FAQ

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

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.

To meet SSA’s definition of disability, the applicant’s diagnosis must be documented in medical records, laboratory reports, or other clinical findings of a physician or psychologist. DDS prefers that medical evidence come from an ongoing treatment provider. If this medical documentation is not available because the applicant has not received treatment for these conditions, we recommend that SOAR practitioners try to arrange for a physician or psychologist to conduct assessments, including documenting the applicant’s diagnosis and functioning, before submitting the SSI/SSDI application.

If it is not possible to arrange an evaluation before submitting the application, DDS may arrange for a consultative exam (CE) for the applicant, including physical or psychiatric testing based on the applicant’s alleged conditions. More information about CEs can be found here. In these instances, it is especially important that the SOAR practitioner provides comprehensive information about the applicant’s impairments in functioning through the Medical Summary Report. Collateral information from caseworkers, family members, and former employers can also be helpful in supporting an application with limited medical documentation.

SOAR is a model developed to help those who are experiencing or at-risk for homelessness, so they don’t need to fit the literal definition of homeless. At-risk for homelessness can include those who are in transitional housing, couch-surfing, exiting jails/institutions without somewhere to live, and those in permanent supportive housing who are entirely supported by grant funding.

Our Definitions of Homelessness page has further clarification on the definitions used by SOAR and SSA.

If you forget to enter “SOAR” in the remarks sections of SSA forms, they may not be directed to the SOAR liaison at your local SSA office (if one has been identified). However, there are other ways you can indicate that the application was completed using the SOAR model, even after you have submitted the online disability report:

1. Ensure that SOAR is written in the remarks section of the SSA-8000 (SSI application) that you deliver to your local SSA office;
2. When you deliver the paper SSA forms to the local SSA office, notify the claims representative that you are using the SOAR process;
3. Call the SOAR liaison at your local SSA office (if one has been identified) and notify him/her that you have submitted an application using the SOAR process.

Not all SSA offices have a SOAR liaison or know about the SOAR process. Remember that the most important part of the SOAR model is providing a complete, high-quality application with medical records and a Medical Summary Report (MSR). These elements, rather than the SOAR label on forms, will ensure that the application is processed efficiently by SSA and DDS.

You can type "This is a SOAR application" in the Remarks section.  You should also indicate whether the applicant is experiencing homelessness and any other clarifying remarks. 

Yes, you can find samples of completed SSA forms here.

Most states have laws that regulate what health care providers can charge individuals for copies of their medical records. However, these rules do not necessarily apply to providers requesting records. In addition, some states provide an exception for records needed to apply for a disability benefits program and stipulate that they be provided at no-cost. For more information on state statutes and regulations regarding the collection of fees for medical records, click here.

If your state does not require a fee-waiver, we recommend contacting the director of the medical records department and advocating for or negotiating one. Explain that the individual is homeless and that you, as a mutual provider, are unable to pay for the records. Let the director know that the records will be used for a disability application and that, upon approval, the individual will likely be eligible for Medicaid and/or Medicare benefits that will pay for uncompensated care that the provider has given as well as future care that is provided. Therefore, it is in the provider’s best interest for the individual’s application to be well supported and documented as an approval may lead to retroactive and future reimbursements.

In addition, offer to the director of the medical records department that you would be happy to write a letter to the administrator of his/her agency regarding how helpful the director has been as well as the potential financial recoupment that such collaboration will mean to the provider.

If they are unwilling to waive the fees, try contacting United Way or other community action agencies that may be able to pay all or part of the bill.