WISE Ticket to Work Webinar
Ticket to Work: Working with a Mental Illness
May 22, 2019

Speakers: Stacey Plizga (Moderator); Tina Skeel & Carla Orr (Presenters)

STACEY>> Welcome to today's Ticket to Work webinar. Ticket to Work: Working with a Mental Illness. My name is Stacey Plizga, and I'm a member of the Ticket to Work team. And I will be your moderator for today's webinar. We are so glad you are able to take time to spend with us today to learn about Social Security's Ticket to Work program and other work incentives that can help you as you start on the path to financial independence through work. 

In connection with Mental Health Month, our webinar will also cover information and resources that may help people with mental illness as they make the decision to find work and transition to the workplace. Each of us has our own path to follow and we hope you will find some information today that will assist you in moving forward on your path to employment and financial independence.

So let's get started by going over some of the functions of the webinar platform so you can interact and get the most out of the information presented today. First, you can manage your audio using the audio option that is at the top of your screen. The audio option is an icon that looks like a microphone or telephone. 

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If you are unable to connect to the audio with your computer or if you prefer to listen to the webinar by phone, you can dial 1-800-832-0736, and enter access code 4189148#. 

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Real-time captioning is available and is displayed in the captioning pod, which is the box that appears below the slide that is on your screen right now. You can also access captioning online by going to http://bit.ly/captions-may19. And this link can also be found in the web links pod under the title Closed Captioning. 

We are all here today to answer questions you have on the Ticket to Work program. So please send in your questions to us at any time throughout the webinar by typing them into the Q&A pod. We will then direct those questions to the appropriate speaker during the Q&A portion of our webinar. We will be addressing questions at two different points throughout today's presentation. So go ahead and send those questions in, and we will do our very best to make sure we answer as many of them as possible.

If you are listening by phone and you are not logged into the webinar, you may ask questions by sending an email to Ticket to Work. And the email address is webinars@choosework.ssa.gov.

Another resource available that we think you will find extremely helpful in connecting to the different resources mentioned today is the web links pod, which you will find at the bottom right hand side of your screen. This pod lists all the links to the resources that are presented during today's webinar. To access any of these resources, you would highlight the topic you are interested in and would like to connect to, and then you select the browse to button at the bottom of the pod and you will be taken to the website requested.

If you're listening by phone and you're not logged into the webinar, or don't have access to the web links pod, you can email Ticket to Work. The email address is webinars@choosework.ssa.gov, or reference the confirmation email that you received for today's webinar for a list of available resources. And please note that SSA cannot guarantee and is not responsible for the accessibility of external websites. 

Today's webinar is being recorded, and a copy of it will be available within two weeks on the Choose Work website, which can be accessed at http://bit.ly/WISE_OnDemand. This link as well as the others can be found in the web links pod we just talked about that is in the bottom right hand corner of your screen. And this link is titled WISE Webinar Archives. 

We hope everyone has a great experience on the webinar today. However, if you run into any technical difficulties, please use the Q&A pod to send us a message, or you can send us an email at the Ticket to Work email address, which is webinars@choosework.ssa.gov. 

As I mentioned earlier, my name is Stacey Plizga, and I am a member of the Ticket to Work team, and I'm very excited to be here with you today as your moderator. We are delighted to have with us two speakers who will not only share information about Social Security's Ticket to Work program, but will also share information and resources that may help people with mental illness as they make the decision to find work and to transition to the workplace. 

Our first speaker, Tina Skeel, is the project director for Northern and Central Indiana Works at Aspire Indiana Inc. Tina has devoted over 25 years to promoting employment opportunity for persons with barriers to employment. She's a nationally recognized trainer and consultant in her field of supported employment and benefits counseling. She was an initial trainer for the Ticket to Work program in Indiana, and has since been working with [inaudible] to develop and enhance employment programming under the Ticket to Work program.

Our second speaker, Carla Orr, has been an employment provider for 20 years working with individuals with various barriers to employment. She is a national community partner work incentive counselor, a board member for [inaudible] and is an advocate for individuals with disabilities. 

We are excited to have these extremely knowledgeable speakers with us today to share their experiences and expertise and assist you with helping your employment journey. Thank you all for joining us today. We have a very informative session planned where your guest presenters will discuss myths and facts regarding mental illness, work as a pathway to recovery, how the Ticket program can support you on your journey to work, work incentives available to you through the Ticket program, reasonable accommodations and disclosure regarding your disability. And then we'll wrap it up by discussing managing stress during your job search and on the job. 

It is my pleasure to introduce Tina Skeel, who will talk to us about the myths and facts regarding mental illness. Over to you, Tina. 

TINA>> Thank you so much, Stacey. And thank you to Social Security for having once more on their [inaudible]. This particular topic is near and dear to me, as I started out, just like Carla, we started out about the same time in supported employment and providing assistance with job placement for individuals who experience mental illness. And so, this, again, is a really important topic. 

We're going to start out talking a little bit about mental illness and the myths and facts. So let's go ahead and talk a little bit about what is mental health. Mental health includes a lot of different things. But the three primary categories are employment, psychological, social well-being. So those are the three components, the emotional side of it, the psychological side of it, and the social well-being. It affects how we think, how we feel, how we act. It also helps determine how we handle stress, relate to others, and also sometimes in making choices. 

Relate to others, and also sometimes in making choice. 

Over the course of your life, if you experience mental illness, you're thinking, moods, and behaviors could be effected.

So let's take a look at some questions. So first of all, let's talk about mental illness. How is it? Do you think it's frequent? Let's take a look. Is it infrequent? Well, apparently not. This is absolutely and completely false. So think about it this way, if you're sitting in a room full of five individuals and you look to your left and you look to your right, there's at least one person who is experiencing mental illness, that's pretty doggone common. So we're looking at stats from 2014, so one out of five American adults experience a mental health issue at least once in a lifetime. One in 10 young people experience a period of major depression, and one in 25 Americans lived with a serious mental illness such as schizophrenia, bipolar disorder, or major depression. I want to make a real quick note, for those of you how are in fact signers, there is a resource link at the bottom. So if you have questions, or would like more information, that's a really great place to look and find more information.

