FAQ

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. 

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)

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.

If an individual becomes disabled before the age of 22 and one of his/her parents is either deceased or receives disability or retirement benefits, the "Disabled Adult Child" may receive benefits based on their parent's earnings record. SSA has an easy to use FAQ page about this topic: https://www.ssa.gov/planners/disability/qualify.html

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.

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 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. 

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 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.