proposed Sec. 411.235 describes the minimum qualifications required of a PM. Proposed Sec. 411.240 describes certain limitations that are placed on a PM regarding the provision of services under the Ticket to Work program. Proposed Sec. 411.245 identifies key responsibilities that a PM must assume to assist SSA in administering the program and proposed Sec. 411.250 explains how SSA will evaluate a PM.
Subpart EEmployment Networks
Section 1148(d)(4)(A) of the Act requires the Commissioner to select and enter into agreements with ENs to provide services as outlined under the Ticket to Work program. Section 1148(f)(1) states that each EN serving under the Ticket to Work program shall consist of an agency or instrumentality of a State (or a political subdivision thereof) or a private entity that assumes responsibility for the coordination and delivery of services under the program to beneficiaries assigning tickets to it.
These ENs are in addition to State agencies administering or supervising the administration of the State plan approved under title I of the Rehabilitation Act of 1973, as amended (29 U.S.C. 720 et seq.), known as State VR agencies, that will also be serving beneficiaries with disabilities under the Ticket to Work program. State VR agencies will have the option of serving beneficiaries with tickets either as an EN (that is, to be paid under one of the EN payment systems described in subpart H of the proposed rules) or under the existing cost reimbursement payment system authorized in sections 222(d) and 1615(d) of the Act. The Commissioner is also directed to enter into an agreement with any alternate participant operating under the authority of section 222(d)(2) of the Act in any State where the Ticket to Work program is being implemented if the alternate participant chooses to serve as an EN. An EN may consist of a onestop delivery system established under subtitle B of title I of the Workforce Investment Act of 1998 (29 U.S.C. 2811 et seq.).
Section 1148(f) of the Act requires that entities seeking to participate in the Ticket to Work program as ENs meet certain qualifications. The Commissioner has discretion in determining the qualifications that an entity must meet to be approved to serve as an EN. We are proposing requirements for ENs that are not unduly burdensome and that are intended to permit both traditional as well as other types of entities to qualify. The Commissioner's intent is to ensure that nontraditional service providers are not prohibited from being approved as ENs, while still requiring evidence that all ENs meet certain minimum qualifications such as licensure, accreditation, academic qualifications, or experience. This inclusive approach is critically important to ensure that beneficiaries with disabilities have a real choice in services necessary to obtain, regain and maintain employment.
Section 1148(f) of the Act also addresses requirements for ENs under the Ticket to Work program. It requires each EN to serve a prescribed service area and ensure that employment services, VR services, and other support services are provided under appropriate IWPs.
Proposed Secs. 411.300 and 411.305 explain what an EN is and what
entities are eligible to apply to serve as ENs. Proposed Sec. 411.310
explains how public or private entities will apply to us to be [[Page 82850]]
approved as ENs and how we will determine whether an entity qualifies
to be an EN. Proposed Sec. 411.315 describes the minimum qualifications
for an EN under the Ticket to Work program. Proposed Sec. 411.320
describes the major responsibilities of an entity serving as an EN.
Proposed Sec. 411.321 explains the conditions under which we will
terminate an EN for inadequate performance. Proposed Sec. 411.325 lists
the reporting requirements placed on an entity serving as an EN and
proposed Sec. 411.330 explains how we will evaluate an EN's performance.
Subpart FState Vocational Rehabilitation Agencies' Participation
Section 1148(c) of the Act addresses participation by State VR agencies in the Ticket to Work program. Among other things, this section gives each State VR agency the opportunity to determine, on a casebycase basis, whether it will participate in the Ticket to Work program as an EN or under the cost reimbursement payment system authorized under sections 222(d) and 1615(d) of the Act (see 20 CFR 404.2101 et seq. and 416.2201 et seq.). The State VR agency must elect either the outcome payment system or the outcomemilestone payment system to be used when it chooses to function as an EN when serving a beneficiary with a ticket. The Commissioner is directed to provide for periodic opportunities to exercise this election. When the State VR agency serves as an EN under the Ticket to Work program, it means that the State VR agency has chosen, with respect to a particular beneficiary, the option of being paid under the EN payment system it has elected for this purpose. Generally under the Ticket to Work program, however, State VR agencies will continue to operate as they do today. For example, when a State VR agency functions as an EN, it will provide services in accordance with the requirements of the State plan approved under title I of the Rehabilitation Act of 1973, as amended, and a client will complete an individualized plan for employment (IPE) with the State VR agency. If a State VR agency has a dispute over a payment under the cost reimbursement payment system, the State VR agency will use the dispute resolution procedures already in place under 20 CFR 404.2127 and 416.2227. The new responsibilities for State VR agencies under the Ticket to Work program include checking if State VR agency clients have a ticket ready for assignment, routing EN payment dispute questions through the PM, and providing reports regarding the outcomes achieved by its clients who have a ticket.
