FAQ

SSA can start payments more quickly than usual in four different types of situations:

• Presumptive Disability (PD) or presumptive blindness (PB) payment: Based on the severity of the condition and the likelihood that the claim will be approved, SSA may make payments for up to 6 months while DDS makes a final decision. This is not based on financial need.
• Emergency advance payment: A one-time advance payment to new claimants who "face a financial emergency and who are due SSI benefits that are delayed or not received"
• Immediate payment: An immediate payment to new claimants and SSI recipients whose benefits are delayed or not received and who face a financial emergency."
• Expedited reinstatement cases: If benefits are terminated because of excess earned income or a combination of earned and unearned income, claimants can request to have benefits started again without having to complete a new application.

We recommend visiting SSA's website to find out more: Understanding SSI - Expedited Payments (ssa.gov)

Yes, someone receiving retirement can apply for SSDI benefits if they elected to take early retirement and are receiving a reduced amount. If they retired at full retirement age then their SSDI benefit would be the same and there is no need to apply. 

They would need to prove that they are medically disabled and unable to work at SGA. (Some people who take early retirement benefits are ready to stop working but don’t meet the definition of disability). 

There is no need to make up any details about your fictional applicant. All of the information you need to complete the Practice Case application packet is provided to you. Take care to review all materials available on the Practice Case pages at the end of Classes 1-4. This includes applicant interviews, medical records, and progress notes.

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.

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.

Yes, you should file a SOAR-assisted application because even if you don’t have access to the medical evidence, DDS will request directly from prior treating sources and/or schedule appropriate Consultative Examinations (CE) to obtain diagnoses. Remember, SSA needs a diagnosis to make a disability determination. Remember, to write in the “Remarks Section” on SSA forms, about your efforts to obtain medical information so that DDS will know what they need to do to medically develop the claim.

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.

When you log-in to the SOAR website, go to your Profile page.  There, you will see a link to access the Certificate of Completion that was e-mailed to you when you passed the course.

• 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

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.