FAQ

First, here is some information about overpayments and how to help prevent them in the future: Avoiding and Managing SSI/SSDI Overpayments. Reporting earnings is absolutely essential to prevent overpayments. SSA has some options for requesting waivers of overpayments and can set up payment plans if they deny the waiver request. 

Deciding whether to quit or cut back their hours depends on the person’s circumstances. No matter what, they need to report their earnings. Those earnings will impact SSI and SSDI differently (read some basic information about SSA Work Incentives). For some people, they can earn a lot more income by working and if they are feeling well and are able to work, that is probably what they should do (their decision!). For others, the stability of their SSDI payment is important and so they work under SGA each month to keep their benefit. Ultimately, I would recommend that they talk to a Benefits Counselor to discuss their options.

If a person is guarded when you are interviewing them for the MSR, you can explain to them the importance of you gathering this information and providing it to Social Security as part of the SSI/SSDI application process. If they still don't want to provide you information then you can document in the MSR the person's guarded nature, their behavior and symptoms you observe, and document that you believe it to be due to the symptoms of their mental illness (paranoia, delusions, suspiciousness, etc.). You can try to obtain the information you need for the MSR from the person's medical records and if they are willing to sign ROIs, you can attempt to interview collateral sources such as family, friends, case managers, etc. to obtain information to include in the MSR. 

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.

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.

We recommend contacting the DDS examiner assigned to the case to find out where they are in the decision making process. If they have just been assigned the case and are starting to process it, then you have time to write and submit a Medical Summary Report. You could let the DDS examiner know that you have additional evidence to submit. If you do not have an SSA-1696 on file, the claimant will need to be with you when you call. 

• The appeal must be filed within 60 days of receipt of the initial denial notice.
• The applicant must submit the following forms:
  • SSA-561: Request for Reconsideration
  • SSA-3441: Disability Report- Appeal
  • SSA-827: Authorization to Disclose Information to SSA
• Additional medical records and evidence can be submitted
• The application will be assigned to a different disability examiner and reviewing physician at DDS

Many of our sample MSRs include information about physical disabilities in addition to mental impairments. Here is an example of one.

We also encourage you to review the Listings for the specific criteria SSA will be looking for, for each condition. You'll want to include information in your MSR about how the person's conditions meet the listing criteria. 

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.

It's great that she has two doctors willing to sign!  Yes, we recommend including both signatures -- it sends a stronger message that they are both on board with the content. And it won't cause any issues.

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.