FAQ

SSI has a monthly federal benefit rate that changes each year plus any available state supplement. You can find the current benefit amounts on our SSA Annual Updates page.

It is unfortunate when we run across physicians who are unwilling to help people access the benefits that they are entitled to, although it is a common problem.  Many doctors will say that they have not seen a person enough to support a report such as the MSR.  Sometimes doctors on ACT (Assertive Community Treatment) teams or in PSR (Psychosocial Rehab) programs may be willing to co-sign reports. When you can’t find a doctor to cosign the report, we recommend you submit the MSR as collateral information along with the medical records that you have collected that document the diagnostic information from a physician.  

You may want to find out why they are refusing to sign the report. Is it because they feel they don't know enough to sign it?  Or that it wasn't written by them so they don't want to sign it?  Are there other reasons?  One of the things we find is that the doctors often misunderstand what we are asking them to do. They believe that, by signing the report, they are "approving" the person for disability benefits. DDS makes that decision. What they're doing is simply attesting that the information contained in this report is true. It's fine if they even write a statement that they believe the information in this report is true. 

You might remind the doctor and the clinic/hospital that when someone is approved for SSI/SSDI they are also going to be eligible for Medicaid/Medicare which means retroactive reimbursement for services provided and ongoing payment for treatment and services in the future.  

One SOAR program contacted the state medical association for the names of retired physicians and asked if anyone was willing to do one assessment pro-bono.  It was fairly successful.

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. 

If an individual becomes disabled before the age of 22 and one of his/her parents is either deceased or receives disability or retirement benefits, the "Disabled Adult Child" may receive benefits based on their parent's earnings record. SSA has an easy to use FAQ page about this topic: https://www.ssa.gov/planners/disability/qualify.html

In certain circumstances, someone can get both SSI and SSDI. This happens when someone is approved for SSDI, but their monthly check is lower than the full SSI Federal Benefit Rate (FBR)*. This could be due to earning low wages throughout the employment history or limited recent work. In this case, the individual will receive SSI to supplement the payment to bring them up to the FBR. Since the Social Security Administration (SSA) discounts the first $20 of earned or unearned income an individual receives when calculating the SSI amount, a concurrent beneficiary will receive $20 above the SSI FBR.

*The Federal Benefit Rate changes annually and can be found at SSA Annual Updates.

If the case is pending at the initial or reconsideration stage, you can become the applicant's representative via submission of the SSA-1696: Appointment of Representative form. You will then be able to communicate with SSA/DDS about the application and request access to the materials that have been submitted. After reviewing the person’s file, you'll know what needs to be addressed, just as when you are starting anew with someone. If the person isn't willing to have you be the representative, ask if they have one - if so, try to assist that person with what needs to be addressed.

If the person is waiting for an appeal hearing, it may be necessary for you to secure legal representation for them through agencies such as the state Protection and Advocacy organization, Legal Services, Legal Aid, or another kind of pro-bono legal service.

Read more at Prior or Pending Applications.

Generally, SSA will not count the retroactive (back-pay) SSI or Social Security benefits for up to nine months after the person receives them. This includes payments received in installments.

When the individual receives his/her award letter it should spell out the exact length of time s/he has to spend down the retroactive payments. If there is any confusion, definitely check with the local SSA office for specifics on the individual's case.  

If he is eligible for unemployment and the amount is more than the Federal Benefit Rate (FBR)*, then he should take the higher amount (unemployment) as long as he can.  The medical approval for SSI will last for 12 months, so if the unemployment only lasts a few months, he can always reapply for SSI (the non-medical application) and SSA will use the medical decision from his last application. 

*This figure is updated annually and can be found at SSA Annual Updates.

SSA considers any life insurance policy with a face value of $1,500 or higher. The face value is how much insurance you're buying, (e.g., $5,000, $10,000, etc.). The cash value is what you'd get for the policy if you cashed it in.  Since this person’s policies are valued at $3,700, they are over the resource limit for an individual ($2,000). In order to fall below the resource limit, they would need to cash in one (or more) of the policies depending on what other resources they have.  They would need to use/spend that money to live on before becoming eligible for SSI.  

To help expedite a hearing, the applicant or their representative can submit a letter of "dire need" to the Office of Hearing Operations (OHO).  The letter should describe the applicant's conditions, how they have worsened since the reconsideration was filed, and why they will worsen still if they are not granted an expedited hearing. You need to explain how the applicant is unable to get shelter, medical care, and/or food. Be as specific as possible and provide examples of the applicant's functional impairment.  If you can reference medical records, that is very helpful. There is no guarantee that the administrative law judge will grant an expedited hearing, but it is worth trying.

Occasionally elected officials will send a form letter (a dire need letter of sorts) to OHO to inquire about the claim and to ask for an expedited process.