Subpart F of the proposed rules establishes that the cost reimbursement payment system is a payment option under the Ticket to Work program for State VR agencies. Proposed Sec. 411.360 explains what a State VR agency must do to function as an EN under the Ticket to Work program with respect to a beneficiary and explains that a State VR agency may choose, on a casebycase basis, to seek payment from SSA under the cost reimbursement payment system or its elected EN payment system. Proposed Sec. 411.365 describes how a State VR agency will select an EN payment system for use when functioning as an EN. Proposed Sec. 411.370 explains that a State VR agency may choose to serve all beneficiaries with tickets under the cost reimbursement payment system. Proposed Sec. 411.375 explains that State VR agencies must continue to provide services to beneficiaries with tickets under the requirements of the State plan approved under title I of the Rehabilitation Act of 1973, as amended (29 U.S.C. 720 et seq.).
Proposed Sec. 411.380 describes how a State VR agency will determine if a person seeking services is a disabled beneficiary with a ticket. Proposed Sec. 411.385 explains what the State VR agency must do when it determines that a person is a beneficiary with a ticket available for assignment and how it will work with the PM to facilitate the assignment of a beneficiary's ticket to the State VR agency when the beneficiary chooses to make such assignment. It also explains how the State VR agency will notify the PM regarding the method of payment it is selecting for a particular beneficiary.
Proposed Sec. 411.390 describes what a State VR agency should do when it determines that a beneficiary already receiving services under an approved IPE is a beneficiary with a ticket available for assignment. Proposed Sec. 411.395 explains that each State VR agency will be required to provide periodic reports to SSA on the specific outcomes achieved with respect to the services provided to beneficiaries under the Ticket to Work program.
Section 1148(c)(3) of the Act requires State VR agencies and ENs to enter into agreements regarding the conditions under which services will be provided when an EN that has been assigned the beneficiary's ticket refers the beneficiary to a State VR agency for services. Proposed Sec. 411.400 explains that an EN may refer a beneficiary that it is serving under the Ticket to Work program to a State VR agency for services only if such an agreement is in place prior to the EN making the referral. Proposed Sec. 411.410 explains that these agreements are broadbased and apply to all beneficiaries who may be referred by an EN to a particular State VR agency. Proposed Sec. 411.415 explains that the PM will verify the establishment of such agreements based on the EN's submission of a copy of the agreement to the PM. Proposed Sec. 411.420 provides guidance on what should be included in these agreements and proposed Sec. 411.425 explains what a State VR agency should do if an EN attempts to refer a beneficiary being served under the Ticket to Work program to the State VR agency without having established such an agreement. Proposed Sec. 411.430 explains what the PM should do when notified that a referral has been attempted in the absence of an agreement. Proposed Sec. 411.435 establishes procedures for resolving disputes arising under these agreements.
Subpart GRequirements for Individual Work Plans
Section 1148(g) of the Act requires each EN to ensure that employment services, vocational rehabilitation services, and other support services provided under the Ticket to Work program are provided under IWPs. The minimum requirements for an IWP are spelled out in this section.
Subpart G of these proposed rules establishes the requirements for the IWP that must be developed when an EN and a beneficiary with a ticket come to a mutual understanding to work in partnership under the Ticket to Work program to assist the beneficiary in achieving employment that is selfsupporting and that reduces dependence on cash assistance. Beneficiaries who are clients of the State VR agencies will continue to use the individualized plan for employment rather than an IWP. Proposed Sec. 411.455 explains the purpose of the IWP and explains that the EN must develop and implement the plan in a manner that gives the beneficiary the opportunity to exercise informed choice in selecting an employment goal. Proposed Sec. 411.460 explains that the beneficiary and the EN share the responsibility for determining the content of the IWP.
