Vocational Rehabilitation Agencies Frequently Asked Questions (FAQs)

Click on a question below to review the answer.

Can Social Security perform a medical Continuing Disability Review (CDR) on a Ticket eligible beneficiary receiving services from my State VR agency under the Cost Reimbursement payment method?

No. When a State VR agency chooses to serve a beneficiary under Cost Reimbursement and sends the proper documentation to MAXIMUS, the beneficiary's Ticket is placed in a status called "In-Use SVR" which carries with it the same protection against medical Continuing Disability Reviews that were previously only associated with a Ticket being assigned and "in-use." 

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When must my State VR agency choose which payment method we intend to use for a particular Ticket Holder? Can we change our mind later and switch the payment method for a particular beneficiary, from being paid as an EN to being paid under Cost Reimbursement, or vice-versa, depending on the case?

State VR agencies must choose between the Cost Reimbursement program and its elected EN payment system at the time that the beneficiary is signing an IPE or SSA-1365 with the State VR agency. If the State VR agency reports an SSN through the electronic process for CR cases, this decision can be changed within 90 days of the IPE signature date. This is done by submitted a completed SSA 1365 with a written note indicated that the case was originally reported as a CR case and is not being changed to Ticket assignment.  SSA allows this change to be made to ensure that the medical CDR protection is in place as soon as possible.  At this time, State VR agencies are not permitted to change SSN reported as Ticket assignments using the SSA 1365 to CR case cases.  Once 90 days from the IPE signature date has elapsed, cases reported as CR cases must continue as CR cases throughout the time that a State VR agency case is open.

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How and when will a beneficiary be informed he or she has an "In-Use SVR" Ticket status with my State VR agency?

Social Security sends a letter to each beneficiary after OSM receives and processes the beneficiaries SSN in an electronic data transfer and that information is transferred to SSA. These letters go out once a month, around the first day of the month.

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Can a beneficiary re-assign his or her Ticket to an EN while my State VR agency has an open case and the Ticket status is "In-Use SVR"?

No, a beneficiary should not be able to assign his or her Ticket to an EN while he/she has an open case with the State VR agency. This is why it is so important to be timely in reporting the opening of both CR and Ticket assignment cases to OSM. If you are not timely in reporting the beneficiaries you are serving, the official records will not reflect that a case is open with your agency and an EN may establish the Ticket assignment before the Ticket is placed "In-Use SVR" or assigned to your agency.

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If an EN serves a beneficiary who does not attain all the payments available on the Ticket, and then the beneficiary decides to return to my State VR agency where the Ticket was previously assigned, can we accept the Ticket again and resume Ticket payments? Would we be able to serve this beneficiary under Cost Reimbursement?

A beneficiary may re-assign his or her Ticket to an EN, including a State VR agency (acting as an EN), with which the beneficiary formerly assigned the Ticket. However, only those Milestone and Outcome payments initially available and not yet paid when the Ticket is re-assigned would be available for payment once the beneficiary attained applicable levels of work and earnings. If your agency previously had a CR case but never submitted a CR claim on behalf of this beneficiary or has not had an approved claim on this beneficiary since January 1, 2002, your agency has the option of opening a Ticket case or a CR case on the beneficiary.  However, if your agency received any reimbursement on behalf of this beneficiary since January 1, 2002, your only option is to open a CR case.

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How does the Partnership Plus option work?

When the State VR agency chooses to serve a beneficiary under Cost Reimbursement and sends proper documentation to OSM, the beneficiary's Ticket is placed in a status called "In-Use SVR" which carries with it the same protection against medical Continuing Disability Reviews which was previously only associated with a Ticket being assigned and "in-use."

During the time the beneficiary has an open State VR agency case, the Ticket is not available for assignment to an EN. After the State VR agency case is closed, the beneficiary may assign the Ticket to an EN and receive job retention services, ongoing support services, or other services and supports to maintain employment and increase his or her earnings.