So let's take another look at another question. People with mental illness needs, even those who are managing their mental health well, don't tolerate the stress of holding down a job as well as people without a mental health need. Let's take a look at what the answer is. True or false? Absolutely false. When employees with a mental illness receive effective treatment, the result can be really amazing. Lower total cost in medical costs, increased productivity, lower absenteeism, and decreased disability costs. So we know that individuals can really work and do great things out there.

So let's look at a couple more statistics. People with mental illness can be just as productive as any other employee, just because you have a mental illness, does not mean that you are less productive than anybody else around you, and if you're on the line and are experiencing mental illness, know that there are lots of people out there that are behind you and we know, for certain, employment is a great option. So what we also found is employers who hired people with a mental illness reported good attendance and punctuality, as well as motivation and good work, like a really good work ethic, and years on the job actually increases on par or greater than other employees. So what that means is, that employers have found that by hiring individuals how maybe experiencing mental illness, they actually get an individual who was highly motivated, good works, and come to work, and are reliable, and that's what employers are looking for.

So let's look at another question. There is little hope for recovery for a person with mental illness. Once a friend or family member develops a mental illness, he or she will never recover. Well, that's completely and absolutely false. Studies have shown that people with mental illness get better. They do much better. I've been in this field for 25 years, and a lot of things have changed, and people do recover, and it may be possible to recover completely, and let's talk a little bit about what recovery refers to.

Recovery refers to the process in which people are able to live, work, learn, and participate fully in their communities. That's really what recovery is. No matter what the definition you might see, but it's really about those four items. There are more treatments and services as I mentioned just a few seconds ago than ever before. There are a number of support communities out there. There are a number of work opportunities and more and more people are going to work.

So, we are through our myths and facts, and I'm going to turn it over to Carla, and she's going to take this into this path of recovery that I mentioned.

Carla?

CARLA>> Wonderful, thank you Tina. I appreciate it. I wanted to talk a little bit about work as a path to recovery.

A person's recovery is a journey and it is just as unique as you and I, and everyone else is, but work is a huge part of this path for many individuals, and I've seen some huge success with folks that have been struggling with the recovery at all levels, because you're not all at one place at one certain time. Everyone's in a different area, and just as Tina explained, there are lots of things that impact your recovery. There's also a different and unique definition for each one of us to explain when we're talking about our recovery.

So let me talk a little bit about work being a part of it. When you're ready to take this step and have that be a part of your path. The benefits of employment for people with mental illness include a ton of opportunity. So you can earn more money, that might mean that you could participate and contribute more in your rent payment, or you may be able to independently pay some bills, and feel really good about that. Then there's some really fun things that you can feel good about like traveling, or hobbies. I've seen some folks be pretty successful at work and managing their money and creating a budget plan with some assistance from other folks that they've been able to save and build and grow and do some pretty interesting things. 

What about establishing a routine? So one of the major founders, well not founders, but a major principle and supported employment as a best practice for individuals with disabilities and primarily working and in recovery when you have a mental health illness, is that it establishes some structure, it's a really healthy, whether it's volunteering or going to school, or having some setup time to do recreation, full activities, but structure is provided for a lot of us through work, and that's kind of a nice way to get your structure, you're actually getting paid to participate in your structured activities, which fuel your mental health and your recovery.

Gaining independence, meeting new people, and being a better, bigger part of the community and being involved. It's pretty exciting to see folks kind of spread their wings and it gives you a self-confidence, you learn new skills, you’re esteeming, your self-esteeming increases, and you just overall feel a lot better.

Setting goals and investing in yourself, working can give you a great sense of the future. Setting goals, such as earning a promotion or developing new skills, that can really motivate you to take better care of yourself perhaps, or to stay engaged in treatment and/or services. Sometimes just having a connection and being engaged with someone else in activities is very healthy for you.

Working as a way of investing in yourself and your future, and the benefits of work discussed on these slides came from Temple University Collaborative on Community Inclusion of individuals with psychiatric disabilities, it can be accessed in the web links pod under Temple University Collaborative guide, and I can tell you from experience, this curriculum has been amazing, it's really written to ... it's very easily understood. It really guides you through each different step...

It really guides you through each different step. It has structured modules. You can do some self-teaching, or you can do it with a peer, or with a family member. I am just pretty impressed with it. It's what I've kind of embraced at my agency as far as using this to work with the person to receive mental services here. It's our go to curriculum, if you will. At that I think I hand it back over to Tina to give you some wonderful information about benefits.

TINA>> All right, well thank you, Carla. Thanks for all your help. Let's talk a little bit about the Ticket to Work Program, and really how it supports your journey to work. The first thing I want to clarify is there's actually two separate types of Social Security Disability Benefit programs. The first one is SSDI, or better known as Social Security Disability Insurance. That means you paid into it. The second one is SSI, Supplemental Security Income. That is a needs based program. One of the first things that's helpful for you to do is understand which type of Social Security you receive. 

The second part of this journey is really to figure out is this the right choice? Only you can decide if work is the right choice for you. Sometimes, I always say the hardest step is always that first step. It always seems like a big jump to make that step, but I just encourage you to link up with some of the partners that we're going to talk about here in just a few minutes, and find those supports. You're not alone in this journey.

What is the Ticket to Work Program? The Ticket to Work Program is a free and voluntary Social Security program. I know some of you have received information through Social Security about the Ticket to Work. Again, it is a voluntary program. It offers career development for people ages 18 to 64 who receive Social Security because of disability benefits. What that means, if you're receiving retirement benefits you would not be eligible for this program, and you must be 18 years of age or older. 