Proposed Sec. 411.465 describes the specific information that must
be included in each IWP and proposed Sec. 411.470 explains that an IWP
becomes effective on the date it was signed by a beneficiary, or the
beneficiary's representative, and by the EN, provided that the program
manager verifies that a beneficiary has a ticket eligible for assignment and records the assignment.
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Subpart HEmployment Network Payment Systems
Section 1148(h) of the Act provides that the Ticket to Work program shall provide for payments authorized by the Commissioner to ENs. These payments shall occur under either an outcome payment system or an outcomemilestone payment system. The two systems are defined in Sec. 411.500. This section also defines two other terms we use related to the payment systems.
The amount we can pay to an EN (including a State VR agency choosing to be paid as an EN) under either payment system is based upon the prior calendar year's national average disability benefits payable under title II or title XVI, not upon the specific benefit payable to a beneficiary with a ticket. The amount payable to an EN will depend upon whether the individual who assigned his or her ticket to the EN is entitled to benefits under title II or is eligible for benefits under title XVI. If the beneficiary is concurrently entitled under title II and eligible under title XVI, we will use the title II payment calculation base.
Payments to ENs are for specific milestones or outcomes achieved by a beneficiary who assigns a ticket to the EN. Such payments are not based upon the costs of specific services provided by the EN.
The outcome payments under either EN payment system are payable for a maximum of 60 months. These months do not have to be consecutive. Section 1148(h)(3)(C) of the Act provides that the schedule of payments to the EN under the outcomemilestone payment system shall be designed so that the total of the payments is less than, on a net present value basis, the total payments the EN would be limited to if the EN were paid under the outcome payment system.
Section 1148(c) of the Act permits each State VR agency to participate in the program as an EN with respect to a disabled beneficiary. When the State VR agency elects to participate in the Ticket to Work program as an EN with respect to a disabled beneficiary, the State VR agency shall be paid in accordance with its elected EN payment system. If the State VR agency chooses not to participate as an EN with respect to a disabled beneficiary, the State VR agency shall be paid for services provided to that beneficiary in accordance with the cost reimbursement payment system under sections 222(d) and 1615(d) and (e) of the Act. Our regulations concerning this cost reimbursement payment system are at 20 CFR Secs. 404.2101 through 404.2127 and Secs. 416.2201 through 416.2227. Payments to State VR agencies are discussed in Sec. 411.510.
Each EN will elect the EN payment system it will be paid under when it agrees to become an EN. We periodically will offer each EN (including a State VR agency) the opportunity to change its elected payment system. If the EN does change its elected payment system, the change will apply only to tickets assigned to the EN after the change in the elected payment system is made known to SSA. These provisions, including the frequency of opportunity for an EN to change its payment system, are discussed in Secs. 411.505 through 411.520.
Sections 411.525 through 411.565 provide our proposed rules for computing payments to ENs under the two EN payment systems and for allocating payments to multiple ENs to whom the ticket was assigned at different times.
Section 1148(h)(2) of the Act provides that the outcome payment system shall provide for a schedule of payments to an EN, in connection with a beneficiary who assigns a ticket to the EN, for each month, during the individual's outcome payment period, for which Social Security disability benefits and Federal SSI benefits based on disability or blindness are not payable to the individual because of work or earnings. There can be a maximum of sixty outcome payment months and, therefore, a maximum of sixty monthly outcome payments. In proposed Sec. 411.525, we explain that an outcome payment month is a month for which Social Security disability benefits and Federal SSI benefits based on disability or blindness are not payable to the individual because of work or earnings. The proposed rules also provide criteria for determining whether a month occurring after the month in which a beneficiary's entitlement to Social Security disability benefits ends or eligibility for SSI benefits based on disability or blindness terminates due to work activity or earnings will be considered to be an outcome payment month. Under the proposed rules, we will consider any month after the month in which such entitlement ends or eligibility terminates because of work or earnings to be an outcome payment month if the individual has gross earnings from employment (or net earnings from selfemployment) in that month that are at or above the SGA dollar amount in 20 CFR 404.1574(b)(2) (for an individual who is not statutorily blind) or in 20 CFR 404.1584(d) (for an individual who is statutorily blind), and the individual is not entitled to any monthly benefits under title II or eligible for any benefits under title XVI for that month.
