SAMHSA SOAR

SSA-8001: Application for Supplemental Security Income (SSI) (Deferred or Abbreviated)

The SSA-8001 is an abbreviated version of the SSA-8000: Application for Supplemental Security Income. While we discourage the use of the SSA-8001 in the SOAR model, this article contains helpful guidance for how to complete this form.

Why is the SSA-8001 not used in the SOAR Model?

We recommend against using the SSA-8001 form for a SOAR-assisted application because it contains less comprehensive information about an applicant’s income and resources. As such, the applicant would still need to complete an in-person or phone interview with SSA in order to complete the SSA-8000. By completing the SSA-8000 and turning it into SSA, you can often avoid the need for this interview.

How to complete the SSA-8001

Type of Claim

It is important to first indicate the type of claim in the initial section of the SSA-8001. The types of claims are:
  1. Individual
  2. Individual with ineligible spouse
  3. Couple
  4. Child
  5. Child with parent(s)

Part 1 – Basic Eligibility (Questions 1-21)

SSA-8001 Questions 1-7: Name(s)

This is a series of questions about the applicant’s name, birth date, and Social Security number (SSN), as well as this information for others if filing as a spouse, couple, or for a child. If you are filing SSI for a child, the SSA-8001 will ask for the parent(s) name.

SSA-8001 Questions 8-11: Current Marriage, Other Names or SSNs Used, and Place of Birth

SSA asks about a current marriage, or if the applicant is living with another person and presenting to others as a married couple. They will also need any other names or SSNs that the applicant, spouse, or parent used, and the place of birth for the applicant and spouse (if applicable).

SSA-8001 Question 12: Onset of Disability

For adult applicants, we recommend using the applicant’s last date of work as the date they became unable to work. SSA will examine all of the applicant’s prior employment to determine if any of the previous work attempts were unsuccessful (i.e.: the applicant was unable to sustain work for more than a few weeks or months due to disabling mental or physical health conditions). For 12(e) you will enter the date the child became disabled.
  • This question will also come up on the SSA-16 and SSA-3368 (for adults) and SSA-3820 (for children). It is important to remain consistent across all forms with the date you provide, or it could delay processing at SSA.
  • Question 12 asks about inability to work, blindness, and for information about his/her parent if the applicant was unable to work due to his or her conditions prior to age 22.

SSA-8001 Questions 13-16: Citizenship and Immigration

Citizenship and residency will affect SSI eligibility. Applicants who are U.S. citizens by birth can skip questions 13-16, as these only apply to immigrants to the U.S. When assisting an individual who is not a U.S. citizen, it can be helpful to contact the local SSA office for assistance with completing the application.

SSA-8001 Questions 17-20: Residence and Mailing Address

Applicants who were born in the U.S. can use their date of birth for question 17. If the applicant has lived outside of the U.S., provide details in 17b-c. Question 18 asks only about trips outside of the country in the 30 days before filing the SSI application. Note: military deployments do not count as residency abroad.
 
Question 19 asks about current mailing address. For applicants experiencing homelessness, this can be the representative’s agency address. Question 20 only applies to those who are blind or visually impaired and asks how the applicant would prefer to receive mail from SSA. Those who are not blind or visually impaired do not need to answer this question.

SSA-8001 Question 21: Warrants

These questions ask about any unsatisfied felony warrants for the applicant’s arrest, or any unsatisfied federal or state warrants for violating conditions of probation and parole. For more information about legal status, please visit our Criminal Justice page. Individuals with active warrants are eligible to apply for and receive benefits as long as the warrant is not related to escape or fleeing to escape prosecution.

Part 2 – Living Arrangement (Questions 22-24)

Since SSI is based on need, where a person is living is an important part of the application. Question 22 asks about the applicant’s residence address. If the applicant is experiencing homelessness, you can write “homeless” here. Question 23 asks the applicant to check the box that best describes their living situation and the date they began living there. Question 24 asks if the applicant lives with other people, but should be left blank if the applicant is transient or homeless or living in a foster home, group home, or institution.

Part 3 – Resources (Questions 25-28)

Remember that SSI is based on need. Determining if a person has assets that can be easily liquidated to help provide support is part of the SSA need equation. Many, if not most, of the individuals you serve will not have countable resources, but it is important to ascertain whether they do. It is possible that an applicant has forgotten about certain assets or that the symptoms of illness have made it difficult to manage their assets.
  • Be sure to explore whether or not the person has any assets for each of the types of resource listed.
  • Provide information about any resources that have been recently sold, transferred, or given away.
  • Note that question 29 asks for permission to obtain financial records for any financial institution. SSA will need to verify the applicant’s income and resources, in order for them to be eligible for SSI.

Part 4 – Income (Questions 29-30)

SSA's questions about income on the SSA-8001 ask about any income received by the applicant (and parent/spouse if applicable). Income can include but is not limited to, wages, self-employment income, Veterans benefits, and court-ordered payments. SSA may exclude some expenses and income from counting for SSI purposes.

Part 5 – Potential Eligibility for Supplemental Nutrition Assistance Program (SNAP)/Medical Assistance (Questions 31-32)

SSA-8001 Question 31: SNAP (also known as Food Stamps)

Congress enacted the Food Stamp Act of 1977 to try to lessen the barriers that SSI applicants/recipients encounter when dealing with two different offices to obtain SSI and food stamp benefits. As a result, SSA jointly files food stamp applications for SSI applicants and recipients.
  • Applicants residing in an institution and applying for SSI before release are able to apply for food stamps/SNAP with their SSI application. They will not be eligible to receive food stamps/SNAP until they are released from incarceration.
  • Note: Not all parts of question 32 need to be answered. Based on the applicant’s answers, you may leave some parts of this question blank.

SSA-8001 Question 32: Medical Assistance

SSI applicants may be eligible for Medicaid. They must also help the state identify other sources that pay for medical care for themselves and medical support for any children. The state cannot provide Medicaid to the applicant if they do not agree to this Medicaid requirement. If the applicant has had recent uncompensated medical expenses or evaluations, answer “yes” to 32c. Providers may be eligible for Medicaid reimbursement for these services if the applicant is approved for SSI.

Part 6 – Miscellaneous (Question 33)

This is relevant only to agencies or individuals who are requesting benefits on behalf of someone else. For example, a parent on behalf of a child or a legal conservator on behalf of a court-ordered legally incompetent adult. In the SOAR model, the case manager is assisting individuals with applications, but the applicant is applying on his or her own behalf.

Part 7 – Remarks

This section can be a useful place to include additional information that helps to support the benefit claim. Use this space to make additional comments or further explain a specific question. You may want to indicate that the information provided represents the best recollection of the applicant. If the applicant had trouble recalling specific information explain this to SSA. You can also include the representative's contact information and a statement that the representative assisted the applicant with completing the form.

Parts 8 and 9 – Important Information and Signatures

This section brings the applicant’s attention to the importance of providing accurate information. Any information offered will be cross-checked with other federal and state agencies or financial institutions. 
 
Finally, there is a place for the applicant and their spouse to sign the application. It needs to be witnessed only if signed with a mark or x. A receipt is provided.

Details

Type:
SSA Forms
Date:
March, 2020

Other Details