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). 

If a person is guarded when you are interviewing them for the MSR, you can explain to them the importance of you gathering this information and providing it to Social Security as part of the SSI/SSDI application process. If they still don't want to provide you information then you can document in the MSR the person's guarded nature, their behavior and symptoms you observe, and document that you believe it to be due to the symptoms of their mental illness (paranoia, delusions, suspiciousness, etc.). You can try to obtain the information you need for the MSR from the person's medical records and if they are willing to sign ROIs, you can attempt to interview collateral sources such as family, friends, case managers, etc. to obtain information to include in the MSR. 

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.

We recommend contacting the DDS examiner assigned to the case to find out where they are in the decision making process. If they have just been assigned the case and are starting to process it, then you have time to write and submit a Medical Summary Report. You could let the DDS examiner know that you have additional evidence to submit. If you do not have an SSA-1696 on file, the claimant will need to be with you when you call. 

Many of our sample MSRs include information about physical disabilities in addition to mental impairments. Here is an example of one.

We also encourage you to review the Listings for the specific criteria SSA will be looking for, for each condition. You'll want to include information in your MSR about how the person's conditions meet the listing criteria. 

It's great that she has two doctors willing to sign!  Yes, we recommend including both signatures -- it sends a stronger message that they are both on board with the content. And it won't cause any issues.

The Mental Status Exam must be performed by an "Acceptable Medical Source" (AMS) in order to establish a "medically determinable physical or mental impairment."

Acceptable Medical Sources include physicians, psychologists, advanced practice nurse practitioners (APRN), or physician assistants (PA).  Further, the APRN category includes: Certified Nurse Midwife, Nurse Practitioner, Certified Registered Nurse Anesthetist, and Clinical Nurse Specialist. Audiologists are also acceptable medical sources for hearing-related disorders.

Licensed Clinical Social Workers (LCSWs) are not included.

Yes. By signing the MSR, the AMS is only indicating that they believe the included information to be true. It is likely that the provider has spoken with the individual about his/her mental illness, seen some records to that effect, and/or has witnessed some symptoms. In order to treat a patient properly for physical health conditions, the provider would need to be aware of medications and mental health treatment.  If the doctor does not want to sign off on anything that does not pertain to their specific field of practice, they could sign a reduced MSR that does not include reference to the other treating sources, but does include reference to all of the conditions that the doctor feels comfortable attesting to. 

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.