James smiling in front of a stone wallAfter a gunshot wound and a later car accident caused James to experience chronic pain, he stopped working to focus on his health. Once his health improved, James found the supports and services he needed through Ticket to Work to return to find a full-time job that he loves.

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Access to Employment Support Services for Social Security Disability Beneficiaries Who Want to Work
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James' Success Story

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Finding the Job that Fits

Published in 2018

James smiling in front of a stone wallOn a Saturday night in late December 1982, 16-year-old James snuck out of his parents' house to meet friends at a party.

"It became clear that we should not be there," he recalls. By midnight, things took a dark turn as the party became crowded with older guests he did not recognize. What happened next made James wish he had stayed home.

Loud music muffled the sound of a .357 Magnum firing as James was shot. He remembers the alarming collection of sensations he felt in an instant. Christmas lights lining the windows morphed into a neon blur as the ground raced up to meet his head. Curled on the floor, the initial numbness was quickly replaced by an excruciating burning in his gut.


That night marked the beginning of James' struggle to regain his health. "I almost died," he reflects. "But getting shot wasn't the worst part. The medical problems in its wake… had me feeling like just giving up at times. That was the worst." During the 3 decades that followed, James was on a roller coaster of life experiences characterized by a mix of fun, pain, drama, love, poverty, depression and resilience.

After the shooting, he underwent 7 hours of surgery that included bowel resections, removal of his gallbladder, a portion of his lung and part of his pancreas. James slowly recovered, but his health would never be the same. He was plagued by persistent abdominal pain, problems with digestion and food absorption.

Returning to Work with Work Incentives

Trial work period iconJames learned that he'd be able to test his ability to work during a 9-month Trial Work Period (TWP), while still receiving cash benefits. After the TWP ends, a 36-month Extended Period of Eligibility (EPE) begins. During the EPE, most people with a disabling impairment get benefits for months in which they earn less than $1,180 (Social Security's definition of "Substantial Gainful Activity" in 2018)

Expedited reinstatement iconThe Work Incentive that put him most at ease was Expedited Reinstatement (EXR). With EXR, Social Security may re-start his benefits without a new application, if he has to stop work because of his disabilities within 5 years. He felt better about returning to work knowing he would have time to settle into a job without fear of losing his benefits.

Social security administration logoYou can learn more about Work Incentives by reading the Red Book, Social Security's guide to Work Incentives at www.ssa.gov/redbook.

You can also talk with a Benefits Counselor, a professional who is qualified to explain how employment will affect your benefits. The Ticket to Work Help Line (referenced at the end of this feature) can help you connect with a Benefits Counselor so you can make informed decisions about work.

In spite of these challenges, James found work in automotive repair and food service, and he was able to pay the bills. He married, started a family, and was content. That period of stability ended when a 1987 car accident ruptured discs in his spine.

"I could hardly move," he recalls. Family helped while James worked with doctors to heal and find relief for back and knee pain. James had 3 more surgeries to fuse vertebrae in his back and later, to fix a torn ACL in his knee. He saw physical therapists, chiropractors, orthopedists and pain management specialists until his mobility improved.

Between 1990 and 2012, James and his family struggled. He worked a variety of jobs between bouts of pain — as a truck driver, in construction, hauling lumber, and in retail and food service.

"I was willing to work just about any job I could find," he recalls. "… but chronic pain from my back and knee persisted. It kept interfering with work. There were days when I could not get up off the floor… the pain was that bad. So, I lost work. We had no health insurance. Bills piled up. I'd find a new job, and then flare-ups interfered. It was a discouraging pattern. Then my wife and I divorced and I became a single parent. It was a difficult and stressful time that lasted far too long…" he says. James became overwhelmed and depressed.

Consistent Care and A Path to Employment

In 2013, James began receiving Social Security Disability Insurance (SSDI) as he sought more consistent and effective treatment for his medical conditions, which now included clinical depression.

He wanted to return to work and knew that employment was what he needed for better mental health. But he felt discouraged. James knew that first he needed quality medical care, therapy and rehabilitation. Now that he was receiving Medicare, he had better access to treatment.

By 2014, some of the more severe symptoms of his depression had lifted. So when James received information in the mail about Social Security's Ticket to Work (Ticket) program, he decided to call the number provided to learn more. Through the Ticket program, authorized service providers, such as Employment Networks (ENs), offer a range of free support services to help people prepare for, find, or maintain employment. Some ENs serve people with a specific type of disability; others offer certain types of services. The program is voluntary and set up to help people progress toward financial independence.

