ENs may be excluded from receiving Phase 1 Milestone payments under certain factors even when a beneficiary achieves qualifying earnings.

Phase 1 Milestone Exclusions

The following factors can exclude an EN from receiving Phase 1 Milestone payments even when a beneficiary achieves qualifying earnings:

  • Phase One Milestone Eligibility with Successful VR Closure: The Ticket Program Manager (TPM) will use the 18-month look-back period to identify if any State Vocational Rehabilitation (VR) agencies closed the beneficiary‚Äôs claim successfully (i.e. successful closure) within 18 months prior to Ticket assignment, to determine initial eligibility for Phase 1 Milestone payments.
    • If a successful closure is found during the 18-month look-back period, the EN is not eligible for Phase 1 Milestone payments.
    • If no successful closure is found during the 18-month look-back period, the EN may be eligible for Phase 1 Milestone payments.
    • If a State VR agency successfully closed a case more than 18 months prior to Ticket assignment date, TPM will do a normal look-back for Trial Work Level (TWL) earnings and not automatically disqualify the EN for Phase 1 Milestone payment.
    • This policy applies to all payments submitted on and after February 1, 2020
  • 18-Month Lookback Rule: If a beneficiary had TWL earnings during some or all of the 18 months prior to the first Ticket assignment, some or all of the Phase 1 Milestones may be excluded from payment. Access the 18-Month Lookback Tool in the Information Center on the Resource Documents page. The earnings criteria used for payment of Phase 1 Milestones are reversed to determine eligibility for payment based on the 18-month lookback rule as noted below.
  • P1M1 is not available if a beneficiary worked with earnings above the TWL in the calendar month immediately prior to Ticket assignment.
  • P1M2 is not available if a beneficiary worked with earnings above the TWL in 3 of the 6 months immediately prior to Ticket assignment.
  • P1M3 is not available if a beneficiary worked with earnings above the TWL in 6 of the 12 months immediately prior to Ticket assignment.
  • P1M4 is not available if a beneficiary worked with earnings above the TWL in 9 of 18 months immediately prior to Ticket assignment.