All right, so let's talk a little bit more about it. I said that it was a free program. What it does is it helps connect you with, again, the word free employment services. Basically you decide if working is right for you. Nobody else can make that decision for you, that is totally up to you. Those employment services can help you prepare for work, find a job, and really succeed at work. Social Security has done an amazing job setting up this program to really create supports which will help you through this employment process. 

How does it work? If you choose to participant you will receive services from authorized Ticket to Work service providers. Now, there are three listed here. There is what's called an Employment Network, and these are entities that contract directly with Social Security to provide employment services. There are also the State Vocational Rehabilitation services. The state of, for instance, in your state there is a Vocational Rehabilitation agency. Now you see that acronym, VR. Some states call it VRS, some states call it other names. If you have a question on how to contact them I'm going to show you here in just a little bit. There should be a link right at the side, oh, I see it, it says Choose Work Website. If you jump on there you can find assistance to find either an Employment Network, or a State Vocational Rehabilitation agency. 

Again, they provide career counseling, they provide resume help, they also provide interviewing advice, and assistance in finding a job. Carla, you're from an Employment Network, correct?

CARLA>> Yes, I am. 

TINA>> Yep, and so are there any other services that you provide outside of this?

CARLA>> Benefits counseling, because we are certified through VCU, so we are able to really help people with their WIPA project, so we do a lot of coordination with your program, as you know, in this state. We're kind of like on the ground. We're like boots on the ground, direct. We're the people that kind of sit with them, and not hold their hand, I mean I don't want to make it sound like that, but we can go to the Social Security office with them if that creates anxiety. We can help them set up an online account so they can report their earnings for the Social Security Disability Insurance benefits and the Supplemental Security Income so that we can really impact and reduce any overpayment situation that can happen when individuals make mistakes in that area.

TINA>> You work really closely with folks to help support them in their job. Earning a living through employment isn't necessarily for everyone. However, if it's right for you, these folks are there to support you all along the way. Many find that the reward far outweighs the risk. I know Carla had mentioned a couple of risks that everybody I think that Carla and I have worked with over the years have really found that opportunity to find the rewards of employment.

The one thing that we really want to stress is to take your time to learn about employment services and the support Social Security offers through the Ticket to Work program. You honestly really may be surprised. That Choose Work website at the far right is a wonderful, wonderful website full of lots and lots of different tools, tips. You can see there are many blogs on there if you're interested in reading about blogs. There are success stories. Just a plethora of information that you can pull down and help you better understand the ticket to work.

One of my favorite parts of the choose work website is the success stories. I love them. I watched several of them many, many times. One of my favorite gals is Lori. Growing up, Lori, she really struggled with managing her anxiety, but as a young adult she found that it made work really unbearable for her. She really struggled throughout that process. However, through the Ticket to Work program, she was able to find a job where she's working from home and with the Ticket to Work services provided, they really helped her find her confidence she needed to sustain the full time employment. Her quote I think at the bottom is really cool. It says, "I felt like I really accomplished something for the first time in many year. I feel like I was connected to society again and didn't have to hold my head down." I think that's just a really powerful statement. If you have the opportunity, I would really encourage you to take a look at that video because it is just so powerful and if you're even remotely concerned about entering the Ticket to Work program, I think some of those success stories will help you feel a little more comfortable in making the choices.

Onto the next part, which is work incentives, and that's my specialty. As mentioned before, I work with a WIPA project that is here in Indiana, that in your state you also have WIPA projects. There are also lots of other providers that provide Ticket to Work or benefits counseling, but for the purpose of this presentation, we're just going to talk about some basic work incentives and give you just a little bit of an idea of how they work.

So, what are Work Incentives? Social Security has more than 20 Work Incentives that make it possible for you to explore work while still receiving benefits. They are designed to help you succeed. I hear a lot of people say, "If I go to work, I am going to lose my benefits." I am telling you, those 20-plus Work Incentives, and I know there are more than 20, there are so many Work Incentives that can help you be successful.

Social Security put those Work Incentives in there as an opportunity for you to get to test your work skills, and feel comfortable. Again, work may not be for everybody, but Social Security wants to give you the opportunity to at least try it out.

You may be able to keep your Medicaid. Now, remember that Medicaid is a state program, and it is administered to your state. It is different for every state. The Medicare option you may also be able to keep while you are working, that is a federal program. So, know that if you are receiving healthcare either from the state or from the Federal Government, that there are many Work Incentives that can help you maintain your healthcare while working. 

You may have access to individual support services, so we talked a little bit about Carla, and some of the things that she does to support individuals. As a matter of fact, we have mentioned it a couple of times on this particular call, you can try work with confidence, knowing that you may be able to keep some or all of your benefits during that transition stage or period.

So, Work Incentive examples. One of my favorite ones is Expedited Reinstatement, because I get this question all of the time, "So, what happens if my benefits stop because I am now working at a higher level?" That happens many times. I just had somebody in this particular situation. So, what happens if your benefits stopped because of your earnings level due to work, and you are no longer able to work because of a medical condition that is the same as, or is related to, the original disabling impairment? 

So, the gentleman that I am speaking of had a back injury a long time ago. He was able to work for many years, then had a wreck, and he damaged the already damaged back injury, and so he was out of work. So, what happens? We use this Expedited Reinstatement of Benefits. There are two bullets. The first bullet is, if you stopped working within five years after the last benefit payment under these conditions, which he was within that five-year period, Expedited Reinstatement allowed him to request to have his benefits reinstated without a new application. So, although he was no longer receiving benefits, he was able to get back onto Social Security due to that back injury, and was able to do that without filling out a new application.

