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Find answers to frequently asked questions.

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:
Are medical providers required to respond to your request for medical records once you provide a copy of the SSA 827 to them? Is eliciting cooperation from them generally an issue for case managers?

Generally speaking, medical providers are not legally bound to provide records to a third party. They are not required to provide records to DDS, either. However, HIPAA regulations require healthcare providers to provide individuals copies of their own records: 

"The Privacy Rule generally requires HIPAA covered entities (health plans and most health care providers) to provide individuals, upon request, with access to the protected health information (PHI) about them in one or more “designated record sets” maintained by or for the covered entity.

We hear from most SOAR providers that they are able to get medical records from most sources. Some states have special laws that cover access to records for disability applications. We also do our best to build relationships with commonly used providers and the medical records departments to try to improve those relationships, and clarify and expedite processes.

 

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Question:
Are Veterans eligible to collect both VA and SSA benefits at the same time? If so, is there a monthly cap?

Absolutely, Veterans who receive VA disability benefits may also receive SSA benefits, depending on the amount received from the VA and if they are approved for SSI or SSDI. 

SSI: VA benefits will affect the SSI benefit amount. SSA classifies VA benefits as “unearned income,” since it does not come from paid employment. As such, it will be deducted dollar for dollar from the SSI federal payment amount, after the general exclusion of $20. (All SSI recipients are eligible for this exclusion, where the first $20 of earned or unearned income is not counted against their SSI payment.)

SSDI: Alternatively, SSDI benefits are not affected by unearned income through VA benefits.

Please read more at SSA and VA Disability Benefits: Tips for Veterans.

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Question:
Once I have passed the SOAR Online Course am I required to attend any other trainings in order to keep my certification?

The SOAR TA Center does not require any further training but we always recommend that SOAR-trained practitioners stay up-to-date by re-visiting the website, reading our e-newsletters, attending our webinars, etc.

While we consider those who pass the SOAR Online Course to be "SOAR-trained," it is not a formal "SOAR Certification" so to speak.  However, many states implement their own SOAR Certification procedures so it is important to know about your state's SOAR Process. Please visit your state's page for more information.

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Question:
VA staff have access to veteran's VA medical record throughout local and remote data system. How do VA staff provide these records as part of the SOAR packet? What does VA require to document disclosures?

In recent years, DDS has developed the ability to quickly access VA medical records electronically, which should be triggered when you fill out the electronic application (specifically the SSA-3368 Adult Disability Report) and document that the applicant received treatment from the Veterans Health Administration. An electronically signed SSA-827 will also need to be in the file. When SSA transfers the case to DDS and it is noted that the applicant received VHA care, the system automatically sends an electronic request for records to VHA. The full process they use is here, and it's pretty interesting: https://secure.ssa.gov/poms.nsf/lnx/0422505022.

For SSA, the only required release of information is the SSA-827. However, the VA may also require that the Veteran sign a form 10-5345 Request for and Authorization to Release Medical Records and Health Information.

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Question:
When requesting medical records, what type of records are specifically needed? I requested ALL records for a client, and received over 500 pages from the hospital. In the future, can I make a more specific request for efficiency purposes?

Great question! While we do typically advise to collect all records, 500 pages is understandably a lot! Not all applicants will have this many, but if you are seeing that certain hospitals/providers tend to send significant amounts (particularly if they aren't helpful for the application), you could ask for: Inpatient hospitalization records, discharge summaries, outpatient/emergency records, and psychiatric examinations/mental status exams. Those are all pretty key for the application. When you submit the records to DDS, I'd recommend adding a note that these were all that you requested, so that it doesn't look like you just weren't sending everything you have.

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Question:
At my client's hearing, the judge said that as the applicant's Appointed Representative, I can't submit the SSA-3380 - Third Party Function Report. Is this correct?

At the hearing level, many Administrative Law Judges (ALJs) will invoke ‘Rule 3.7: Lawyer/Advocate as Witness’.  Under the advocate-witness rule, you cannot serve as both advocate (via the SSA-1696) and witness.  The ‘witness’ is required to testify on the basis of personal knowledge, while an advocate is expected to explain and comment on evidence given by others. This dual role can give rise to a conflict of interest.

In your case, the ALJ viewed the 3rd Party Function Report you completed as ‘providing witness testimony’ which can prejudice the ALJ’s decision. Often, the ALJ will recognize that the SOAR case worker is not familiar with this rule, and educate them on their options.  When there is other evidence in the file and the SOAR case worker does not need to testify themselves, they will remain the official 1696 representative. By doing so, they are able to cross examine expert witnesses and directly examine the applicant (i.e. ask them questions in front of the judge during the hearing).

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Question:
Is it necessary to have a psychiatrist conduct the Mental Status Exam (MSE) on an applicant or will a licensed social worker suffice?

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.

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Question:
Are there county jails or correctional facilities that have a quick check list that is used to determine who may or may not qualify for SSI/SSDI?

Yes, see the Criminal Justice version of the "Identifying SOAR Applicants" tool on the SOAR Tools & Worksheets page.

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Question:
Is a Section 8 housing unit/voucher qualify as transitional housing for purpose of meeting homelessness definition?

Section 8 Housing Choice Vouchers are not time-limited and so typically are not used in transitional housing. Individuals and families who are using housing vouchers may be eligible for SOAR assistance if they do not have their own income that would allow them to remain stably housed without the voucher.

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