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). 

First, here is some information about overpayments and how to help prevent them in the future: Avoiding and Managing SSI/SSDI Overpayments. Reporting earnings is absolutely essential to prevent overpayments. SSA has some options for requesting waivers of overpayments and can set up payment plans if they deny the waiver request. 

Deciding whether to quit or cut back their hours depends on the person’s circumstances. No matter what, they need to report their earnings. Those earnings will impact SSI and SSDI differently (read some basic information about SSA Work Incentives). For some people, they can earn a lot more income by working and if they are feeling well and are able to work, that is probably what they should do (their decision!). For others, the stability of their SSDI payment is important and so they work under SGA each month to keep their benefit. Ultimately, I would recommend that they talk to a Benefits Counselor to discuss their options.

If a person is approved for both SSI and SSDI they will maintain Medicaid because SSI benefits include Medicaid. However, some states require a separate Medicaid application, (https://www.ssa.gov/disabilityresearch/wi/medicaid.htm).

Medicaid coverage for services varies from state to state. Here is a link that will take you to your state's Medicaid agency: https://www.medicaid.gov/about-us/contact-us/contact-state-page.html.

SSDI benefits include Medicare, but there is typically a 24 month waiting period before the SSDI beneficiary can begin to have Medicare coverage (see Page 12 at https://www.ssa.gov/pubs/EN-05-10029.pdf).

Once the beneficiary has both Medicaid and Medicare, Medicare is typically the primary insurance.

If a person is working while applying for SSI and is earning above the Substantial Gainful Activity (SGA) limit set annually by SSA, they will not be eligible for benefits.

However, SSA has many work incentive programs for SSI beneficiaries to assist their efforts to return to work. These programs exclude some income/resources so that SSI recipients can attempt work, and even earn above SGA, without fear of losing their benefits. We recommend that beneficiaries speak with a work incentives specialist to discuss how work will affects their own benefits. A good place to start to find local resources is SSA's Ticket to Work website.

1619(b) is continued Medicaid coverage for those individuals that were receiving SSI benefits prior to returning to work. You can find more information on SSA's website here: http://www.socialsecurity.gov/disabilityresearch/wi/1619b.htm

You can contact your SOAR State Team Lead or Local Lead to find out if there is a designated SOAR liaison at your local SSA office.

Most SOAR programs that have a hospital collaboration will work with the hospital’s billing department to collect information on reimbursed expenses for each SOAR applicant approved. Some are able to separate out Medicaid and Medicare reimbursements; others have just a total for all reimbursements. The information isn't any more complicated than: "We helped 100 individuals get approved for SSI/SSDI and the hospital has been reimbursed $500,000 in the past year in Medicaid/Medicare expenses for these individuals."  It can be helpful to also collect the totals for unreimbursed expenses for those same individuals for the year prior to approval to use as a comparison.  One SOAR provider looked at emergency room usage for the year prior and the year after approval to see if there was a reduction. They found a 24 percent reduction in ER usage and 52 percent reduction in psychiatric ER usage.

Some SOAR providers will meet monthly with the billing department and collect reimbursement data, others will do it quarterly.  We would recommend doing whatever works best for the staff at the hospital and the SOAR staff.  

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.