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 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.

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.  

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.

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. 

1619(b) is continued Medicaid coverage for those individuals that were receiving SSI benefits prior to returning to work. You can find more information on SSA's website here: http://www.socialsecurity.gov/disabilityresearch/wi/1619b.htm