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Question:
Can an Acceptable Medical Source (AMS) sign the Medical Summary Report if the client's main disabilities are mental but the AMS has mainly treated them for physical conditions?
Yes. By signing the MSR, the AMS is only indicating that they believe the included information to be true. It is likely that the provider has spoken with the individual about his/her mental illness, seen some records to that effect, and/or has witnessed some symptoms. In order to treat a patient properly for physical health conditions, the provider would need to be aware of medications and mental health treatment. If the doctor does not want to sign off on anything that does not pertain to their specific field of practice, they could sign a reduced MSR that does not include reference to the other treating sources, but does include reference to all of the conditions that the doctor feels comfortable attesting to.
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Question:
When the MSR is signed by an Acceptable Medical Source (AMS) is there any HIPAA concern if the MSR contains information from other treating providers?
An MSR that has been written based on properly released records can be shared with the primary AMS. At the point of obtaining the signature, it is primarily a privacy issue, not HIPAA. However, it would be a best practice to have a release signed by the applicant permitting the case worker to communicate with the AMS.
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Question:
If someone asks for a copy of their Medical Summary Report, do you give them a copy ?
The short answer is "yes." If someone asks to see their Medical Summary Report, you can provide it to them in the same manner that your agency would release a copy of their medical records to them.
However, there are some other factors to keep in mind. Since the MSR focuses on an applicant's symptoms and functional limitations rather than their strengths, we recommend talking with them first to explain that the report is written in this manner to demonstrate how they may be eligible for SSI/SSDI and that SSA needs to see numerous examples of their limitations. Remind them that they have a lot of personal strengths and that this report is not a full reflection of that.
It is important to speak with the applicant throughout the process in order to alleviate any concerns about what information will be included in the MSR. One best practice to establish transparency and trust is to ask permission on the first interview to take notes. Tell the applicant that at any time they can ask you to stop taking notes or to see what you are writing. Emphasize that your goal is to capture their words so that they can tell their story to SSA through this process. Ultimately, the MSR is comprised mainly of their quotes and information they have provided to you.
Reading about one's symptoms and limitations can be very difficult and through this conversation applicants may find that they aren't prepared for that or that it would not be beneficial for their recovery. But, if after this preparation, the applicant wants to read the MSR, then that is their right to do so, following your agency's guidelines.
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Question:
What if a client has diagnoses of both personality disorder and depression? Do they apply under both categories?
Absolutely - when applying for SSI/SSDI you should include all physical and mental health conditions/diagnoses. A person can be approved based on impairments from one or a combination of illnesses.
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Question:
Do I need to submit a SSA-3369 Work History Report with an initial application?
Question:
If someone already receives SSI, is it possible that they might qualify for SSDI instead? Is it worth pursuing?
When an applicant files for SSI, they are automatically also considered for any SSDI benefits (or other associated benefits) for which they may be eligible at the time of application. If the applicant is not eligible at the time of application for SSDI, but is eligible for SSI, they may become eligible for SSDI in the future. This occurs one of two ways:
- If the beneficiary works and earns enough work quarters to qualify for SSDI based on their own earnings record, they could be moved to SSDI. The beneficiary can check their work quarter status by signing up for a “my Social Security” account.
- If the beneficiary became disabled before age 22 and was receiving SSI, they may be able to switch to SSDI based on a parent’s earnings record if the parent retires, becomes disabled, or dies.
If the beneficiary believes that he/she may be eligible based on the above situations, we encourage him/her to reach out to SSA to discuss their circumstances before filing the application.
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Question:
Can a person establish a protective filing date online even if they are only applying for SSI and not SSDI? What if they have no work credits and can't apply for SSDI?
Absolutely! Initiating the Online Disability Benefit Application sets the protective filing date for SSI as well as SSDI. Even without work credits, there are other ways an applicant may qualify for SSDI so we recommend applying for both programs. Further, completing the online application is an efficient way to submit medical and work information that is necessary to apply for SSI.
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Question:
Do veterans pay into Social Security?
Yes, members of the military do pay into the Social Security system and earn work credits during military service. SSA has a great publication about military service and work credits here: https://www.ssa.gov/pubs/EN-05-10017.pdf.
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Question:
How can I access Social Security documents in Spanish?
The Social Security Administration publishes Spanish versions of all their forms. There is also a Spanish version of their website: https://www.ssa.gov/espanol.
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Question:
My client has not been completely honest with hospital staff because he "does not trust people." Therefore, his medical records do not show all of his illnesses. Should I send all of the records I have, or just the parts that actually show his illnesses?
You should definitely send all of the medical records. SSA has a rule called the “All Evidence Rule” which requires applicants (through their representative) to submit all medical information known, which includes knowledge of impairment and/or treatment sources.
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