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Find answers to frequently asked questions.

Question:
My client's SOAR case has been denied and I would like to ask for another representative to review the case. How do I ask for reconsideration and which forms do I use to request this?
The first level of appeal is the reconsideration. It is an opportunity to have the application reviewed by different staff at DDS and to add new or additional information.
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Question:
My client has not been completely honest with hospital staff because he "does not trust people." Therefore, his medical records do not show all of his illnesses. Should I send all of the records I have, or just the parts that actually show his illnesses?

You should definitely send all of the medical records. SSA has a rule called the “All Evidence Rule” which requires applicants (through their representative) to submit all medical information known, which includes knowledge of impairment and/or treatment sources. 

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Question:
My client had been receiving SSI prior to being incarcerated. He is now out of jail and would like me to get his benefits turned back on. He has not had it for 2 years now - do we have to start all over again?

For applicants that have received SSI prior to incarceration, a new application must be submitted if the applicant was incarcerated for more than 12 months.

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Question:
My client had a phone interview with the local SSA office during which they did her application. Am I still able to submit her medical records and MSR to support her claim? Do I need to submit a 1696 to the local office?

Yes, you will need to submit the completed SSA-1696: Appointment of Representative form to the local SSA field office. I recommend faxing it and then calling within 1-2 days to confirm that it was received and added to your client's record/claim.

Ask the SSA field office if they completed both an SSDI and SSI application during the phone interview and if they need anything else for the claim to be complete. You can also ask whether they would like you to submit the medical records and MSR directly to them or to wait until the claim gets moved over to DDS for medical review.

I recommend staying in close contact with SSA to find out who the DDS analyst is, especially if you or your client don't receive any mail from DDS within a few weeks.

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Question:
My agency received a bill for medical records. What should we do if we do not have funding available to pay the bill?

Most states have laws that regulate what health care providers can charge individuals for copies of their medical records. However, these rules do not necessarily apply to providers requesting records. In addition, some states provide an exception for records needed to apply for a disability benefits program and stipulate that they be provided at no-cost. For more information on state statutes and regulations regarding the collection of fees for medical records, click here.

If your state does not require a fee-waiver, we recommend contacting the director of the medical records department and advocating for or negotiating one. Explain that the individual is homeless and that you, as a mutual provider, are unable to pay for the records. Let the director know that the records will be used for a disability application and that, upon approval, the individual will likely be eligible for Medicaid and/or Medicare benefits that will pay for uncompensated care that the provider has given as well as future care that is provided. Therefore, it is in the provider’s best interest for the individual’s application to be well supported and documented as an approval may lead to retroactive and future reimbursements.

In addition, offer to the director of the medical records department that you would be happy to write a letter to the administrator of his/her agency regarding how helpful the director has been as well as the potential financial recoupment that such collaboration will mean to the provider.

If they are unwilling to waive the fees, try contacting United Way or other community action agencies that may be able to pay all or part of the bill.

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Question:
Must the client be present when the SSA-1696 Appointment of Representative form is submitted to SSA?

No, the claimant does not need to present when you turn in the signed SSA-1696. We do recommend submitting an original copy with a "wet-signature." Be sure to keep a copy for your records.

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Question:
Is there any reason to apply for SSDI for someone who has a 1 year work history and does not qualify for Disabled Adult Child benefits?

Yes! SSA will explore eligibility for SSDI for any adult applying for SSI benefits. The application is quick, easy and online. You will complete the SSDI application (called the Online Disability Benefit Application) when you are online completing the Online Adult Disability Report. It comes first in the process and is your way to help set the protective filing date for SSI. The applicant may get a denial letter for SSDI pretty quickly in the process. Do not despair, DDS will still be processing the medical decision and the SSI application will still be pending, despite that denial letter for SSDI.

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Question:
Is there any place to find a completed sample of the SSA-8000-BK?

Yes, you can find samples of completed SSA forms here.

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Question:
Is there any guidance or training on assisting with the appeal process?

Yes, we have a number of resources on the SOAR website to help provide information and guidance through the appeals process. They can all be found in the SOAR Library. I recommend starting with the article About Appeals and then checking out the Appeals Toolkit.

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Question:
Is there a school records request form?

There is no general form for requesting school records. To obtain school records, contact the specific School District to obtain their request form. 

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