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Find answers to frequently asked questions.

Question:
Who do I contact to find out the status of a claim when the applicant is waiting for a hearing?

The second stage in the appeals process is when the applicant requests a hearing before the Administrative Law Judge (ALJ). These hearings are scheduled through the Office of Hearings Operations (OHO). Visit the SSA website to find the appropriate hearing office based on the applicant’s address or ask your local SSA field office. 

You can also take a look at Prior or Pending Applications and other Appeals resources in the SOAR Library.

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Question:
Can a person receive both unemployment and SSDI?

Technically, it is possible to receive both unemployment benefits and SSDI, but 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 folks might apply to both programs but must actively seek work to maintain the unemployment benefit.

 

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Question:
How does SSA define homelessness for the Living Arrangement question?

Homeless/Transient (Living Arrangement): A transient is an individual with no permanent living arrangement, i.e., no fixed place of residence. A transient is neither a member of a household nor a resident of an institution. 

Examples:

  • a homeless individual (i.e., someone who sleeps in doorways, overnight shelters, parks, bus stations, etc.); or
  • a person who stays with a succession of friends or relatives and has no permanent living arrangement on the first moment of the month.

(Source: https://secure.ssa.gov/apps10/poms.nsf/lnx/0500835060)

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Question:
Does DDS use GAF (Global Assessment of Functioning) scores in their decision?

The disability adjudicators do not use GAF scores specifically in their assessment, since the disability criteria are not the same as the DSM. 

DDS basis their decision on the extent to which the “Listings” (Disability Evaluation Under Social Security) are met. For mental impairments they are looking for A) the diagnosis and B) the functional impairment. The main focus is on how the person's illness affects their functioning in four areas: Acitvities of Daily Living (ADLs); social; concentration, persistence and pace; and decompensation. DDS needs evidence that the person has marked impairment in at least two of these areas, or moderate impairment in at least three areas. It is more important for them to have clear, detailed descriptions with examples of how someone is functioning.

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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.  

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Question:
Can SSA flag a case as a SOAR case?

Some states will have SSA flag the case as "Homeless" and then put "SOAR" in the remarks section. This is not fool-proof because DDS has to open the case and look for the SOAR "remark" in order to assign it to the appropriate unit. They may not always look for it when assigning cases.

What they are talking about doing in one state is to use a "special handling" flag with SOAR in the remarks. Anytime a case goes to their DDS with the special handling flag the case control has to open it and see what needs to be done- if it is marked SOAR- they know where to send it.

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Question:
How can I get our local hospital involved in our SOAR effort?
Question:
Can we get funding from the SOAR TA Center to pay for SOAR in our organization?

The SOAR TA Center does not have funds available to pay for SOAR in local organizations and there is no dedicated source of funding for SOAR programs. And yet, all 50 states participate in SOAR at some level by reallocating existing resources; by securing funding through federal and state grants or foundation funding; or by establishing collaborations with hospitals and criminal justice systems.

To support local organizations, the SOAR TA Center developed resources and tools for funding and sustainability, based on best practices from SOAR programs around the country. The SOAR TA Center also maintains a webpage dedicated to upcoming funding opportunities, which is updated frequently with new resources.

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Question:
Do SOAR providers screen applicants before helping them with their applications?

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.

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Question:
I'm working with a youth in foster care who is receiving SSI and will soon be turning 18. When can he apply for SSI as an adult?

In general, a child/youth can apply for adult benefits the month before they turn 18.

However, there is an exception for disabled youth transitioning out of foster care. Disabled youth receiving Title IV-E federal foster care benefits usually cannot become eligible for SSI until foster care payments have stopped. Even if the individual had been receiving SSI as a child, a new determination must be made under the adult rules once that person is 18. To help with this transition, SSA will accept an SSI application from a youth up to 180 days before his or her foster care eligibility will end due to age. You can start collecting all of the youth's medical records and preparing the application materials. Then you would have the completed SOAR packet ready to go as soon as they are able to submit the application.

For more details, see https://secure.ssa.gov/apps10/poms.nsf/lnx/0500601011!opendocument.

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