James holding a babyAfter talking to a representative from the Ticket to Work Help Line, James connected with an EN called A Path to Employment, where he would find the help he needed to transition back to work. A Path to Employment, also known as Operation: Job Ready Veterans, has been helping people (especially veterans) enter or return to the workforce since 2015. With help from his Benefits Counselor, James learned about Social Security Work Incentives. Work Incentives make it easier for adults with disabilities to explore work and still receive healthcare and, in some cases, cash payments from Social Security. He felt at ease knowing that with the help of Work Incentives, he would have time to determine whether another attempt at sustained employment would work for him. If his disabilities interfered with work in the future, there were Work Incentives that might allow him to return to benefits without a new application. James decided to try work again.

"The difference this time was that I really felt supported." He says his Benefits Counselor "was a positive influence. She educated me about the potential risks and benefits of work; and gave me the encouragement I needed. If it wasn't for the information she provided and the proactive support she gave me, I would have given up. [She] stayed in touch ... even went with me to the local Social Security office to help me follow Ticket program rules. That type of hands-on approach made all the difference at a vulnerable time ..."

James and his EN worked together on an Individualized Work Plan (IWP) – a roadmap to help him reach his employment goals. The IWP included work and earning goals that he would meet and identified supports and services that A Path to Employment would provide to help him make progress.

Continuation of Healthcare Coverage for People with Disabilities Who Work

James was particularly relieved to learn about Continuation of Medicare Coverage. With this Work Incentive, SSDI recipients who work continue receiving healthcare coverage, even after they no longer receive cash benefits.

Medicaid and medicare iconContinuation of Medicare Coverage for SSDI Beneficiaries: Most people with disabilities who work will continue to receive at least 93 consecutive months (7 years and 9 months) of Hospital Insurance (Part A); Supplemental Medical Insurance (Part B), if enrolled; and Prescription Drug coverage (Part D), if enrolled, after the 9-month Trial Work Period (TWP). You do not pay a premium for Part A. Although cash benefits may cease due to work, you have the assurance of continued health insurance. To qualify, you must have a disability, already have Medicare and be working at the Substantial Gainful Activity (SGA) level.

Social security disability iconMedicare for Persons with Disabilities Who Work (SSDI only): If your Medicare stopped due to work, you continue to have a disabling impairment, and you are under age 65, you can buy continued Medicare coverage. If you have limited resources, you may be eligible for state assistance under various Medicare Savings Programs. Your state Health and Human Services agency makes the determination about whether you qualify for this help.

To learn more about these Work Incentives and Work Incentives available for people who receive SSI, read the Redbook at www.ssa.gov/redbook, or call the Ticket to Work Help Line to find a provider that can help you.

In addition to Benefits Counseling and career coaching, A Path to Employment helped identify reasonable accommodations James would need to succeed in the workforce. They assessed the types of work that would be the best fit, given his desire to work with his hands, his need to move around throughout the day, to avoid heavy lifting, and to have a flexible work schedule. A Path to Employment supported James throughout his transition to work, and they are still by his side today.

Building Success

James started on his path by finding part-time work at 2 local stores, which helped him build confidence. But he couldn't wait to work with his hands again, and it wasn't long before a friend helped him find work at Jasper Seating, a furniture manufacturer, where he joined the upholstery team.

James uses Computer Aided Manufacturing (CAM) tools to cut furniture parts, and he loves the work. He has been with Jasper since 2015, and expresses gratitude for the way employment has improved his circumstances.

Increased earnings from full-time work have replaced his SSDI payments, and James feels he is on a good path. It has also become clear that he is not alone as he considers his future. His EN is there when he has questions or needs help.

"I'm not sure if I would have had the courage to go back to work if it wasn't for the Ticket program," he reflects. "My desire and determination were always there. But at some point, my confidence just got beaten down. [My Counselor] helped me see that I had more to gain than to lose by finding that path back to where I wanted to go. Every day I feel better about myself. My confidence has come back and with extra support from A Path to Employment, I feel I have the tools to manage whatever the future brings."

The Ticket to Work program helped James find his path to a better future.

Find yours! To learn more, contact the Ticket to Work Help Line at 866-968-7842 or 866-833-2967 (TTY), Monday through Friday, 8 a.m. to 8 p.m. ET. Ask a representative to send you a list of service providers, or find providers on your own with the Ticket to Work Find Help tool.