So, while Social Security was determining that, they have something called Temporary Benefits. While Social Security determines your benefits reinstatement, you are actually eligible to receive temporary benefits for up to six months. So, while they are trying to figure out if that disability is still in check, they will go ahead and give you six months of benefits. 

What a cool Work Incentive. It keeps you going, gives you an opportunity so you do not feel like, and I use the term, "feel like you are jumping off a cliff." This is a great safety net to ensure the success of your employment.

Where to learn more about those Work Incentives. So, I have several listed on the slide. You can see Social Security Red Book, I love that tool, it is wonderful. I have used it for many years to help explain benefits to individuals. You have the whole Choose Work Library, and you have the whole Choose Work Blog. Now, as I said, there is the link there, but the best option is to go right over to that web link that is on the right-hand side, and you can connect right there.

So, if you are looking for more information about what Work Incentives are, and how they can be used on the path to financial independence through work, check it out. It is really neat. They have so many neat tools. 

All right, I think we are at the point where we want to take some questions. Am I right?

STACEY>> Hi, Tina-

TINA>> I have got one more slide, just kidding.

Take the Next Step. Okay. So, let's take the next step. First of all, the first thing that you want to do is gather information and resources. The reason we recommend this is we want to make sure that you know what all your options are. All those little links at the side give you an opportunity to do some research. I will say that not every Employment Network is the same. There is always a little bit of difference. What one Employment Network might offer might be very different from another. One Employment Network may do "boots on the ground" as Carla referred to, where their staff actually work face-to-face with you, and actually live in the community where you are hoping to find employment.

Other Employment Networks may actually be outside of the state, or may serve many counties within the state, so get to know that resource before making decisions. I always say call and interview your Employment Network. So, gather that information, and the resources, for your journey for employment. Ticket to Work and the Work Incentives can help make your journey a smooth one, you know really helping provide that support to you.

Get started. The best thing that you can do is to contact the Ticket to Work Help Line. That number is 1-866-968-7842, or if you are using a TTY, 1-866-833-2967. And, I just want to encourage you to call that line, it is open Monday through Friday, 8:00 to 8:00, and that is Eastern Standard Time. And, do take the opportunity to visit choosework.ssa.gov.

All right, I am going to hand it back to Stacey now, sorry about that.

STACEY>> All right, thank you so much, Tina, and Carla, for sharing the information on the myths and facts about mental illness, and also the information on the Ticket to Work program, including Work Incentives. You provided a lot of great information about the Ticket to Work program. We are going to pause here and take a few moments to address some of the questions that we have received from our audience on these topics. 

Tina, you had talked about Ticket to Work service providers. What if there is no Ticket to Work service providers in my area? Are there any that work with people virtually?

TINA>> Absolutely, and I mentioned at the very end we were talking about some Ticket to Work providers provide services nationally, so there is actually national Ticket to Work folks. So, what they would do is they would contact you, most likely it will be through a phone, and work with you in that way. Some of the Ticket providers actually have video conferencing available, but most of them do it by phone if they are a national EN. There are also, and I am going to use Indiana as an example, there are areas in Indiana that are not covered by Employment Networks that are housed within that particular area, but I guarantee you there are almost always at least one Employment Network that will provide.

At least one employment network that will provide services in your area. It just might be virtual. Does that answer your question, Stacey?

STACEY>> That sure did, Tina thank you so much. And that's great to know that you can connect virtually. Another one for you, Tina, does the Ticket to Work provide assistance with starting a business or being self-employed?

TINA>> Absolutely, so one thing we want to encourage you to do, is really pay attention to do your discovery or do your research on the employment network. Actually, employment network that are specialized within self-employment. Now they aren't necessarily going to completely assist you with every part of set up with self-employment. But, I know Carla and I both have worked with people who are self-employed.

STACEY>> Great, thank you Tina. Another question, that has to do with Ticket to Work and that is will I be able to continue receiving Medicare or Medicaid when I start working?

TINA>> That's a great question. One thing that we want to say, every person is different and what I'd encourage you to do is contact your WIPA project that's in your state and get that information or one of the very very best options is to go directly to the Ticket to Work helpline and I mentioned that earlier, right at the end of the slide, that 1-866-968-7842 you can call that number directly and get information about your benefits. 

It's probably not going to be able to identify 100% how your state is impacted, how the state benefits are impacted, but get connected through the WIPA project through that 1-800 number and then you can receive a detailed benefits analysis that can help identify first of all, how work is going to impact that health insurance. We want to be very clear there are lots of work incentives. Almost every state in the United States has a buy in program for Medicaid and what that does is that it allows you to work and continue to receive your health care benefits with a small or moderate premium, hence the buy in language. 

There are several Medicare work incentives as well. So depending on what you receive, whether it's Medicare or Medicaid and whether you receive SSI or SSDI will depend on how your health insurance would be impacted. So get in touch with your WIPA project and see how they can help you.

STACEY>> Great, thank you Tina. Earlier you talked a little bit about ENs or employment networks. Do all ENs have benefits counselors on staff?

TINA>> Well, we use, Carla's does, she's, there are several that do have them and several of them, when you talk about benefits counseling, there are different levels of benefits counseling, and understanding of benefits counseling, so I would encourage you, if you receive benefits counseling outside of the WIPA project, ask them about how they are certified to be a benefits counselor. 

As per updated, they have to go through the same exact training that we do with the WIPA project and so therefore I can say her staff are knowledgeable on the program. We want to make sure that nobody gets misinformation. So make sure whoever you are getting the benefits counseling from knows what they're talking about because there are some ENs that provide initial counseling, that there's a little more to the story so just make sure that you're getting the full story and also something that is important, just because you received initial benefits counseling, benefits counseling should go on throughout the duration of your employment. 

