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Find answers to frequently asked questions.

Question:
When do I need to complete the SSA-4814?

The SSA-4814 is only necessary for individuals who are alleging HIV infection. It is the Medical Report on Adult With Allegation of Human Immunodeficiency Virus (HIV) Infection.

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Question:
How do I get started writing the medical summary report? It is so intimidating.

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.

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Question:
Why would someone have their SSI benefits check reduced by one-third?

It sounds like they may be living in a situation that SSA calls Living Arrangement B, which is when someone is living with a family member or friend and is receiving food and shelter at no cost. SSA calls that "in-kind support and maintenance" and generally reduces the individual's SSI check by one third.

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Question:
Can someone who is in prison and not receiving any benefits apply for SSI?

Social Security has what they call Pre-release Procedures for individuals who want to apply for SSI while they are still in an institution (jail, prison, state hospital, etc). The general rule is that an individual can apply 30 days prior to their expected release date, although there are exceptions. Some SSA field offices set up informal or formal pre-release agreements with local institutions to extend that time period up to 90 days prior to release. If there is no pre-release agreement currently in place with his institution and that field office, you could speak to the manager at the SSA office and see about setting up an agreement, especially if you are going to be assisting with multiple prerelease applications at this institution. When you submit the application you will need to bring a letter from the institution stating that the applicant is expected to be released on a specific date. SSA has a brief FAQ on the SSI Prerelease Procedure for additional information: http://www.ssa.gov/ssi/spotlights/spot-prerelease.htm

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Question:
In a community collaboration, is it appropriate that an attorney handle the SOAR process as opposed to a case manager?

People from varying backgrounds, education and experience can successfully assist with SSI/SSDI applications using the SOAR process.  It takes the right training and commitment!

Case managers can and do successfully represent applicants in the initial application process and the appeals process.  

Attorneys in some communities are key members of the SOAR community and also assist SOAR applicants at no charge. 

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Question:
Can someone apply using the SOAR process whose primary ailment is a physical ailment?

You can absolutely use the SOAR critical components for a person with a physical ailment.  There are many people that have been denied for years without the help of an advocate to get through the process.  That said, we don't want to encourage people to only help those that have an "obvious" disability. Often people's illnesses are complicated -- they may seem okay one day but on other days they struggle so much that they aren't able to work at a substantial gainful level. SOAR is a great process for these individuals because of all the evidence gathering and additional assessments that we do.

 

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Question:
I am looking for a contact at my local SSA office, who should I call?

You can contact your SOAR State Team Lead or Local Lead to find out if there is a designated SOAR liaison at your local SSA office.

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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:
How do unemployment benefits affect a client's Social Security Benefits?

Unemployment benefits would affect SSI because it is counted as unearned income. So, each dollar of unemployment would count against the Federal Benefit Rate (FBR)* for SSI. Unemployment benefits do not count toward the substantial gainful activity (SGA)* limit because they are not the result of current work activities.

Unemployment benefits would not affect SSDI in the same way. While technically it is possible to receive both unemployment benefits and SSDI, 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 individuals might apply to both programs but must actively seek work to maintain unemployment benefits.

*These figures are updated annually and can be found at SSA Annual Updates.

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Question:
I am working with a person who has already applied for SSI and been denied. His request for reconsideration has also been denied. What can I do now to help? Is there anything I can do to speed up the process?

You can help the applicant file for a hearing before an administrative law judge. It is in the applicant's best interest to keep the appeals process going because if they are approved at the hearing level they will be eligible for back payments going back to the protective filing date of the initial application.

See our Appeals resources in the SOAR Library. Here you will find our Prior or Pending Applications document which outlines some of what you need to do at the hearing level. You'll want the applicant to sign the SSA-1696: Appointment of Representative form, if you haven’t already. Then, request their file from Social Security. Together, you'll need to complete the HA-501: Request for a Hearing and the SSA-3441: Disability Report- Appeal (available on SSA’s website). You'll also need to turn in a new SSA-827:Authorization to Release Information. Be sure to submit the Request for a Hearing within 65 days from the date of the denial letter. If you haven't already, request medical records, do the general and functional assessments, and write a Medical Summary Report (MSR) just as you would for an initial SOAR application.

The other thing we would recommend is to file for a review on record. This might help you to avoid a hearing and eliminate a long wait. People who are eligible for a review on record are those individuals who may have additional diagnoses/medical records that were not considered previously. This does not take them out of the line for a hearing. So, if they are denied at review on record, they are still eligible for a hearing.

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