Cost Reimbursement Program

Social Security's Vocational Rehabilitation (VR) Cost Reimbursement (CR) program, authorized in 1981, is only available to State VR agencies. The two purposes of the CR program are:

1. To make State VR services more readily available to Social Security beneficiaries with disabilities; and
2. To generate savings to the Social Security Trust Fund, for Social Security Disability Insurance (SSDI) beneficiaries and to the General Revenue Fund, for Supplemental Security Income (SSI) recipients.

Under the CR program, the Social Security Administration pays State VR agencies compensation in the form of reimbursement when beneficiaries served by State VR agencies enter the workforce and achieve nine continuous months of earnings. The earnings must be at or above the Substantial Gainful Activity (SGA) level, called a continuous period of SGA.

When the beneficiary achieves this benchmark, the State VR agency completes the Vocational Rehabilitation Provider Claim form (SSA-199) and submits it to Social Security with supporting documentation. This documentation includes a breakdown of the direct costs associated with the case.

The payment period starts with the beneficiary’s date of onset for SSDI beneficiaries or the date of entitlement for SSI recipients.

The payment period ends with the ninth month of SGA level earnings, or the month before the last month of SSDI entitlement or SSI eligibility, whichever comes first. CR claims must be filed timely to qualify for payment. A claim is considered timely if filed with Social Security within 12 months of the last day of the ninth month of SGA level earnings. If the claim is approved, the reimbursement constitutes a lump sum payment to the State VR agency.

When a State VR agency chooses to serve beneficiaries under the CR program, it must abide by the legislative and regulatory requirements of the CR program:

For SSDI beneficiaries:

• Social Security Act, Section 222(d)
• Governing regulations: 20 CFR 404.2101 through 404.2127:
  • 404.2101 General.
  • 404.2102 Purpose and scope.
  • 404.2103 Definitions.
  • 404.2104 Participation by State VR agencies or alternate participants.
  • 404.2106 Basic qualifications for alternate participants.
  • 404.2108 Requirements for payment.
  • 404.2109 Responsibility for making payment decisions.
  • 404.2110 What we mean by "SGA" and by "a continuous period of 9 months".
  • 404.2111 Criteria for determining when VR services will be considered to have contributed to a continuous period of 9 months.
  • 404.2112 Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program.
  • 404.2114 Services for which payment may be made.
  • 404.2115 When services must have been provided.
  • 404.2116 When claims for payment for VR services must be made (filing deadlines).
  • 404.2117 What costs will be paid.
  • 404.2118 Applicability of these provisions to alternate participants.
  • 404.2119 Method of payment.
  • 404.2120 Audits.
  • 404.2121 Validation reviews.
  • 404.2122 Confidentiality of information and records.
  • 404.2123 Other Federal laws and regulations.
  • 404.2127 Resolution of disputes.

For SSI recipients:

• Social Security Act, Section 1615
• Governing regulations: 20 CFR 416.2201 through 416.2227:
  • 416.2201 General.
  • 416.2202 Purpose and scope.
  • 416.2203 Definitions.
  • 416.2204 Participation by State VR agencies or alternate participants.
  • 416.2206 Basic qualifications for alternate participants.
  • 416.2208 Requirements for payment.
  • 416.2209 Responsibility for making payment decisions.
  • 416.2210 What we mean by "SGA" and by "a continuous period of 9 months".
  • 416.2211 Criteria for determining when VR services will be considered to have contributed to a continuous period of 9 months.
  • 416.2212 Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR program.
  • 416.2214 Services for which payment may be made.
  • 416.2215 When services must have been provided.
  • 416.2216 When claims for payment for VR services must be made (filing deadlines).
  • 416.2217 What costs will be paid.
  • 416.2218 Applicability of these provisions to alternate participants.
  • 416.2219 Method of payment.
  • 416.2220 Audits.
  • 416.2221 Validation reviews.
  • 416.2222 Confidentiality of information and records.
  • 416.2223 Other Federal laws and regulations.
  • 416.2227 Resolution of disputes.

State VR agencies serving beneficiaries under the CR program must also abide by the requirements in the Social Security Administration's Vocational Rehabilitation Providers Handbook