FAQ

The SAMHSA SOAR TA Center considers a "SOAR application" to be one in which all (or most) of the SOAR critical components are done. These include serving as the person's representative with the SSA-1696, collecting medical records and writing a Medical Summary Report documenting the person's functional impairment. If the SOAR provider is unable to get all of the records or is unable to get the Medical Summary Report signed by a treating physician, it would still be counted as a SOAR application because all was done that could be done.

Read more about SOAR application critical components.

Yes! Please see Steps to Completing an Initial SOAR SSI/SSDI Application. This guide is intended to help you complete a SOAR SSI/SSDI application in stages so that you aren’t overwhelmed.

It is unfortunate when we run across physicians who are unwilling to help people access the benefits that they are entitled to, although it is a common problem.  Many doctors will say that they have not seen a person enough to support a report such as the MSR.  Sometimes doctors on ACT (Assertive Community Treatment) teams or in PSR (Psychosocial Rehab) programs may be willing to co-sign reports. When you can’t find a doctor to cosign the report, we recommend you submit the MSR as collateral information along with the medical records that you have collected that document the diagnostic information from a physician.  

You may want to find out why they are refusing to sign the report. Is it because they feel they don't know enough to sign it?  Or that it wasn't written by them so they don't want to sign it?  Are there other reasons?  One of the things we find is that the doctors often misunderstand what we are asking them to do. They believe that, by signing the report, they are "approving" the person for disability benefits. DDS makes that decision. What they're doing is simply attesting that the information contained in this report is true. It's fine if they even write a statement that they believe the information in this report is true. 

You might remind the doctor and the clinic/hospital that when someone is approved for SSI/SSDI they are also going to be eligible for Medicaid/Medicare which means retroactive reimbursement for services provided and ongoing payment for treatment and services in the future.  

One SOAR program contacted the state medical association for the names of retired physicians and asked if anyone was willing to do one assessment pro-bono.  It was fairly successful.

It depends! In many DDS offices the consultative exam (CE) examiners are allowed 30 days to file their report/evaluation after the exam.  They may or may not be turned in on time. Once the DDS examiner gets the report it may take some time to finish their recommendation and transfer it to the physician at DDS who will review the case. This can sometimes happen very quickly or, when there are backlogs, it may take a few days, weeks or longer.  We would recommend that the case manager call the DDS examiner to see whether the CE report has been submitted and whether they can provide any other needed information.  

My first recommendation would be to go with your client to the local SSA field office with whatever information you have been able to verify and that he is able to report. SSA can sometimes find someone's Social Security number with their name, DOB and parent's information. It often depends on how unique their name is and how easily they can narrow it down. SSA has a special provision to establish a new SSN for folks who are unable to identify themselves by reason of homelessness, amnesia or mental impairment.

The explanation in the SSA Program Operations Manual is at the following link: https://secure.ssa.gov/apps10/poms.nsf/lnx/0110210120!opendocument

You will want to talk to the local SSA office about taking the steps to go through this process if necessary.

First and foremost we want to make sure that people who need our assistance with their SSI/SSDI applications get that assistance. That said, each provider has to make decisions about how many people they are able to serve and how many SOAR applications they complete. We recommend that when providers are not able to do a complete SOAR application with someone that they refer the individual to SSA and give them the tools to apply on their own or with another advocate.

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.

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.

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

You can type "This is a SOAR application" in the Remarks section.  You should also indicate whether the applicant is experiencing homelessness and any other clarifying remarks.