It's not something, if you get connected with someone like Carla's group or with a WIPA project in your state, keep connected with them, things change, so therefore continuing to have that relationship can help prevent some of the kind of bumps in the road in employment that sometimes occur with healthcare benefits and social security benefits. So hopefully that explains it.

STACEY>> Sure does.

Carla, you had said earlier that goal setting is very important to help achieve financial independence. Can you tell us a little more about that?

CARLA>> Yes, every person that I meet with when we first interview one another and decide if we're going to be a good fit, a good partnership to work with their ticket and their plans to return to work. We go through what they call an individual work plan. So we kind of write up in a real state wide process and I think if we don't set goals then people aren't able to really celebrate those goals when they're achieved even when they're small baby steps, right? 

So, I think it's pretty important, it's way to measure it. I believe it's kind of my responsibility to help individuals learn how to set specific goals that are measurable and attainable and realistic and we set time frames so we kind of measure each other's performance. So if we're not making progress towards their goal then we can reevaluate the plan and the Ticket to Work, I think that's the easiest plan in the world to change too because you don't have to answer to a lot of different funders, right? So that's kind of nice.

STACEY>> Thank you Carla, sounds like settings goals is definitely something that everybody should do when looking for a job or working. So Carla can you offer some examples of kinds of goals that can be set if I don't know what type of job I want?

CARLA>> Well, yeah, what I'll try and do during that first initial counseling session and I typically already had maybe a phone interview so we'll talk about and maybe have a career counseling session around different interests. Sometimes people just are not real sure what the job is called today. It might be that they did it twenty years ago when they were working or two years ago and with the rapid cycle change of our society right now, it might just be that I can help them access the O*NET which is the occupational network for employment and training. 

They just kind of learn different things about what careers are out there. We might do a Bureau of Labor search so we'll look at statistics and see what jobs are out there. And sometimes people just see things and are like "Oh, well I can do that." So that might be how we'll identify it, especially if they have no idea. And I always let individuals know that this isn't set in stone, plans are meant to be changed, adapted, modified; we change over time and you know, everybody does. So try to just make it really, I try and stay away from any fear based like well now you know you got to pick something, it's our goal. That's not how I do it.

STACEY>> Sounds like a great strategy and very important with that goal setting. So again on the topic of goals, Carla, you kind of did kind of already get into this but can incentive to work providers help set career related goals?

CARLA>> Oh absolutely, so that's part of the work plan, so when I first meet with someone, I say what would you like to do in the next year or two. And then they may know that one, but when I get to that five year or what about the next few years you may want to increase your earning levels. So we'll just talk about different options of ways they can advance in their career and the nice thing about working with the ticket holder is they walk their journey through work. There's not a defined start and stop time. I mean, I work with a lot of folks that have mental health illness and they cycle right? So, I may be hot and heavy for six months with people and then they kind of fall off. And then they come back and I'm not mad at them. I'm just... I meet them where they're at and we start over and start again and move forward. And some people keep with me straight through and then they get more independent and step away. And if they want to come back and say, "Hey here's a promotion we'll identify it there". 

But it's really laid out in the individual work plan. And it's so user-friendly. I think the clients really... the people I work with really understand that individual work plan is pretty simple. 

STACEY>> I'm sorry. Thank you Carla. Great information there. And I just wanted to mention that there is a resource that is available for download that is called Planning Your Employment Goals with the Ticket-to-Work Program that you may find helpful and the link to that pdf can be found in the web links pod. If you scroll down to the bottom it should be under planning employment goals. So, that is available for download also. 

All right. We're going to jump back over to you Tina. Earlier you talked about how the ticket program can assist in finding a job. Does the ticket-to-work program provide assistance with finding a work-from-home job? 

TINA>> Absolutely. Again there are... Each employment network is different and they have different specialties. So, therefore there are some of those employment networks that specialize in work-from-home. To do the research, I believe if you look at the link there's actually a success story. And we just talked about somebody who was working from home. As you remember our gal that... Laurie is one of those examples of a work-from-home person.  

STACEY>> Great, thank you Tina. And I do have another question for you. And Tina can you share with us how to apply for work incentives?

TINA>> That's a really good question. So each work incentive is a little different. Some are automatic and some you have to fill out a specific form. For instance, for a plan to achieve self-support or PASS for those individuals who are on SSI or eligible for SSI there is a form to complete. For individuals who are for example taking an impaired related work expense, it may be as simple as going into your claims representative and suggesting that you might have an impaired related work expense and bring those receipts in. So, each one is a little bit different. Again your employment network or WIPA provider will be able to help you navigate that system as well as your Social Security Office. They have wonderful people in the Social Security Office that can help you navigate through some of those work incentives. So, again each work incentive is a little bit different. The paperwork for each is a little different. And sometimes there is no paperwork.  

STACEY>> All right Tina. We have some individuals who are interested in furthering their education. Does the ticket-to-work program provide any assistance with getting a college degree? 

TINA>> You know, it's a good question. I know of some. There's only a few employment networks that have... it's not necessarily a college degree but they might offer a certificate of training. If you were interested in colleges or universities I would really have that conversation with a vocational rehabilitation counselor in your state. They would have the resources, but not everybody is eligible for a vocational rehabilitation. So, know it is an option. And you might want to consider contacting them. There are also a number of grants and foundations that you could apply for as well. If that is an option for you. 

STACEY>> Those are great options. Carla, what if I work with a service provider and set goals in an individual work plans and I want to change my goals. For example, what if I started out wanting to be self-employed and now want to find a job with a company. 

CARLA>> Then we might just get together and we would revisit that plan. We would edit it and it's as simple as that. We would both sign off on it and then we would just change our paths, right? We would start knocking on different doors. Probably would need to tailor the resume some to a different type of area of skill sets and identification as far as that goes, but it's really, really just as simple as that. 