In Sec. 411.525, we propose that monthly payments under the outcome payment system will be 40 percent of the payment calculation base, which is defined in Sec. 411.500. This percentage is the maximum the law allows at the beginning of the program. Under the outcome payment system, each monthly outcome payment is the same during a calendar year. At the end of each calendar year, the payment calculation base will be refigured for the next year.
For example, at the end of calendar year 2000 the national average disability benefits payable per month for 2000 will be calculated for title II and for title XVI. Forty percent will be multiplied by each of these two amounts to determine the monthly outcome payment amounts for calendar year 2001 under the outcome payment system. At the end of 2001, the computation will be repeated using the 2001 national average disability benefits payable per month to determine the monthly payment under the outcome payment system for 2002.
To illustrate with sample data, if outcome payment months occurred in calendar year 2, the following maximum monthly outcome payments would be based upon the calendar year 1 payment calculation base as follows
For title II and concurrent title II/XVI beneficiaries:
Average national disability benefit for year 1 = $693 per month $693 x 40% = $277
$277 is the monthly payment amount to the EN for an outcome payment month in calendar year 2
For title XVI recipients:
Average national disability payment for year 1 = $440 per month $440 x 40% = $176
$176 is the monthly payment amount to the EN for an outcome payment month in calendar year 2
As the national average disability benefit payable tends to rise every year due, in part, to costofliving adjustments, the annual computation of the payment calculation base should increase the monthly outcome payment amount for each succeeding year.
The outcomemilestone payment system provides payments to the EN when the beneficiary achieves milestones directed toward the goal of permanent employment. Payments for the milestones achieved come before, and are in addition to, payments made during the outcome payment period.
Proposed Sec. 411.525 explains that we will pay an EN to whom a ticket has
[[Page 82852]]
been assigned only for milestones or outcomes that are achieved prior
to the month in which an individual's ticket terminates. We will not
pay milestone or outcome payments based on an individual's work
activity or earnings in or after the month a ticket terminates.
Section 411.535 describes the two milestones we are proposing. Both milestones occur after work begins and are based upon an earnings level and duration of work. Both milestones can be attained even if there are interruptions in the work pattern. The amount of the second milestone payment is more than the first, but the beneficiary must work longer in order for the EN to receive the second milestone payment. Both milestones are based upon the dollar amount we use when we evaluate monthly earnings to determine if work activity is SGA. For calendar year 2000, these dollar amounts are $700 per month for beneficiaries who are not statutorily blind and $1,170 per month for beneficiaries who are statutorily blind. Section 411.535 proposes the milestone requirements. Section 411.540 proposes how we will calculate the payment for each milestone. For milestone one, we propose using a percentage of the payment calculation base defined in Sec. 411.500 that approximately equals two outcome payment months under the outcome milestone payment system. For milestone two, we propose to double the percentage used for milestone one.
Section 411.545 proposes how, under the outcomemilestone payment system, we will calculate the amount payable for outcome payment period months following the payment of milestones. Monthly outcome payments during the first 12 outcome payment period months (months 112) will be the lowest and also will be reduced each month by an amount equal to \1/12\th of the total milestone payments made with respect to a ticket. Monthly outcome payments during the fifth interval of 12 outcome payment period months (months 4960) will pay the highest amount per month. The outcome month payments under the outcomemilestone payment system will be a percentage of the payment calculation base applicable to the year in which the outcome payment month occurs. Under the outcomemilestone payment system we propose to use, the total potential payment will be about 85 percent of the total potential payment that could be made under the outcome payment system. As stated previously, the outcome payment months do not have to be consecutive months under either EN payment system.
Section 411.555 proposes that an EN may generally keep its milestone and outcome payments received under the elected payment system, even if the beneficiary does not sustain work for 60 outcome payment period months. This section also states that retroactive adjustments to payments already received by ENs may occur for reasons related to our modifying our previous determination about a beneficiary's right to benefits, or due to allocating a prior payment with another EN.