For more information regarding the Partnership Plus, you may review the Partnership Plus section of this site.

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What payments are available to my EN after the beneficiary has worked with the State VR agency?

A beneficiary, who works with a State VR agency under the Cost Reimbursement program, would be able to use his or her Ticket with an EN once the State VR agency closes the beneficiary's case. If the beneficiary is working when the State VR agency closes the case, the EN with the Ticket assignment can receive Phase 2 Milestone and Outcome payments as the beneficiary attains the required levels of work and earnings.

When a State VR agency serves a beneficiary as an EN, the beneficiary's Ticket is assigned to the State VR agency. If the beneficiary chooses to assign his or her Ticket to another EN after a State VR agency closes the case, any available EN payments that have not been made could be made to the new EN once the beneficiary attains the required level of work. In cases where a State VR agency provided significant services that contributed to the beneficiary's achieving SGA level earnings, you may be looking at a split payment situation.  Some State VR agencies have created Shared Ticket Payment agreements that spell out how Ticket payments will be split in these situations.  If there is no such agreement,  the State VR agency and the EN may seek advice from OSM regarding how payments should be split. OSM is tasked with determining how Ticket payments should be split based on the services each entity provided and how those services contributed to the beneficiary's ability to attain the required levels of work and earnings to trigger Ticket payments.

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Is the Partnership Plus option only available when my State VR agency is serving a beneficiary under the traditional Cost Reimbursement program?

Yes. As in the past, a State VR agency can choose on a case-by-case basis whether to serve a beneficiary under the traditional Cost Reimbursement program or as an EN under the Ticket to Work program. If a State VR agency chooses to serve a beneficiary under the Cost Reimbursement program, the option for a State VR agency and an EN to provide sequential, but not concurrent services, comes in to play. A State VR agency can provide the up-front services the beneficiary needs to get to work and, after the State VR agency case is closed, the beneficiary can assign his or her Ticket to an EN for job retention or ongoing support services. If the beneficiary gets to earnings (after deductions for Impairment Related Work Expenses and subsidies) above SGA for 9 months within a 12 month period, the State VR agency can submit for Cost Reimbursement. As soon as the beneficiary's earnings get to the gross SGA level (without any deductions based on work incentives), the EN can start submitting requests for Phase 2 Milestones. When the beneficiary's net earnings are above SGA and the beneficiary is placed in zero cash benefit status, the EN can start submitting for Outcome payments. The Phase 1 Milestones are not available to the EN if a State VR agency closed the case with the beneficiary in employment. This is because the State VR agency provided the services and placed the beneficiary in employment and SSA views the Phase 1 Milestones as compensation for the initial efforts to get a beneficiary in the workforce and stabilized in employment. In a couple of states, the State VR agencies have created Partnership Plus models that provide one or two job retention payments to the EN that gets a State VR agency graduate to SGA level earnings for a designated period of time (e.g., 3 or 8 months).  These benchmark payment models provide some compenstation to ENs that are willing to take successful State VR agency graduates since the Phase 1 Milestones are not available for beneficiaries that a State VR agency places in employment prior to case closure.These models are based on the assumption that the job retention or ongoing support services the EN provided contributed to the beneficiary's success in getting to 9 months of net SGA earnings, at which time a State VR agency is able to submit for Cost Reimbursement.  If this benchmark payment is made prior to the nineth month of SGA level earnings, the State VR agency can submit this expense are part of its CR claim as a purchased post-employment service.

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If a beneficiary currently has his or her Ticket assigned to an EN, does my State VR agency need to get the Ticket "un-assigned" from the EN in order to serve the beneficiary under Cost Reimbursement?