STACEY>> All right. Well great. Thank you so much Carla. Tina you had talked with us about what mental health is and how mental illness can affect your thinking, your mood, your behavior. How can someone find out how to get help if they think they may have a mental illness? 

TINA>> Each state has numerous resources available. Most of the time... Or one of the best resources I find is to get connected with what states typically call the Division of Mental Health. In Indiana we call it the Mental Health the ... I'm sorry. In Indiana we call it Mental Health and Addiction or DMHA, Division on Mental Health and Addiction. So depending on what your state calls it the reason I encourage you to contact them is that typically they are the entity within the state that does the licensing and approval of services for state-funded agencies. So those are wonderful, wonderful tools to get connected with is that Division of Mental Health and Addiction. You can Google your state and just put in that phrase and my guess is that it will come up. It will often times show you maps where mental health providers are located. On some websites you can actually go and click right directly on that mental health provider website right from the Division of Mental Health and Addiction link. So, know that that resource is there. 

There are also a number of private entities in this day and age of Google. It is a good option to Google and also to check out what people think of their services. Again, I can't stress actually doing your research. It's a great opportunity for you to learn about the resources. And again each provider is a little bit different on what they provide. But check in with the Division of Mental Health in your area. Or a lot of states have what's called a 2-1-1 system where you can actually call and you ask them a question such as, "Where can I get mental health services close to me?" And they'll just pop it up in their computer and tell you right off the bat. So two really good options that are typically state-wide. Also, one other option that I totally forgot was you may want to contact NAMI or the National Association on Mental Illness, NAMI.org and see if they have a provider that they would recommend as well. So, three options I guess. 

Carla do you have anyone else that you would recommend? 

CARLA>> I was just going to type in NAMI. I think that's a wonderful resource. 

STACEY>> Okay, thank you both to Tina and Carla for providing those resources that is extremely helpful. Tina, for those individuals who have recently started working, can a Ticket program service provider still help as they get used to their workplace?

TINA>> Absolutely. I think that might even be a Carla question because she's actually an employment network. That sound about right to you, Carla?

CARLA>> Yeah, and we are actually going to talk a little bit about some of the resources that I actually tap into in the next couple areas. But absolutely. When they need ... you don't know what accommodations you need until you get the job, right? So that's usually when some of the hats come back on and we have to get more involved to help them get set up so that they're making sure if they need a flexible work option or if they need a different environment to fit in or different supports or extra help. Once you get a job, the game kind of starts over again for a while until you hit that stability point. So yeah, we're not one and done and once they get a job, we sit back. We stay involved. 

STACEY>> Great, thank you so much, Carla. Your experience as a [inaudible] is very helpful. Tina, you had mentioned that there are many different work incentives and Carla, please jump in on this one too, if you have something to add. Is there somewhere that I can go to find out which work incentives apply to me?

TINA>> Absolutely. Again, I would refer you back to that Ticket to Work helpline, where you can actually call in, and they will link you up with a [inaudible] provider. And again, sometimes your employment networks will have information as well, and one of the really vast resources is your own social security office. So you have three options right there, right off the bat, that you can go to and get information. 

CARLA>> And I'll just add one thing that I have found really helpful with some of my folks that are working and doing a substantial enough wage that the social security office wants to do a work activity report. So they'll reach out to the individual and send them what they call this WAR form, which is an assessment of their work activity, and what's pretty powerful on that tool is that's where they're kind of laying the seeds for the social security beneficiary to throw out information at what's really going on at work, so that the expert at social security can help guide you through some of that.

For example, it prompted one of my individuals to get back with me, and we really sat down and took the subsidy tool into the business and sat down with what social security had sent to them. And that was really helpful. There's also places where you can write down if you're paying for medication or if you're getting support from someone to be successful, because that triggers the expert at social security to ask those probing questions and find out what incentives might be available for that individual. So that's been one of the things I've learned in the last maybe five to 10 years, just working with these individuals. I didn't understand what that work activity report was really for but it has been very helpful for some of my beneficiaries to actually realize some incentives. That's all.

STACEY>> All right. Thank you, Carla. And I just wanted to reiterate, Tina had mentioned the Ticket to Work helpline and that phone number is 1-866-968-7842, or for TTY, it's 1-866-833-2967. And also, more information about what work incentives are and how you can use them on the path to financial independence through work, can be found in the social security's red books, which Tina did mention earlier, she said was one of her favorites. And that can be accessed in the web links pod under "Social Security Red Book." 

So thank you, Tina and Carla, for the thorough answers to the questions that have been sent in by our participants so far today. Although we do have more questions, we are going to stop here and before we move on, I would like to just remind everyone that accessible materials from today's webinar are available, either in the web links pod that we have directed you to or in your confirmation email for today's webinar or by emailing Ticket to Work at the email address webinars@choosework.ssa.gov. We are now going to turn things over to Carla, who will share information on reasonable accommodations and disclosure. So over to you, Carla.

CARLA>> Okay, great. Thanks. I did just mention this a little bit when you guys asked the question. The audience asked the question about how supports continue once you find a job and I find it very interesting that there's a lot of different things set up for it. So under the Americans with Disabilities Act, employers are required to provide modifications or adjustments to the job to help applicants and employees be successful. 

They want to get the return on their investment in paying you and training you and getting all that stuff up and going, so if there's something that you feel like you need, absolutely, it's their obligation to work with you. So requesting a reasonable accommodation does require disclosure of your disability but employers are not allowed to discriminate against you because of this.

There's so many of these but some reasonable accommodations you may want to include are ... Some considerations. Maybe reduce distractions in the work area. I had a coworker that worked here that could not focus on her documentation requirements in a bullpen area, where it's kind of set up as cubicles, so we established an office setting, a side that she was able to use. A very simple, very inexpensive ... It was a shared space. It was already there and it was an unused office. So she's able to go there for certain periods of time to do her notes, which is really good. 

