Ticket utilization and implementation: Investigating use patterns of the Ticket to Work program from the consumer’s perspective

BACKGROUND: The Ticket to Work Incentives and Improvement Act provides work incentives for Social Security Administration (SSA) beneficiaries with various disabilities. Of the 9,963,114 tickets "rolled" out, approximately 64,000 Tickets were used. The small amount utilized indicated a further need to investigate individual Ticket usage. OBJECTIVE: This article takes a policy perspective, exploring and discussing personal experiences of Supplemental Security Income beneficiaries who received a "Ticket to Work" in 2003. METHODS: A small pilot survey was administered to five beneficiaries. A close read of the responses in concert with a discursive approach was conducted to determine additional factors that may play a role in the participants' decisions to use their Tickets. RESULTS: Participants were overwhelmed with the amount of information provided in the Ticket packages and perceived disincentives (e.g., loss of existing health care and disability benefits) to act on their Tickets. CONCLUSIONS: Considering the ambiguity expressed by the participants, customized employment may be a viable solution to reduce load on agencies and increase participation in Federal programs. From a policy perspective, this study illustrates the value of small pilot studies and first-person accounts to determine participants' ability to understand complex activities and to decide to act. It also reinforces the importance of consumer-led input into long-term support programs.