One fifth of all federal government spending is payment of social security benefits to persons with disabilities (SSDI) or with minimal income and assets (SSI). During the 1990s the Social Security Administration determined that less than 1% of the 9 million people of working age with disabilities who receive SSDI ever return to work on a continuous basis. Washington responded in 1999 with the Ticket to Work and Work Incentives Act (TWIIA). It is a new federal program with the stated purposes of: lowering barriers to work for people on SSDI or SSI; encouraging those persons to utilize existing vocational rehabilitation services in their communities; and to increase the number of private providers of vocational rehabilitation services to serve this population. In 2002 TWIIA was adopted by 13 states. More states will participate in 2003, and by the end of 2004 all 50 states (including California) will have adopted it.

The statute has two parts, the Work Incentives and the Ticket to Work. The Work Incentives part offers a variety of different means to promote employment among recipients of social security: (1) the government has hired experts called benefits planners to calculate the financial impact of taking a particular job on your social security benefits (2) when your earnings increase to the point of ending eligibility for Medicaid, you can pay a small premium to keep your health coverage, and can extend it for 4.5 years after you are off SSI (3) if your new job does not work out, and you have to go back on social security, you will be entitled to expedited re-instatement of benefits for up to 3 years after your job ends (4) Protection & Advocacy (a non-profit firm of advocates for the disabled) will be utilized to resolve conflicts between the bureaucrats who run the program and the consumers.

The government has contracted with a private firm called Maximus to administer TWIIA. In each participating state, Maximus will mail out a paper ticket to work to all recipients of SSDI/SSI on its computer. While this should include all people who actually get benefits, the great probability is that some people will be missed. Such people can call Maximus and demand inclusion, but only if they learn of the program, something requiring more extensive publicity than has yet been given. If you misplace or lose your ticket, you can call Maximus for a replacement. Maximus can be contacted by phone at 1-866-986-7842 or on line at www.yourtickettowork.org

Under TWIIA, an Employment Network is any state vocational rehabilitation department and any private provider of vocational rehab services who qualifies by filling out a 90 page questionnaire submitted to and approved by Maximus. Each person receiving a paper ticket can bring it to any Employment Network for vocational rehab services and receive those services free of charge, because the cost will be paid by Social Security (at a set discount) directly to the service provider. Employment Networks are not obligated to accept every ticketholder, and can exercise free choice as to who they will and will not accept.

Will the program result in a net movement of people from SSDI or SSI to gainful employment, and if so, how many people? Critics of the program contend it has builin flaws that doom it to failure. For instance, the huge burden of filling out the 90 page questionnaire may discourage private service providers from entering the program. Further, the government is not obligated to pay Employment Networks at the immediately at the market rate in a lump sum. Rather, the government gets to pay at a discounted rate in installments over a 5 year period, and payments will terminate if the client ceases to work. ENs are also allowed to reject ticketholders without giving a reason, so disabled persons who present the most challenges and the highest risk of failure at re-employment are least likely to be accepted.
While YWIIA has its critics, it also has its supporters, who remain hopeful it will have some success, however modest, in getting people back to work. Since the program is still so new, it is too early to tell either way. Even if the ticket to work portion of TWIAA does not help a particular individual, that person might still benefit from the work incentives programs in the Act.