Although Social Security disability beneficiaries are presumptively eligible for State VR agency  services, Social Security will not make Cost Reimbursement payments to a State VR agency if the Ticket is assigned to an EN during the same time period. The State VR agency should check with OSM to learn whether a potential client's Ticket is available for assignment. If your agency is notified that a Ticket is already assigned to an EN, the State VR agency counselor may contact the EN or the beneficiary to discuss unassign the Ticket while the State VR agency case is open. These situations provide unique opportunities to take advantage of the Partnership Plus option. Under Partnership Plus, a State VR agency may be able to work with the EN to get the Ticket un-assigned during the period the beneficiary is receiving State VR agency services with the intention of referring the beneficiary back to that EN when State VR agency services are completed.  Another alternative is for a referring EN to keep the Ticket assignment and have an agreement with the State VR agency which clearly states the types of services to be provided by each entity and how the State VR agency will be compensated for the services it provides since the agency will not be able to submit a CR claim on this beneficiary.

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Can an EN who has a beneficiary's Ticket assignment refer that Ticket Holder to my State VR agency for services (such as a vocational evaluation) without losing the Ticket assignment?

An EN that holds a beneficiary's Ticket assignment may refer the beneficiary to a State VR agency for services. However, both the Ticket regulations and the EN Request for Quotation (RFQ) require the the EN and the State VR agency to have a written agreement that specifies the conditions under which the State VR agency will provide services. The agreement must be in writing and signed by both parties before the EN can refer a Ticket Holder to the State VR agency and keep the Ticket assignment. The alternative is for the EN to unassign the Ticket to release it to the State VR agency to provide services.  If your agency has identified a particular EN that is not complying with this requirement, you should contact your Point of Contact at OSM or email the Partnership Plus Help Desk at  PartnershipPlus@yourtickettowork.com.

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What documentation will my State VR agency need to submit to Operations Support Manager (OSM) to place a beneficiary's Ticket for "In-Use SVR" under the State VR agency Cost Reimbursement option?

To place a Cost Reimbursement case "In-Use SVR", the State VR agency need only submit two data elements:  the beneficiary's SSN and the date that the IPE was signed. This information must be submitted to OSM by the end of the month following the IPE signature date to ensure that all of the services provided between the IPE signature date and the date the case is placed "In-Use SVR" are approved for reimbursement.  This also ensure the beneficiary's timely access the the medical CDR protection associated with using the Ticket.

When closing a CR case, the State VR agency must submit to OSM the beneficiary's SSN, the date the case was closed, and the status of the beneficiary's case at case closure, i.e., 26/28, employment/not employed, or successful/unsuccessful. The timely reporting of case closures is also important because a beneficiary is granted a 90-day grace period for the medical CDR protection, starting the date the case is closed.  The sooner a CR case is reported as closed, the sooner the Ticket is available for assignment to an EN for ongoing employment supports.

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What does my State VR agency need to submit to OSM to show that we have an open case that will be eligible for payment under either the Cost Reimbursement payment option or to be paid as an EN?

When a State VR agency is operating as an EN, it must complete, sign, and have the beneficiary sign the SSA-1365, State Agency Ticket Assignment Form, and return this form to OSM to secure the Ticket assignment.  The beneficiary should be informed that the Ticket is assigned to a State VR agency. For a beneficiary that has consented to assign the Ticket to the State VR agency but has not signed an SSA-1365, the process remains the same. In this case, OSM will continue to accept an unsigned SSA-1365 along with an IPE bearing a statement of the beneficiary's informed consent to assign the Ticket as evidenced by the beneficiary's signature.

When serving a beneficiary under the CR program, a State VR agency must submit information on the beneficiary (SSN and IPE signature date) to OSM using one of the approved methods for submitting electronic reports (i.e., using the MoveIt secure website, sending a password protected comma delimited file through email to svrticketdata@yourtickettowork.com, giving OSM access to a state-sponsored secure website, or mailing a CD).  Using the MoveIt secure website is the simplest and preferred method. A beneficiary being served under CR should be informed that his/her Ticket is not available for assignment to an EN while the State VR agency case is open, that the Ticket will still have value after a State VR agency closes the case, and that he/she will have the option of taking the Ticket to an EN after a State VR agency has closed the case to secure services and support to stay employed and increase his/her earnings.

