Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 22 - Office of Vocational Rehabilitation for the Blind, Resource Guide › Section 32-22-3.18 - SELECTED SOCIAL SECURITY SERVICES › Section 32-22-3.18.2 - Social Security Reimbursement Program

Current through June 25, 2024
I.
				Overview
Under the Social Security Administration/Vocational
				  Rehabilitation Reimbursement Program, the Agency has a formal agreement with
				  SSA that allows the Agency to receive incentive payments from SSA on all
				  SSDI/SSI clients (receiving benefits based on disability) who receive services
				  resulting in the client working at least nine months out of 12 continuous
				  months at the Substantial Gainful Activity (SGA) level. The 2011 SGA amount is
				  $1000 per month for all disabilities except blindness and $1640 for individuals
				  who are blind. Because the Agency is entitled to incentive payments from SSA
				  based on the period a client receives SSDI/SSI during the rehabilitation
				  process, care should be taken in properly coding and updating cases. In
				  addition, care should be taken to properly code disability-based SSDI/SSI cases
				  since the Agency is not entitled to incentive payments on those cases receiving
				  retirement, childhood, widows, and other non-disability-based benefits.
Claims for reimbursement must be filed within 12 months after
				  the month in which the client completes nine months of SGA. For example, if the
				  individual completed a period of 9 months of SGA in April 2008, the claim must
				  be filed for reimbursement before May 2009. Therefore, all rehabilitated cases
				  considered for reimbursement are pulled by the Ticket Unit approximately one
				  year after closure since cases are normally closed 90 days following the date
				  the client is successfully employed. However, should there be a situation where
				  a client reaches the SGA threshold amount during the time the case is in open
				  status, the Ticket Unit should be notified at 601-853-5351 so that a
				  reimbursement claim can be filed within the allotted 12-month period.
II. Reimbursement Process
The Ticket Unit verifies receipt of SSDI/SSI benefits during
				  the VR service period by means of SSA queries. Wage verification documentation
				  is secured by the Ticket Unit on cases receiving VR services while in SSDI/SSI
				  benefit status through an agreement with the Mississippi Department of
				  Employment Security. The Ticket Unit searches for nine months of SGA within a
				  continuous twelve-month period.
When wage verification is not available through this process,
				  the Ticket Unit will explore AACE seeking documentation of employment at SGA.
				  If qualifying criteria is identified, the Ticket Unit will forward a Wage
				  Verification Letter to the counselor who closed the case. The counselor will
				  contact the previously served client in an effort to obtain written
				  verification of wages. The signed Wage Verification Letter or an explanation of
				  inability to secure cooperation from the previously served client will be
				  forwarded back to the Ticket Unit.
Good Provider Claims, Form SSA-199, are then submitted to the
				  SSA Claims Processing Unit for consideration of reimbursement for direct costs,
				  administrative costs, and tracking costs. Required documentation to accompany
				  the SSA-199 is usually pulled from AACE.
Requests for all signed authorizations for direct costs for
				  services provided prior to implementation of the AACE System in October 1999
				  will be forwarded to the counselors from the Ticket Unit. Counselors will make
				  copies of the signed authorizations and return to the Ticket Unit.
Upon receiving the SSA-199 with attachments, SSA can also
				  request Payment Validation Reviews (PVRs) on a sample of cases for which they
				  may request all signed authorizations and a copy of the IPE. These requests
				  will be forwarded to the counselors who will copy the requested documents and
				  return to the Ticket Unit. After reviewing submitted claims, SSA will forward
				  notice of approval or denial to the Ticket Unit.