Some people like those white noise machines because they're easily distracted, maybe by chitter-chatter in the office or whatever is going on. I have a couple staff that work with me that constantly have the music on because that's what they need. And there's another person in the same office who will wear those noise canceling headphones because they don't like that music. Try to plan for uninterrupted work time. That's kind of like that special office aside, without distractions. 

Increase natural lighting. What I've found is fluorescent lights bother a lot of people, so you may be asking for an accommodation that would really benefit your whole team, right? It's just, leave the fluorescent lights off. Divide large assignments into smaller tasks and goals. That's a really common one. Very easy to do. Oh, I'm sorry. I thought I forgot to talk about a website. My bad. So while you have questions or concerns about disclosing your [inaudible], remember, under the ADA, employers and businesses are not allowed to discriminate against you due to your disability, nor can they ask you specific questions about your disability. 

Disclosure is necessary to request and receive accommodations that can help you succeed. It's always your choice to disclose. You can find information and confidential guidance about this on the Job Accommodation Network and the reasonable accommodations discussed here are from askjan.org and can be accessed in the web links pod, under the Jan information. So moving right along. 

Managing stress during a search and on the job. So some of you asked some really good questions around this, in the last section. Looking for work is stressful and so is once you're on the job. But what I also have found is that stress triggers a lot of different things, like anxiety, depression, post-traumatic stress. It affects each one of us differently, so if you can maybe identify the signs, we've got some really good peer counselors that work in our state here and I think they're pretty powerful, because what they help people do is identify a plan around what am I going to do when I notice these things? Well, I encourage my folks that I work with to reach out to me. If I haven't talked to you in a minute and you're having a hard time or you're feeling kind of stressed or you're noticing you're not sleeping well, I want to hear from you. And I want to maybe meet you for a soda or do something to help you talk through that. Or just share with you some tools. There's so many self-help tools out there that folks can have access to on a pretty easy and independent basis. And I'll do a lot of that type of coaching.

So some tips they have here for managing stress, is if you're working or looking for work, try these strategies. Make a plan. I think we did that in, like, the first few slides here. So it's really important to break things down into smaller tasks, so you can celebrate those successes and see progress. It helps to keep you motivated, it really does. Take care of yourself. Be mindful of your sleep, and your nutrition, and your medications. Try to keep a structured work schedule. Or structured activity schedule, if you will. And ask for help when you need it. I think so many times people keep trying to take on so much that they don't sometimes stop and ask for help when they can. 

And you can learn more about managing stress by going to the choose work blog, listed in the web links pod under managing stress blog post. And I will let you guys know, if you can sign up for the blog posts, they are really, really good. I, I find them so useful and so helpful. And so, Brenda, I like Tina [inaudible] success story. I love my own, when I have that personal connect. And I don't know Brenda, but I'll tell you what, I could definitely see her journey in a lot of folks that I work with on a day in and day out basis. Because she struggles a lot with psychosis and she was diagnosed with schizoaffective disorder. In the blog it's really interesting. It talks about her onset being right around that 19 years old age, when you've just been, kind of, limping through life and then it just got really, really hard for her. So it's a pretty powerful story. I encourage you to read the article. I really liked it and I got a lot out of it. I'll tell you a couple things that she said that... Like her quote here is, "With the Ticket to Work program and personal growth, I have more confidence than before." And she feels like she has the tools that she needs moving forward.

That's when the network did a really good job in helping her build her own arsenal and her own toolkit, which is great. But I love that she called her employment network and shared later, because I feel like I can relate to that with a lot of my folks here. And that's kind of how I explain it. I say you know I'm just going to, kind of, be on the sidelines here, this is your game. And I also like that she said the Ticket to Work program allowed me to put myself out there even when she was not sure. So I thought that was pretty powerful. 

Anyway, check it out. It was a neat story. Oh, and it's in the pod link to the right there. How to get mental health help. If you or someone... Oh, Tina talked a lot about this and I think Stacey mentioned some sites, but if you or someone you know has a mental illness, there are ways to find help. But, www.mentalhealth.gov/get-help, you can get immediate help, help for veterans and their families and additional mental health services. 

How to get started. Social Security's Ticket to Work program has a variety of service providers and other resources ready to help you get started. And remember Tina's advice, ask lots of questions. Because my Ticket to Work employment network probably works very different than the one next door. So you want to know what you're signing up for and it's just as important for you to interview them as it is for them to interview you.

Get a list of all providers, find answers, ask questions and the number for the Ticket to Work helpline, of course, is 1-866-968-7842. And, I'm sorry, the rest of the number's kind of blocked out, I can't read it, the rest of the number, and I don't know why. But, maybe Stacey can tell you that.

TINA>> The number is 1-866-968-7842, or the TTY number is 1-866-833-2967. And again, remember that's Monday through Friday, 8 a.m. to 8 p.m. Eastern Standard Time. 

CARLA>> Okay, and we're going to pass it over to Stacey.

STACEY>> Okay, thank you so much, Carla. I just wanted to mention that a lot of the information that you provided to us on accommodations and mental illness and disability disclosure, that information came from the Job Accommodation Network, and the link to that can be found, also, in that web links pod toward the end. Or it can be found on www.askjan.org, so that information is available to you also. 

Then, earlier in the presentation, Tina had talked about mental health, and we wanted to say thanks to the mentalhealth.gov for all the information about the myths and facts surrounding mental illnesses. So, some really great resources for the information that we have been able to provide to you today.

All right, so we are going to jump back into some questions. We do have a little bit of time left, so Carla, I'm going to start off with you. And you had mentioned, or shared with us, that in order to receive reasonable accommodations, you must disclose your disability. Does the ADA mean that my employer cannot discriminate against me because of my mental illness, if I do disclose that to them? 

