FAQ

An MSR that has been written based on properly released records can be shared with the primary AMS.  At the point of obtaining the signature, it is primarily a privacy issue, not HIPAA. However, it would be a best practice to have a release signed by the applicant permitting the case worker to communicate with the AMS.

The short answer is "yes." If someone asks to see their Medical Summary Report, you can provide it to them in the same manner that your agency would release a copy of their medical records to them.

However, there are some other factors to keep in mind.  Since the MSR focuses on an applicant's symptoms and functional limitations rather than their strengths, we recommend talking with them first to explain that the report is written in this manner to demonstrate how they may be eligible for SSI/SSDI and that SSA needs to see numerous examples of their limitations. Remind them that they have a lot of personal strengths and that this report is not a full reflection of that.

It is important to speak with the applicant throughout the process in order to alleviate any concerns about what information will be included in the MSR. One best practice to establish transparency and trust is to ask permission on the first interview to take notes. Tell the applicant that at any time they can ask you to stop taking notes or to see what you are writing.  Emphasize that your goal is to capture their words so that they can tell their story to SSA through this process.  Ultimately, the MSR is comprised mainly of their quotes and information they have provided to you.

Reading about one's symptoms and limitations can be very difficult and through this conversation applicants may find that they aren't prepared for that or that it would not be beneficial for their recovery. But, if after this preparation, the applicant wants to read the MSR, then that is their right to do so, following your agency's guidelines.

The Medical Summary Report (MSR) Interview Guide and Template is a great tool for writing the MSR. The Interview Guide portion contains key questions to ask applicants when gathering evidence for the application. The Template contains main headings that may be used when formatting the MSR. Be sure to remove the Interview Guide and guidance under the Template headings before turning the MSR in to DDS. It is also important to put the MSR on your agency's letterhead whenever possible.

This guide and template can be found on the SOAR Tools and Worksheets page.

We recommend using headings throughout the MSR to divide information so that DDS can quickly find the evidence they are looking for. These headings typically include: personal history, employment, physical health, psychiatric health, and functional information. You can include sub-headings in these categories to further organize the information if you’d like.

Naturally, information may overlap in some of the sections. For instance, in legal history you may talk about how an applicant’s incarceration was related to their symptoms and then add extra information about symptoms in medical history. In these areas of overlap, there’s no need to repeat information you have already provided. By avoiding excessive repetition in the MSR and grouping the information using broad headings, we can help walk DDS through the documentation of how the applicant meets the disability criteria.

The SOAR TA Center is available to review Medical Summary Reports from SOAR practitioners. To submit your MSR for review, email soar@prainc.com and attach your MSR with the applicant’s name, birthdate, and Social Security number removed for HIPAA compliance.

Trying to write the Medical Summary Report (MSR), a key component of the SOAR approach, can seem challenging at first. Everyone is going to have a different approach to writing that works for them.

We recommend starting with the Medical Summary Report Worksheet as a template.  Work on only one section in each sitting.  Breaking it up into smaller chunks can take some of the pressure off of writing a long report. It may also help if you don't set a target length. Think about just writing a letter that tells all you know about someone's Personal History, Psychiatric History, or Functional Information. If you can get a couple sections complete and then put them together, you will likely see that the MSR comes together easier than you anticipated.

For more information about Medical Summary Reports, see the SOAR Library.

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.

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.  

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.

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.  

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.