FAQ

HALLEX (Hearings, Appeals and Litigation Law Manual) is a publication from the Social Security Administration's Office of Disability Adjudication and Review (ODAR). ODAR administers hearings and appeals for people seeking reviews of their applications for disability benefits. HALLEX contains policy statements from the SSA's Appeals Council, as well as procedures directed to lower levels of the SSA for carrying out the SSA's guiding principles

This is definitely something we hear quite a bit and a very pervasive rumor that an applicant has to be denied X number or times, or can only win on appeal. The truth is that if the evidence is in the initial filing showing that an applicant meets the criteria for SSI or SSDI, he/she will be approved at the initial stage. Using the SOAR model results in higher approval rates (see our national outcomes) because we focus on getting all of the information in the file from the beginning, whereas many people who are eligible for benefits are denied because they don’t have assistance in gathering this documentation.

Some lawyers who take fees for assisting with disability claims specialize in appeals and don’t provide the evidence in the initial stage – they wait for the application to be denied and then work on the appeal. For an application at the appeal stage to be successful, the vast majority of the time it requires new evidence that wasn’t originally presented (there are some cases that are overturned due to oversights at DDS). So, it’s not that DDS wants to deny the case from the beginning, they just didn’t have the right information. It doesn’t save them any money to automatically deny people and then send them to appeal (in fact, it actually costs them more money in adjudicator time, medical records requests, and consultative exams).

All of that said, we understand why people think this is true. The overall national approval rate for SSI/SSDI (without SOAR) is only 29%. So yes, that means 71% of people are denied. It's not possible to know how many applicants needed more evidence and how many just didn't meet the disability criteria, but it certainly leads to many myths about the process.

We recommend against using the SSA-8001 form for a SOAR 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 in to SSA, you can often avoid the need for this interview.

If you find that your local SSA office is not accepting the SSA-8000 from in lieu of an interview, I encourage you to reach out to your SOAR TA Center Liaison and SOAR State Lead so that they can provide local assistance.

All of our resources are open-access and free to use when helping applicants. However, we request that you only use the “SOAR” label at Social Security when you are working with individuals who are experiencing or at-risk for homelessness. Read more about how we define homelessness and at-risk. If the applicants you assist do not fit this criteria, you are still welcome to use any of our materials that you find helpful, without marking the application as “SOAR” at Social Security.

The Medical Summary Report (MSR) Interview Guide and Template is a great tool for writing the MSR. The Interview Guide portion contains key questions to ask applicants when gathering evidence for the application. The Template contains main headings that may be used when formatting the MSR. Be sure to remove the Interview Guide and guidance under the Template headings before turning the MSR in to DDS. It is also important to put the MSR on your agency's letterhead whenever possible.

This guide and template can be found on the SOAR Tools and Worksheets page.

We recommend using the applicant’s last day of work as their date of onset when helping someone apply for SSI/SSDI. The Social Security Administration (SSA) will examine the applicant’s medical records and prior work history 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).

If the applicant is currently working, enter the date that he or she believes the condition(s) became severe enough to prevent him or her from performing substantial gainful activity.

For individuals who have never worked, such as youth exiting foster care, SSA’s guidance is to “enter the date when he or she believes the condition(s) became severe enough to keep him or her from working.” Since youth can work before age 18, you can enter dates prior to their 18th birthday if that is relevant.

When providers of substance use services (drug and alcohol) release records, they are required to include the following notice from the CFR Title 42:2.32:

“This information has been disclosed to you from records protected by Federal confidentiality rules (42 CFR part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The Federal rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug abuse patient.” Source: http://edocket.access.gpo.gov/cfr_2002/octqtr/42cfr2.32.htm

However, the law allows the records to be disclosed to any entity the person names in the consent. When you complete the SSA-827: Authorization to Disclose Information to SSA be sure that it specifically mentions the release of drug and alcohol treatment records.

We recommend creating a case-file folder for each applicant, specifically for SSA and SOAR paperwork. It is helpful if this folder has separate sections to organize your material. While you are gathering information for the application, you can store your interview notes, signed agency releases of information used to gather medical records, and any medical records or collateral information you have gathered. You can also store any completed SSA forms or worksheets in this folder. As you gather medical records, it is helpful to read through them and fill out the paper SSA-3368 Adult Disability Report as a worksheet with the key information from the records.

It may also be helpful to write a short summary of the medical records from each treatment provider as you gather them and include this in the folder. This will save time when you start to write your Medical Summary Report (MSR), as you can utilize the information from the summaries rather than re-reading the medical records. Additionally, your interview notes from the folder will be beneficial to use as a basis for your MSR.

When you are ready to submit the SSI/SSDI application, the folder will contain all the information you need to complete the disability application. Once you’ve submitted the application, place copies of the online application receipt, paper forms submitted to the SSA office (SSA-1696 and SSA-8000), and a copy of your MSR in the folder. Finally, once you receive the decision letter from SSA, include this in the folder for your records and store the information according to your agency guidelines.

The expectation is that providers involved with SOAR do not charge persons applying for SSA disability benefits for their services. We work closely with providers to identify alternative sources of funding for their programs. All 50 states and the District of Columbia have identified various methods to fund SOAR activities that do not involve charging the applicant or collecting a fee from the applicant’s back pay. Resources related to SOAR funding and sustainability can be found in the SOAR Library.

The SOAR process can definitely be used to assist applicants with appeals, as SOAR practitioners are often well positioned to assist given their relationships with applicants and knowledge of their impairments and related functional limitations. SOAR case managers can help by gathering additional medical records, writing a Medical Summary Report, and assisting with SSA forms specific to the appeal process. More information on assisting applicants with appeals, including a full issue brief with tips for practitioners, is available in the SOAR Library.