Sections 411.560 and 411.565 explain that it is possible to pay more than one EN for the same milestone or outcome payment month. In this situation, the payment would be allocated among the ENs that qualify for payment. Section 1148(e)(3) of the Act provides that the PM will determine the allocation based on the services provided by each EN. We propose it also will be possible to pay more than one EN for different milestones or outcome payment months on the same ticket. When more than one EN is eligible for payment with respect to a ticket, we propose paying each EN in accordance with its elected payment system at the time the ticket was assigned to each EN.
Section 411.570 provides that the Act prohibits an EN from requesting or accepting compensation from a beneficiary for the EN's services.
Proposed Sec. 411.575 describes how an EN will request payment for either a milestone payment, or an outcome payment month. The EN will make a written request to the PM for payment for each milestone. The request will be accompanied by evidence showing that the milestone was achieved. We do not have to stop a beneficiary's monthly cash payment in order to pay a milestone payment to an EN.
For outcome payments under either EN payment system, an EN must submit a written request for payment to the PM. The request and evidence of work or earnings that is sufficient to reduce monthly Federal cash benefits to zero are required in order to begin outcome payments to the EN. We will make the determination that the work or earnings are sufficient to stop the beneficiary's monthly cash payment by using the same criteria we already use to make this determination. For outcome payments for months after a beneficiary's entitlement to Social Security disability benefits ends or eligibility for SSI benefits based on disability or blindness terminates due to work activity or earnings, an EN must submit evidence that the individual has monthly gross earnings from employment or net earnings from self employment that are at or above the applicable SGA dollar amount. In order to continue receiving monthly outcome payments, the EN must provide ongoing evidence of work and earnings to demonstrate that it is entitled to each monthly outcome payment.
Proposed Sec. 411.580 explains that an EN must first have had the ticket assigned to it before it can be eligible to receive milestone or outcome payments.
As a beneficiary is free to choose where to assign a ticket, proposed Sec. 411.585 explains that a State VR agency and an EN can both be eligible for payment on a ticket if the State VR agency elects to be paid as an EN. Therefore, each entity can be paid as an EN under its respective EN payment system. However, if the State VR agency chooses to serve a beneficiary with a ticket and to be paid under the cost reimbursement payment system, then we will pay either the State VR agency under the cost reimbursement payment system or we will pay an EN under its elected payment system. We propose that, for each ticket, a payment either under the cost reimbursement payment system or under an elected EN payment system will exclude any payment under the other payment system. We propose this restriction to comply with the payment limitations that exist in the Act for the cost reimbursement payment system and for the EN payment systems. Absent this restriction, it would be possible to pay separately under both the cost reimbursement payment system and under the EN payment systems such amounts as, when combined, would exceed the statutory limitation of one or both of these payment systems for serving the same beneficiary under the same ticket.
Following is a chart showing an example of payments under each of
the two EN payment systems. This chart illustrates how we propose to
calculate payments under the outcome payment system and under the
outcomemilestone payment system. The payment calculation base was
determined as discussed above in the preamble. Actual data, based upon
calendar year 2000, should be available at the end of the calendar year
for implementing the EN payment systems in calendar year 2001. BILLING CODE 419102P
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[GRAPHIC] [TIFF OMITTED] TP28DE00.015
BILLING CODE 419102C
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Proposed Sec. 411.590 describes what an EN or State VR agency can do if either disagrees with our decision on a payment request which is submitted. This section also explains that an EN cannot appeal our determination about a beneficiary's right to benefits even when that determination affects the payment to an EN.
Proposed Sec. 411.595 identifies various methods
FOR FURTHER INFORMATION CONTACT
Geoffrey Funk, Team Leader, Legislative Implementation Team, Office of Employment Support Programs, Social Security Administration, 6401 Security Boulevard, Baltimore, Maryland 212356401. Call (410) 9659010 or TTY 1(800) 9885906 for information about these proposed rules. For information on eligibility or filing for benefits, call our national tollfree number, 1(800) 7721213 or TTY 1(800) 3250778. You may also contact SSA Online at www.ssa.gov.