FAQ

To meet SSA’s definition of disability, the applicant’s diagnosis must be documented in medical records, laboratory reports, or other clinical findings of a physician or psychologist. DDS prefers that medical evidence come from an ongoing treatment provider. If this medical documentation is not available because the applicant has not received treatment for these conditions, we recommend that SOAR practitioners try to arrange for a physician or psychologist to conduct assessments, including documenting the applicant’s diagnosis and functioning, before submitting the SSI/SSDI application.

If it is not possible to arrange an evaluation before submitting the application, DDS may arrange for a consultative exam (CE) for the applicant, including physical or psychiatric testing based on the applicant’s alleged conditions. More information about CEs can be found here. In these instances, it is especially important that the SOAR practitioner provides comprehensive information about the applicant’s impairments in functioning through the Medical Summary Report. Collateral information from caseworkers, family members, and former employers can also be helpful in supporting an application with limited medical documentation.

We recommend using headings throughout the MSR to divide information so that DDS can quickly find the evidence they are looking for. These headings typically include: personal history, employment, physical health, psychiatric health, and functional information. You can include sub-headings in these categories to further organize the information if you’d like.

Naturally, information may overlap in some of the sections. For instance, in legal history you may talk about how an applicant’s incarceration was related to their symptoms and then add extra information about symptoms in medical history. In these areas of overlap, there’s no need to repeat information you have already provided. By avoiding excessive repetition in the MSR and grouping the information using broad headings, we can help walk DDS through the documentation of how the applicant meets the disability criteria.

The SOAR TA Center is available to review Medical Summary Reports from SOAR practitioners. To submit your MSR for review, email soar@prainc.com and attach your MSR with the applicant’s name, birthdate, and Social Security number removed for HIPAA compliance.

SOAR is a model developed to help those who are experiencing or at-risk for homelessness, so they don’t need to fit the literal definition of homeless. At-risk for homelessness can include those who are in transitional housing, couch-surfing, exiting jails/institutions without somewhere to live, and those in permanent supportive housing who are entirely supported by grant funding.

Our Definitions of Homelessness page has further clarification on the definitions used by SOAR and SSA.

If you forget to enter “SOAR” in the remarks sections of SSA forms, they may not be directed to the SOAR liaison at your local SSA office (if one has been identified). However, there are other ways you can indicate that the application was completed using the SOAR model, even after you have submitted the online disability report:

1. Ensure that SOAR is written in the remarks section of the SSA-8000 (SSI application) that you deliver to your local SSA office;
2. When you deliver the paper SSA forms to the local SSA office, notify the claims representative that you are using the SOAR process;
3. Call the SOAR liaison at your local SSA office (if one has been identified) and notify him/her that you have submitted an application using the SOAR process.

Not all SSA offices have a SOAR liaison or know about the SOAR process. Remember that the most important part of the SOAR model is providing a complete, high-quality application with medical records and a Medical Summary Report (MSR). These elements, rather than the SOAR label on forms, will ensure that the application is processed efficiently by SSA and DDS.

You can type "This is a SOAR application" in the Remarks section.  You should also indicate whether the applicant is experiencing homelessness and any other clarifying remarks. 

Yes, you can find samples of completed SSA forms here.

Trying to write the Medical Summary Report (MSR), a key component of the SOAR approach, can seem challenging at first. Everyone is going to have a different approach to writing that works for them.

We recommend starting with the Medical Summary Report Worksheet as a template.  Work on only one section in each sitting.  Breaking it up into smaller chunks can take some of the pressure off of writing a long report. It may also help if you don't set a target length. Think about just writing a letter that tells all you know about someone's Personal History, Psychiatric History, or Functional Information. If you can get a couple sections complete and then put them together, you will likely see that the MSR comes together easier than you anticipated.

For more information about Medical Summary Reports, see the SOAR Library.

Most states have laws that regulate what health care providers can charge individuals for copies of their medical records. However, these rules do not necessarily apply to providers requesting records. In addition, some states provide an exception for records needed to apply for a disability benefits program and stipulate that they be provided at no-cost. For more information on state statutes and regulations regarding the collection of fees for medical records, click here.

If your state does not require a fee-waiver, we recommend contacting the director of the medical records department and advocating for or negotiating one. Explain that the individual is homeless and that you, as a mutual provider, are unable to pay for the records. Let the director know that the records will be used for a disability application and that, upon approval, the individual will likely be eligible for Medicaid and/or Medicare benefits that will pay for uncompensated care that the provider has given as well as future care that is provided. Therefore, it is in the provider’s best interest for the individual’s application to be well supported and documented as an approval may lead to retroactive and future reimbursements.

In addition, offer to the director of the medical records department that you would be happy to write a letter to the administrator of his/her agency regarding how helpful the director has been as well as the potential financial recoupment that such collaboration will mean to the provider.

If they are unwilling to waive the fees, try contacting United Way or other community action agencies that may be able to pay all or part of the bill.

You can help the applicant file for a hearing before an administrative law judge. It is in the applicant's best interest to keep the appeals process going because if they are approved at the hearing level they will be eligible for back payments going back to the protective filing date of the initial application.

See our Appeals resources in the SOAR Library. Here you will find our Prior or Pending Applications document which outlines some of what you need to do at the hearing level. You'll want the applicant to sign the SSA-1696: Appointment of Representative form, if you haven’t already. Then, request their file from Social Security. Together, you'll need to complete the HA-501: Request for a Hearing and the SSA-3441: Disability Report- Appeal (available on SSA’s website). You'll also need to turn in a new SSA-827:Authorization to Release Information. Be sure to submit the Request for a Hearing within 65 days from the date of the denial letter. If you haven't already, request medical records, do the general and functional assessments, and write a Medical Summary Report (MSR) just as you would for an initial SOAR application.

The other thing we would recommend is to file for a review on record. This might help you to avoid a hearing and eliminate a long wait. People who are eligible for a review on record are those individuals who may have additional diagnoses/medical records that were not considered previously. This does not take them out of the line for a hearing. So, if they are denied at review on record, they are still eligible for a hearing.

First and foremost we want to make sure that people who need our assistance with their SSI/SSDI applications get that assistance. That said, each provider has to make decisions about how many people they are able to serve and how many SOAR applications they complete. We recommend that when providers are not able to do a complete SOAR application with someone that they refer the individual to SSA and give them the tools to apply on their own or with another advocate.