Social Security Administration Programs for Expediting Disability Claims and Payments
Social Security Administration (SSA) disability benefits programs, Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI), provide essential income and health insurance that can facilitate access to housing and treatment for people experiencing or at risk of homelessness. SSA is committed to expediting claims and quickly issuing payments for the most serious conditions and applicants in dire need. SOAR providers are trained to develop complete and comprehensive claims that help to naturally expedite SSA disability applications. When working with an applicant who is experiencing or at risk of homelessness, SOAR providers should be aware of the following SSA initiatives and practices.
Expediting Claim Processing
SSA uses a special “flag” for applicants who are experiencing unstable housing or homelessness. An applicant is considered homeless “if he or she does not have a fixed, regular, and adequate nighttime residence.” SSA’s homeless definition also includes people who are experiencing or fleeing domestic violence. When an SSA Claims Specialist sees “homeless” in the Remarks section of the disability application, a “Homeless Flag” is added to the applicant’s electronic file. The Homeless Flag indicates that the application should receive expedited processing and ensures special considerations are made regarding the applicant’s ability to respond to correspondence and make it to Consultative Examinations.
The Compassionate Allowances (CAL) initiative quickly identifies and processes claims for applicants with diseases and other medical conditions that, by definition, clearly meet SSA’s definition of disability. There are over 275 CAL conditions that primarily include certain cancers and brain disorders. CAL conditions are identified based on information gathered from the public, advocacy groups, medical and scientific experts, and others. Individuals can suggest that conditions be added to the CAL list via the SSA website. There is no special application or form to complete – SSA will expedite the disability claims of those who qualify. The qualifying condition should be clearly listed on the Disability Report and in the Remarks of all application forms.
Terminal illness cases (TERI) are those in which the applicant has an untreatable condition that is expected to imminently end in death. There is no special form to complete for a case to be expedited under the TERI program. An SSA claims specialist or DDS claims examiner can identify a TERI case when the applicant’s illness is terminal, they are receiving hospice care, or have been diagnosed with ALS (i.e., Lou Gehrig’s Disease) or AIDS.
Military Service Personnel
100% Permanent and Total Veterans Initiative
Veterans with a 100% Permanent and Total (P&T) disability rating from the Veterans Administration (VA) receive expedited processing of their applications. While these applications are prioritized, it does not guarantee approval for SSI/SSDI. To receive expedited processing, Veterans should identify themselves as a “Veteran rated 100% P&T” when initiating the SSI/SSDI application and should provide the VA rating notification letter to SSA
Personal or Public Safety
If there is evidence that an applicant is suicidal or homicidal, SSA will expedite the claim. Evidence of suicidal or homicidal ideations may come from any source, including the applicant, treating physicians, collateral sources, SSA employees, or law enforcement officials. If it is determined that an applicant is a threat to either themselves or others, SSA will contact the appropriate authorities and provide referral services for local physicians, community service centers, suicide prevention programs, or other appropriate medical facilities
If a disability benefit appellant has a pending hearing with an Administrative Law Judge and does not have the resources to get food, medical care, or shelter, the claim may be expedited as a “dire need” case. You can submit a "dire need" letter to SSA that explains why waiting the typical amount of time for a hearing might have dire consequences for the applicant. The applicant does not need to provide specific evidence to support the allegation of dire need. However, if SSA discovers evidence that contradicts the claim, it may require that proof be provided. Some examples of evidence that may be helpful in a dire need case include:
notification of immediate eviction from a landlord or from a lender that foreclosure is imminent
a letter from a homeless shelter that states the applicant is no longer eligible for services
copies of medical bills and estimated costs for any needed medical treatment
SSI Expedited Payments
Presumptive Disability or Blindness
Presumptive disability (PD) or presumptive blindness (PB) payments support SSI applicants for up to 6 months while SSA processes their disability claim. SSA’s decision to grant PD payments is based on the severity of the applicant’s conditions and the high likelihood that the claim will be approved. Financial need is not considered. An applicant may granted PD or PB payments if they have one or more of the eligible medical conditions, such as terminal illness with a life expectancy of 6 months or less or total blindness or deafness. SSA will not require the applicant to repay PD payments, even if they are later found not to be disabled. SSA makes most PD and PB decisions, but DDS can also make a determination in some circumstances.
Emergency Advanced Payment
SSA may be able to make an advance payment to new applicants who face a financial emergency (i.e., need money right away for food, clothing, shelter, or medical care) and are due SSI benefits that are delayed or not received (e.g., due to processing or mail delays). However, SSA can only make one advance payment. The maximum emergency advance payment an applicant may receive is the smallest of
- the SSI federal benefit rate (plus any federally administered State supplement);
the total amount of the benefits due; or
the amount requested for the financial emergency
SSA may be able to make an immediate payment to SSI applicants or current beneficiaries whose benefits are delayed or not received and who face a financial emergency (i.e., need money right away for food, clothing, shelter, or medical care). The immediate payment cannot be higher than $999.00. SSA will subtract the immediate payment from the individual’s first regular payment due.
Direct Payment While a Representative Payee is Pending
If SSA determines that a beneficiary needs help managing their money, they may require the applicant to identify a Representative Payee. If the applicant cannot identify a suitable Representative Payee on their own, SSA will work to assign a reputable organization to serve as the applicant’s payee. SSA will directly pay the beneficiary while working to identify a Representative Payee.
Expedited Reinstatement of Benefits (EXR)
If benefits are terminated because of excess earned income or a combination of earned and unearned income, former beneficiaries can request to have their benefits started again without completing a new application. SSA calls this process “expedited reinstatement.” Individuals can apply for expedited reinstatement of benefits if their impairment(s) is the same or related to their original impairment and their income falls below substantial gainful activity within 5 years of the month their benefits stopped.
- April, 2015
- SSA Information