As a Social Security disability beneficiary, you probably know that returning to work can trigger a review and potential termination of your benefits. The Social Security Administration (SSA) has rules about paying benefits to people who are able to earn a living, and they will want medical evidence to reevaluate your eligibility. This puts you in a challenging position: you need to earn more than your benefits provide, but if you stop working again, you could be left with no income or benefits.
The Social Security Administration created the Ticket to Work (TTW) program to make it easier for people to return to the workforce gradually. One of the many advantages of TTW is that it protects beneficiaries from undergoing disability medical reviews. As long as you meet the program's requirements, you could potentially continue to receive benefits and earned income—without risking the sudden loss of your monthly check.
What Is a Continuing Disability Review?
The SSA is required by law to schedule reviews of every disability case to identify beneficiaries who might no longer qualify as disabled, known as a Continuing Disability Review (CDR). If the SSA decides that your medical condition is sufficiently improved for you to return to work based on a CDR, your SSI or SSDI benefits will end.
Most cases are reviewed every three to seven years, but an immediate review can be triggered if:
- A beneficiary returns to work.
- A beneficiary informs the SSA that their condition has improved.
- A beneficiary’s medical evidence suggests that their condition has improved.
- A third party has informed SSA that a beneficiary is not following their treatment plan.
- There is a new treatment for a beneficiary’s disabling condition.
Becoming a Ticketholder Prevents Medical Disability Reviews
As your Employment Network, we will help you complete and sign an employment plan to achieve a work goal. Once your ticket is assigned, the ticket’s status is marked In Use on your disability file. You won’t have to worry about your benefits being suspended or discontinued based on a medical determination from a scheduled CDR.
If you qualify for the program, the SSA cannot initiate a medical CDR when your Ticket to Work is in use. A Ticket to Work can be assigned to beneficiaries who are between 18 and 64 years old, are entitled to receive disability benefit payments, and:
- Receive federal cash disability or blindness payments from the SSA
- Does not receive section 301 payments
- Does not receive benefit continuation payments during medical cessation appeal
- Is not receiving SSI benefits based on the childhood standard
- Is not currently receiving temporary cash benefits under Expedited Reinstatement
- Is not presently receiving presumptive disability or blindness payments
Time Requirements for Stopping Continuing Disability Reviews
If you are working under a Ticket to Work, you should be exempt from medical reviews if you have received Title II disability benefits for at least 24 months. These months do not have to be consecutive, and SSA will count any months that a beneficiary qualified for benefits in addition to months where benefits were received.
SSA will also not count any month in which the beneficiary:
- Is in prisoner suspension
- Receives Medicare Qualified Government Employment (MQGE) wages
- Has full workers’ compensation offset status
- Is a disabled adult child (CDB) who is entitled to a disability maximum (DMAX)
- Receives benefits pending an appeal of a medical cessation
- Is entitled to Title II and Title XVI benefits but only received Title XVI payments
If you don’t meet the 24-month requirement before your first medical CDR is triggered by work activity, you could still meet the requirement for future CDRs. Once a beneficiary qualifies for medical review suspension based on work activity, the suspension continues until the end of disability entitlement or if the Ticket becomes inactive.
Could I Lose My Protection From Medical Reviews?
If a Ticketholder or Employment Network decides not to continue with the ticket assignment, the ticket may be unassigned. The Ticketholder’s status may remain In Use for 90 days after the ticket becomes unassigned, giving the Ticketholder up to three months of medical CDR suspension while the ticket is reassigned.
If a Ticketholder cannot reassign their previously-active ticket, they may be eligible to continue medical exemption by undergoing an approved vocational rehabilitation program. This will change the ticket status to In Use-SVR. If the ticket remains unassigned at the end of the 90-day extension period, the beneficiary’s medical CDR protection will end.
Ticketholders can also lose their exemption from CDRs based on the following:
- Inactive status. If the ticket remains assigned and falls into inactive status, the Ticketholder will be subject to medical CDRs.
- Failed timely progress reviews. All Ticketholders must progress toward their work goals to maintain medical CDR protection. Suppose a Ticketholder does not meet the work, vocational training, or educational requirements for a timely progress review. In that case, the ticket status may change to Not In Use, ending the protection from scheduled medical CDRs. The only way to reinstate the exemption is for the Ticketholder to meet the criteria for their progress review.
- Termination. If the ticket is terminated, the Ticketholder is no longer protected from scheduled medical CDRs nor eligible to participate in the Ticket to Work program.
Let Us Help You Return to Work and Keep Your Benefits
The Ticket to Work program has numerous benefits for people living with disabilities who wish to reenter the workforce. In addition to providing recipients with a safety net of additional income and relief from having to worry about medical reviews, TTW makes it easy for people to change jobs or go back on benefits as their needs change.
Ticket to Work Program participants also have access to free employment support services, such as resume help and job-searching skills. Individuals working while receiving Social Security benefits have greater peace of mind, financial flexibility, and the opportunity to reach their full career potential efficiently and securely.
The dedicated employment and benefits professionals at Disability Services of America have years of experience helping people achieve their work goals. If you need help returning to work after an injury without losing your SSDI or SSI benefits, please fill out our online contact form or call (888) 689-6760 to learn more.