1. Ticket to Work Program Payment Request Form

2. This training will help you Expedite your payments from Social Security Decrease the rejections for payment requests Save you time in processing payments 2

3. Expectations How to submit a payment request through the Portal Please discuss the different payment types Discuss the reason why Employment Networks (EN) must ask for an employer signature How long does it take for the Operations Support Manager (OSM) to process a payment once the form is submitted? 3

4. Objectives Determine when a payment is available for your Employment Network Differentiate between evidentiary payment requests and certification payment requests Describe the process to complete a Payment Request form through the Portal Identify resources to aid you with the Payment Request form 4

5. Determining When a Payment is Available 5

6. When to Request a Payment 6

7. Milestone/Outcome Payment Method Phase 1 Milestone 1 TWL for one month after ticket assignment date. Entire month of work not necessary 7 Ticket Assignment Month Earnings month June May

8. George Ticketholder First paycheck = $640 gross Began 3 rd week of January 32 hours per week $10 per hour 8 Phase 1 milestone 1 st month earnings are equal or greater than 50% TWL (earned during last two weeks of month) Beneficiary would have earned TWL for entire month

9. George Ticketholder Phase 1, Milestone 2 Jan Feb March April May June July Ticket Assigned

10. Phase 1 Milestone 3 Payment 10 Earnings months at TWL Ticket Assignment Month 12 months 6

11. Phase 1 Milestone 4 Payment 11 Earnings months at TWL Ticket Assignment Month 18 months 9

12. Phase II Milestones 12 SGA With Federal Cash Benefits Each month is treated individually

13. Outcome Payments SGA with no Federal Cash Benefits 36 or 60 months 13

14. Progress Check One What are the requirements for a Phase I Milestone 3 payment? A.Earning Trial Work Level for three months within a six month period B.Earning Substantial Gainful Activity Level for three months within a six month period C.Earning Trial Work Level for six months within a twelve month period D.Earning Substantial Gainful Activity Level for six months within a twelve month period 14

15. Payment Request Types 15

16. Types of Payment Requests 16

17. Evidentiary Request Primary evidence o Pay stubs o Earnings statements prepared and signed by employer o The Work Number Must include: o Beginning and ending dates of the pay period o Pay date o Gross earnings for the claimed month o Year-to-date gross earnings o Withholdings 17

18. Certification Request Payment Option Secondary earnings information o Recent dated contact Type of contact Date of contact Description of the information you learned regarding the beneficiary’s earnings level o National Directory of New Hires data or Unemployment Compensation Insurance Record* o Self Employment Income Form Signed repayment agreement 18

19. Certification Request Option Repayment Agreement Certification requests can take longer to process Earnings info may change request to evidentiary request 19 “I will either repay the amount or allow the amount to be deducted from future payments if it is determined later that I was not entitled to the payment.”

20. Progress Check Two What two items are required for the Certification Request option? A.Secondary Earnings Information and Signed Repayment Agreement B.Individual Work Plan (IWP) and Request for Quotation (RFQ) C.Earning Statements Prepared by Employer and The Work Number D.The Work Number and Paystubs 20

21. Completing Payment Request Form 21

22. Click Payment Request 22

23. Payment Request Form 23 Indicate bank account status Indicate payment method ticket assigned under

24. Payment Request Details 24

25. Earnings Information 25

26. Complete EN Service Details 26

27. Evidentiary Earnings/Certification Payment Request 27

28. Additional Supporting Documents 28

29. Review for Accuracy 29

30. Confirmation Page 30

31. Upload Additional Supporting Documents 31 1 2 3 4 Enter SSN Choose file

32. Processing the Form Documents reviewed for completion, authenticity, and sufficiency Payment transferred to EN bank account Denials noted on EN Payment Status Report 32

33. Click Transaction History 33

34. Transaction History Results 34

35. Submitting the Form Secure Provider Portal Fax: 703.893.4020 Address: P.O. Box 1433 Alexandria, VA 22313 Must be fully completed form 35

36. Payment Request Form Resources 36

37. How to Submit EN Payment Request Form 37

38. EN Payments Checklist Guide 38

39. Other Portal Resources 39

40. EN Payment Status Report 40 If no payment or denial after 30 days, contact the Payment Help Desk for more information.

41. Payment Request Form Presentation 41 1 2 3

42. Questions? 42