FAQ

HIPAA requires medical providers to release the patient's records within 30 days after the request is received (https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/ind…). Some states have laws that require the release of medical records in fewer than 30 days.

RFC forms are very useful and can be a vehicle for the treating source to provide medical opinion evidence, forcing the ALJ to consider it.  Sometimes the ALJ will discount the RFC form if he/she feels that it is not supported by the medical records.  For instance, sometimes a doctor will give the opinion that the applicant “can sit for 30 minutes” but nowhere in the medical record is there anything about this at patient appointments. So, be aware of that.  Also, be sure that the answers on the form are internally consistent. 

For the second question, once DDS determines the applicant has met a Listing (at Step 3 of the Sequential Evaluation), DDS stops developing the claim for other impairments.  DDS looks at the applicant’s RFC at Step 4 and Step 5.  The applicant’s RFC is determined and compared to the physical and mental demands of the past relevant work (Step 4). When it is determined that the applicant cannot perform past relevant work, RFC, age, education and past work experience must be considered to determine if there is other less demanding work the applicant can do.

Finally, RFC forms which are designed with space for the physician to provide their medical opinion, and not merely a form with check off boxes, is most effective. 

Most states prohibit the re-release or “further release” of records once they have been released to an entity that originally requested them. However, if you send a request for records using the SOAR Process, which includes (1) a signed SSA-827 Authorization to Disclose Information and (2) a signed Agency Authorization to Release Information (either using the sample on the SOAR Tools & Worksheets page or your agency’s HIPAA compliant release), you will be able to send those records on to SSA.

Also included on the SOAR Tools & Worksheets page is a Medical Records Request Letter, which explains the purpose of the records request. This process of sending two releases is permitted under the HIPAA Privacy Rule as a “compound authorization.” The regulation can be found in the Code of Federal Regulations: Title 45 Part 164 Section 164.508. Source: Code of Federal Regulations: Title 45

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.

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.

You should be able to use the copy of the authorization that you have to request the records. According to a clarification letter drafted by the Director of the Office of Civil Rights on April 25, 2003, “A copy, facsimile, or electronically transmitted version of a signed authorization is also a valid authorization under the Privacy Rule.”
Source: https://www.socialsecurity.gov/disability/professionals/documents/HHS-OCRfeedback.pdf

Absolutely! The U.S. Department of Housing and Urban Development (HUD) Continuum of Care Program (CoC) plays a key role in ending homelessness in communities and states. HUD’s description of the program includes: “The Continuum of Care (CoC) Program is designed to promote communitywide commitment to the goal of ending homelessness; provide funding for efforts by nonprofit providers, and State and local governments to quickly rehouse homeless individuals and families while minimizing the trauma and dislocation caused to homeless individuals, families, and communities by homelessness; promote access to and effect utilization of mainstream programs by homeless individuals and families; and optimize self-sufficiency among individuals and families experiencing homelessness” (emphasis added)

SOAR is critical in HUD’s mission to promote access to Social Security disability benefits for individuals with disabling conditions. This access helps promote housing stability and prevents future homelessness for these individuals. As a result, SOAR should be included in local CoC plans to end homelessness.

"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."

Generally when an attorney is fired after the individual has signed the SSA-1696 (and possibly other binding documents with the attorney), the attorney has to file a fee petition with SSA defending their right to be paid. The attorney/representative must detail what services were performed while assisting the applicant. You can read more about the fee petition on the SSA website and see the form that is filed: http://www.ssa.gov/representation/fee_petitions.htm. SSA will determine whether or not the representative is granted the entire fee or a partial fee. 

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.