Skip to main content

Icon faq FAQ

Find answers to frequently asked questions.

Question:
How can we track Medicaid reimbursements?

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.  

View
Question:
How can you expedite a hearing?

To help expedite a hearing, the applicant or their representative can submit a letter of "dire need" to the hearing office (ODAR).  The letter should describe the applicant's conditions, how s/he has worsened since the reconsideration was filed and why s/he will worsen still if s/he is not granted an expedited hearing. You need to explain how the applicant is unable to get shelter, medical care, and/or food. Be as specific as possible and provide examples of the applicant's functional impairment.  If you can reference medical records, that is very helpful. There is no guarantee that the administrative law judge will grant an expedited hearing, but it is worth trying.

Occasionally elected officials will send a form letter (a dire need letter of sorts) to the hearing office (ODAR) to inquire about the claim and to ask for an expedited process.  

View
Question:
How do I assist a client who already has a pending SSI/SSDI application that was submitted without a case manager's assistance? Is it best to fill out ROIs to learn more about the determination or withdraw?

The SOAR process can definitely be used to assist applicants with a pending initial or reconsideration level SSI/SSDI claim. To confirm the correct claim level, you will submit the SSA-3288: Consent for Release of Information to the SSA field office.

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 submitting the SSA-1696: Appointment of Representative form to the SSA field office, gathering additional medical records, noting previously unreported medical conditions, writing a Medical Summary Report, and assisting with SSA forms specific to the initial and appeal process.

However, if you learn that the applicant is at the ALJ level of appeal, you will need to discuss with the applicant whether they wish to continue to appeal at the hearing level or withdraw their current application to submit a new initial application using the SOAR model with your representation.

You can learn more about this by reviewing the article, "Prior or Pending Applications."

View
Question:
How do I become involved in SSI/SSDI cases that are already in process? What about cases that have been going on for a long time, such as those waiting for a hearing or appeal?

If the case is pending at the initial or reconsideration stage, you can become the applicant's representative via submission of the SSA-1696: Appointment of Representative form. You will then be able to communicate with SSA/DDS about the application and request access to the materials that have been submitted. After reviewing the person’s file, you'll know what needs to be addressed, just as when you are starting anew with someone. If the person isn't willing to have you be the representative, ask if they have one - if so, try to assist that person with what needs to be addressed.

If the person is waiting for an appeal hearing, it may be necessary for you to secure legal representation for them through agencies such as the state Protection and Advocacy organization, Legal Services, Legal Aid, or another kind of pro-bono legal service.

Read more at Prior or Pending Applications.

View
Question:
How do I download SSA forms from the SOAR Online Course to my computer where I can complete them?

All of the forms required for the SOAR online course are located in Class 1 Practice Case page, “Meet your Client”. Right-click on each file, choose "Save Target As" (or "Save Link As"), and save in an easily-accessible location on your computer. The forms may also be opened as pdfs and then completed and saved. The course will instruct you on when each form needs to be completed and uploaded to the website. If you have any trouble uploading the completed forms, you can see our Troubleshooting Tips.

If you are looking to download and complete SSA forms outside of the SOAR Online Course, many forms can be found in our Library or on the SSA website.

View
Question:
How do I get started writing the medical summary report? It is so intimidating.

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.

View
Question:
How do I print my SOAR certificate?

When you log-in to the SOAR website, go to your Profile page.  There, you will see a link to access the Certificate of Completion that was e-mailed to you when you passed the course.

View
Question:
How do unemployment benefits affect a client's Social Security Benefits?

Unemployment benefits would affect SSI because it is counted as unearned income. So, each dollar of unemployment would count against the Federal Benefit Rate (FBR)* for SSI. Unemployment benefits do not count toward the substantial gainful activity (SGA)* limit because they are not the result of current work activities.

Unemployment benefits would not affect SSDI in the same way. While technically it is possible to receive both unemployment benefits and SSDI, it gets tricky. When you apply for unemployment benefits you attest that you are ABLE to work but you lost your job through no fault of your own and are actively looking for work. When you apply for disability benefits you attest that you are UNABLE to work at a substantial gainful level. There are certain circumstances where someone might be receiving unemployment and become disabled after becoming unemployed or became unable to work while they were employed due to an illness or injury on the job. These individuals might apply to both programs but must actively seek work to maintain unemployment benefits.

*These figures are updated annually and can be found at SSA Annual Updates.

View
Question:
How do we determine the initial Residual Functional Capacity (RFC) that shows us where to begin? Is this based on the RFC that comes from DDS? How do we determine RFC before that?

If you are working on an appeal, you will want to review the file to see DDS’s RFC which was the basis for denial. DDS officially determines the RFC. DDS’ opinions take the form of RFC assessments, physical, mental, or both. Essentially, the DDS physician reviews the claimant’s medical records, including narrative reports or CEs, and prepares a written opinion. Taking the form of an RFC assessment, the opinion is expressed in terms of the physical and mental limitations that the DDS physician believes accurately describe the claimant’s capability. To find the right Grid rule, determine the claimant’s maximum RFC (and find the correct table). You are looking for the table that fits the claimant’s exertional level (sedentary, light, medium), and find the rule that fits the claimant’s other characteristics, e.g.) age, education, skill level. The specific rule will mandate a conclusion of disabled and not disabled. Remember, for a rule to apply it must be consistent with all the claimant’s characteristics. In no grid rule fits, then all evidence and factors must be considered independent of the Grids.

View
Question:
How do we find out why a client was previously denied?

You can obtain valuable insight into the reason an applicant was previously denied by reviewing the applicant’s electronic folder, or at minimum, obtaining the “Disability Determination Explanation” or denial notice. Most likely, you will have easy access to the denial notice from the applicant or, if you are the authorized representative, SSA should have mailed a copy to you. You can also request reason for denial by contacting your local SSA office. Learn more at Reviewing Denial Notices.

View