Skip to main content

Icon faq FAQ

Find answers to frequently asked questions.

Question:
I have a client who is well past the 60 day mark in appealing his case. Is he able to appeal or do we need to start over with his case?

Generally, an applicant is required to appeal within 60 days (+5 days for mailing) from the date of the denial letter. However, SSA considers "Good Cause" for late filing. They will often accept the appeal request late for someone who is experiencing homelessness or has a serious mental illness. They are also accepting Good Cause for late filing due to COVID-19. We definitely recommend appealing the decision (to preserve the original protective filing date and potential back-payments).

You can find a sample Good Cause letter on our SOAR Tools & Worksheets page.

View
Question:
If a client I'm working with gets denied at the initial application, should I submit a revised medical summary report (MSR) with their reconsideration if I already submitted an MSR with the initial application?

We recommend that you submit an amended MSR along with the Reconsideration appeal forms. This will give you an opportunity to address any updates to the applicant’s condition(s) or treatment. It is advisable to include an addendum with updated dates and signatures.

The DDS examiner will review the updated MSR along with the Disability Report-Appeal (SSA-3441) that you will complete as part of the iAppeal packet. Remember the SSA-3441 allows you to provide  updated information for a complete appeal submission. SSA uses the SSA-3441 to update the disability information since the Disability Report (SSA-3368) was submitted at the initial level. You will have space to provide additional information about any changes in the applicant's conditions or limitations. Also, you can supply missing medical information and attach medical records or any additional evidence as part of the online iAppeal application, including an amended MSR.

View
Question:
Should I actually include information from the Listings and Grids in the MSR, or should I wait until the applicant is denied?

The SAMHSA SOAR TA Center recommends that you don’t cite the Listing and Grid numbers, e.g.) Ms. Jones meets Listing 12.04, and the alternative Grid rule 203.03. Rather, at the DDS level (initial and reconsideration) we suggest providing a description of how the applicant meets a particular Listing(s) or Grid rule through specific examples from the medical records, applicant quotes, and other collateral sources.

View
Question:
How do we find out why a client was previously denied?

You can obtain valuable insight into the reason an applicant was previously denied by reviewing the applicant’s electronic folder, or at minimum, obtaining the “Disability Determination Explanation” or denial notice. Most likely, you will have easy access to the denial notice from the applicant or, if you are the authorized representative, SSA should have mailed a copy to you. You can also request reason for denial by contacting your local SSA office. Learn more at Reviewing Denial Notices.

View
Question:
My client's SOAR case has been denied and I would like to ask for another representative to review the case. How do I ask for reconsideration and which forms do I use to request this?
The first level of appeal is the reconsideration. It is an opportunity to have the application reviewed by different staff at DDS and to add new or additional information.
View
Question:
Is there any guidance or training on assisting with the appeal process?

Yes, we have a number of resources on the SOAR website to help provide information and guidance through the appeals process. They can all be found in the SOAR Library. I recommend starting with the article About Appeals and then checking out the Appeals Toolkit.

View
Question:
If someone has a pending claim for SSDI under appeal with an attorney involved, should/can a SOAR application be submitted?

SSA does not allow an applicant to have multiple applications pending at the same time.  If the applicant chooses to have a new initial SOAR-assisted application for SSDI benefits submitted, then the applicant would need to withdraw their current application.  It is important that the applicant understands that the new application would create a new application date which may result in the loss of retroactive 'back' benefits based on withdrawing the current pending application.

View
Question:
I was told there was a list of questions that was good to use during an ALJ appeal hearing.

"Questions for Direct Examination at SSA Administrative Law Judge (ALJ) Hearing," along with other helpful resources, can be accessed on the webinar "Hearing Tips for SOAR Practitioners."

View
Question:
At my client's hearing, the judge said that as the applicant's Appointed Representative, I can't submit the SSA-3380 - Third Party Function Report. Is this correct?

At the hearing level, many Administrative Law Judges (ALJs) will invoke ‘Rule 3.7: Lawyer/Advocate as Witness’.  Under the advocate-witness rule, you cannot serve as both advocate (via the SSA-1696) and witness.  The ‘witness’ is required to testify on the basis of personal knowledge, while an advocate is expected to explain and comment on evidence given by others. This dual role can give rise to a conflict of interest.

In your case, the ALJ viewed the 3rd Party Function Report you completed as ‘providing witness testimony’ which can prejudice the ALJ’s decision. Often, the ALJ will recognize that the SOAR case worker is not familiar with this rule, and educate them on their options.  When there is other evidence in the file and the SOAR case worker does not need to testify themselves, they will remain the official 1696 representative. By doing so, they are able to cross examine expert witnesses and directly examine the applicant (i.e. ask them questions in front of the judge during the hearing).

View
Question:
Is a Section 8 housing unit/voucher qualify as transitional housing for purpose of meeting homelessness definition?

Section 8 Housing Choice Vouchers are not time-limited and so typically are not used in transitional housing. Individuals and families who are using housing vouchers may be eligible for SOAR assistance if they do not have their own income that would allow them to remain stably housed without the voucher.

View