CARLA>> True. They cannot discriminate against you. You're protected through the ADA.

STACEY>> All right, awesome. And then Carla, again, sometimes requesting an accommodation can be a difficult conversation to have with an employer. So, can you recommend how I would start the conversation with my employer, to request a reasonable accommodation?

CARLA>> What I try to with both is some role playing, like communicating with them just to kind of get an idea of their comfort level. And see if they know what they're asking for, right? I'll tell you what. I've had employees come to me directly as a team leader, and they've asked me for an accommodation and we've been able to talk through some of it, but anytime there's an accommodation, it's really important to get human resources involved. So, I think that's probably, I mean, I'm no expert, but I think that HR is a good place to start. 

STACEY>> Okay, I think that is great advice to start with HR. Again, Carla can you tell us how to find out which type of reasonable accommodation would be right for us?

CARLA>> Well, I love the Job Accommodations Network, and I think it's right there in the web links pod. And they've got a whole booklet on job accommodations specifically for individuals with mental illness. And it just goes into such wonderful depth and it gives you a lot of different ideas. But one thing I try and talk to folks about on an individual and a personal basis, is just to found out, what is it you need? Where are you struggling? What are other folks doing? And just kind of having that initial discussion to see where it is that they need the support, and then, ideally, our human resources, I mean human resources, they're professionals and they can really guide that conversation and be very helpful to both the employment provider, if they're even invited to the table, because some people don't disclose that I'm involved, but they may disclose what they need so they can get an accommodation. I can't remember, I just started rambling.

STACEY>> No that's perfect, and thank you for that, Carla. Just, again, to reiterate that the link for the job accommodation network where you can get additional information is located in that web links pod under job accommodation network or JAN.

All right, Carla, how can I found out who to talk to at my organization about disclosing my mental illness? Would that also be an HR function?

CARLA>> Yep. That's where I would start. That's kind of what's been successful both with my employees and some of the folks that I have worked with through the Ticket to Work program. Every once in while you find just this rock star boss or manager or team leader that's really involved and engaged. If that's where you can start, that's where you can start. I think some of it just has to do with common sense, but most likely that boss will also loop in HR because once you say accommodation, they just need to be involved.

TINA>> Carla, I'd like to add, I know that you've done this multiple times as well as myself as an employment network is the opportunity to practice how you're going to disclose that information. Sometimes practicing that before you go and talk to HR is helpful as well.

CARLA>> Yep. Have a plan. Always a good idea.

STACEY>> Okay thank you, Tina and Carla, for the information on that. Tina, I'm going to jump back over to you and can you tell us what happens if I cannot work full time but I wish to start with part time work?

TINA>> As far as what happens with your benefits would be my guess that you're asking, so depending on what type of benefit you receive would dictate kind of how that income change would be impacted on your current benefits. For instance, for individuals who are on SSI, they use a calculation. There are a couple of disregards, but after those disregards they look at a two for, for every two dollars that you earn, your SSI will decrease by one dollar, but don't panic because what that means is that you're actually earning more income. Working with that WIPA person or the benefits person on your employment network can help with that transition if you're on SSI. If you're on SSVI, there's a whole other world of different types of how income is impacted. 

I just would encourage, I don't want to ignore your question, Stacey, but I want to make sure that people know the importance of, first of all, knowing what type of benefits you receive, because you might receive both SSI and SSVI, so you would get two different types of checks from social security, and they have very different work incentives and how work impacts them from going from a full time job to a part time job is going to look a little bit different. That's why it's important to find those experts that can help you navigate that.

Hopefully I didn't skirt your question, but I just want to encourage you that there are those resources that can help. In most instances when you go from full time to part time, you may either go back on benefits or your benefits may increase. It just depends on where you are and the different work incentives.

STACEY>> Thank you Tina. I also wanted to mention that we do have Lori's success story in the web links pod, so you may want to take a look at that and her story has to do with achieving financial independence by earning enough income to work one's way off benefits. If you'd like to read a little bit more about Lori and her success story, go ahead and check that out in the web links pod.

Also, for those of you who may be experiencing some stress with your, while you are looking for a job, also in the web links pod there is something that is titles Manage Stress blog post, so you may want to check out that blog post and read what we have to say about managing stress while you are looking for that job.

All right, so at this point I would like to thank Carla for sharing information on accommodations and managing stress, and also for Tina for helping out and jumping in on questions and responding to them. There are so many different tools available to assist us with our journey, and all the links to these tools can be found in the web links pod if you would like more information on any of these topics that either Tina or Carla has discussed.

We are out of time for questions for today's webinar, so thank you to all of you for sending in those great questions. We hope we have provided answers to all of the ones that you have sent in that have to deal with the ticket program. If we were not able to answer your question today, or if you have additional questions, you can reach out to the Ticket to Work help line. That number is 1-866-968-7842, or for TTY, the number is 1-866-833-2967. Or you can visit the Ticket to Work website at choosework.ssa.gov. You can also find us on social media or subscribe to blog and email updates by visiting choosework.ssa.gov/contact, and this link appears in that web links pod under Ticket to Work contact information.

Please join us for our next WISE webinar, which will be held on Wednesday, June 26th, 2019, from 3:00 to 4:30pm Eastern Time. To register for this webinar, you can register online at choosework.ssa.gov/wise, or you can call that help line at 1-866-968-7842, or for TTY 1-866-833-2967.

Your feedback is extremely important to us and it helps us to plan our future webinars, so please take the time to provide your feedback, tell us what you think about today's webinar. To take this survey you can follow the link that will pop up after this webinar, or you can visit the Ticket to Work website to complete the survey. Thank you again for attending today to learn about the Ticket to Work program. Please take the opportunity to reach out to any of the resources we have discussed today to help take that next step in your career path. This concludes today's webinar. Have a wonderful evening.