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How frequently must my State VR agency submit information about completed IPEs and case closures? Why is it important to submit this information on a regular basis?

Effective April 1, 2012, information on the opening an closing of CR cases must be submitted monthly to OSM. There are three important reasons for reporting this information in a timely manner. First, OSM must ensure that the Tickets for these beneficiaries are placed in the "In-Use SVR" status that provides them protection against medical Continuing Disabilities Reviews (CDRs). Second, OSM needs to remove the names of these beneficiaries from the list of assignable Tickets to prevent other ENs from securing that beneficiary's Ticket assignment. And third, if case closure information is not received promptly, the beneficiary may not benefit from the 90 day window to reassign a Ticket without losing the protection against medical Continuing Disability Reviews (CDRs).

For a beneficiary that has consented to assign the Ticket to the State VR agency but has not signed an SSA-1365, the process remains the same. In this case, OSM will continue to accept an unsigned SSA-1365 along with the first and last page of the IPE which should include a statement of the beneficiary's informed consent to assign the Ticket as evidenced by the beneficiary's signature.

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Are there specific desired formats my State VR agency should use for Social Security Numbers and dates when submitting case data?

The SSN should not contain any dashes (e.g., 22345678) and the dates (IPE signature date and case closure date) should be an 8 digit numeric field in MMDDYYYY format (e.g., 03222012).  

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How should my State VR agencies submit our monthly reports on CR cases to OSM?

There are several alternative ways that the data can be sent to OSM.

  1. The preferred method is to use the MoveIt secure website. 
  2. The data can be sent by email to svrticketdata@yourtickettowork.com. If this method is used, the file must be zipped using WinZip, password protected, and encrypted. Passwords to the files must be sent in a separate email.
  3. A CD may be mailed to OSM at P.O. Box 1433, Alexandria, VA 22313, and email the password to the CD to svrticketdata@yourtickettowork.com.  This is the least efficient and least timely method.
  4. A secure FTP site hosted by the State VR agency may be used. The State VR agency puts the files on its server and gives OSM a passwork to log into the server and download your electronic files.

More information on submitting monthly reports on CR cases and the options for submitting those reports can be found on this website by going to Vocational Rehabilitation, clicking on the "Training" icon and scrolling down to "Cost Reimbursement: Monthly Electronic Reporting – Your Cost Reimbursement Depends on It."

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My State VR agency is small compared to other State VR agencies. Can't we just submit data quarterly instead of monthly?

Although a State VR agency may have relatively few records compared to the rest of the nation, SSA is still requiring each State VR agency to submit monthly files on CR cases  Effective April 1, 2012, SSA will no longer approve CR claims on cases that have not been reported to OSM and placed "In-Use SVR."  In addition, effective July 1, 2012, SSA implemented a "previous month rule" to ensure beneficiaries are given access to the medical CDR protection as soon after the IPE is signed as possible. This means a State VR agency must report each CR case within the month following the month during which the IPE was developed. This means an IPE for a CR case that is signed in July 2012 must be reported to OSM by the end of August 2012. To ensure compliance with this rule, SSA will not reimburse any expenses incurred during the month the IPE was signed or the following months up until the month the case was reported to OSM and the Ticket was placed "In-Use SVR."

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I am getting bombarded by calls from beneficiaries suddenly getting pulled for a medical review, right after they failed TPR. Why?

The normal TPR process includes beneficiary failures being reported by OSM  to Social Security each night. This notification removes the CDR protection from the beneficiary. At that point, the beneficiary falls into the normal schedule of his/her medical review. Timing has nothing to do with failing the TPR. If the beneficiary immediately gets called for medical review, it is only because this happens to be the timing for a medical review based on the original schedule set up when the disability determination was made. Regardless of when the beneficiary fails a TPR, the medical review is due at a certain time (every 1, 3, 5 or 7 years). As soon as the CDR protection is removed, the beneficiary is eligible for, and will be called for, the next scheduled review.

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