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Find answers to frequently asked questions.

Question:
A client has already met with SSA to begin an application. Can the application be switched to SOAR and then I can work with them?

Yes, the SOAR process can assist with an application that has already been started. It won't be "switched" to SOAR by SSA because SOAR is a model for submitting a complete and thorough SSI/SSDI application.

I would recommend submitting the SSA-1696: Appointment of Representative form to the local SSA field office where the claim was started. Then, you can assist by collecting and submitting medical records, writing and submitting a Medical Summary Report, and making sure all application forms are complete.

Since the applicant met with SSA, their application is already being processed - so the more information you can provide quickly to SSA and DDS, the better!

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Question:
After registering for the online course, at what point has it been too long to send in the MSR?

It's never been too long! You are welcome to submit your documents for the SOAR Online Course practice case at any time and the system will never time you out.

If you have specific questions about your practice case, email them to soaronline@prainc.com.

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Question:
Am I allowed to disclose mental health treatment and counseling records to SSA?

Mental health treatment records are a necessary and integral part of the evidence needed for DDS to make a disability determination for someone alleging mental illness as an impairment. You are permitted and encouraged to support a claimant’s application with the disclosure of your records (with proper authorization). The records that are excluded from this authorization are “psychotherapy notes,” which are a specific type of note not typically a part of most medical records, especially in publicly funded settings.

As HIPAA defines the term, “psychotherapy notes means notes recorded in any medium by a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. Excluded from “psychotherapy notes” are medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.

If you keep psychotherapy notes separate from your other medical records, you can send the set of records without the psychotherapy notes. If you do not keep psychotherapy notes separate from other parts of the medical records, you can legally disclose all of the records. However, you can choose to black out or remove the parts of the records that would be considered psychotherapy notes. Another option is to prepare a report that details the critical current and historical aspects of the applicant’s treatment and functional information, such as a SOAR Medical Summary Report.

For more information, see SSA’s Fact Sheet for Mental Health Care Professionals.

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Question:
Are medical providers required to respond to your request for medical records once you provide a copy of the SSA 827 to them? Is eliciting cooperation from them generally an issue for case managers?

Generally speaking, medical providers are not legally bound to provide records to a third party. They are not required to provide records to DDS, either. However, HIPAA regulations require healthcare providers to provide individuals copies of their own records: 

"The Privacy Rule generally requires HIPAA covered entities (health plans and most health care providers) to provide individuals, upon request, with access to the protected health information (PHI) about them in one or more “designated record sets” maintained by or for the covered entity.

We hear from most SOAR providers that they are able to get medical records from most sources. Some states have special laws that cover access to records for disability applications. We also do our best to build relationships with commonly used providers and the medical records departments to try to improve those relationships, and clarify and expedite processes.

 

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Question:
Are the CEUs offered by SOAR Online Course approved by the American Counseling Association or the National Board of Certified Counselors?

The CEUs offered by the SOAR Online Course are approved by the National Association of Social Workers (NASW).

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Question:
Are there any sources of income that are not counted towards your SSI claim (i.e., VA Disability, Child Support)?

Yes, there are a number of unearned income (e.g. income derived from a source other than working) exclusions in the SSI program. There is a comprehensive list here, with links to more information about each source: https://secure.ssa.gov/poms.nsf/lnx/0500830099.

VA Disability payments are not excluded when looking at countable income for the SSI program, and you’ll see that they aren’t included in this table. These benefits are counted dollar for dollar, after a general exclusion of $20. For Veterans who receive a VA Disability Pension and are applying for SSI, their income will almost certainly be too high from the Pension payment to qualify for SSI. That said, they paid into SSDI through their military service and may qualify for SSDI, so that is worth exploring (for that, check with SSA to see if the Veteran has enough work quarters to potentially qualify for SSDI).

Child support payments are in this exclusions table (though the regulations can be a bit hard to sift through) – basically, SSA will exclude one-third of support payments made on behalf of a child when determining countable income. I find this link easier to read when discussing child support and main exclusions: https://www.ssa.gov/OP_Home/cfr20/416/416-1124.htm

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Question:
Are there county jails or correctional facilities that have a quick check list that is used to determine who may or may not qualify for SSI/SSDI?

Yes, see the Criminal Justice version of the "Identifying SOAR Applicants" tool on the SOAR Tools & Worksheets page.

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Question:
Are Veterans eligible to collect both VA and SSA benefits at the same time? If so, is there a monthly cap?

Absolutely, Veterans who receive VA disability benefits may also receive SSA benefits, depending on the amount received from the VA and if they are approved for SSI or SSDI. 

SSI: VA benefits will affect the SSI benefit amount. SSA classifies VA benefits as “unearned income,” since it does not come from paid employment. As such, it will be deducted dollar for dollar from the SSI federal payment amount, after the general exclusion of $20. (All SSI recipients are eligible for this exclusion, where the first $20 of earned or unearned income is not counted against their SSI payment.)

SSDI: Alternatively, SSDI benefits are not affected by unearned income through VA benefits.

Please read more at SSA and VA Disability Benefits: Tips for Veterans.

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Question:
As the appointed representative, if I am not able to pay for copies of the medical records, can I get them from SSA or DDS?

As the claimant’s representative (using the SSA-1696 Appointment of Representative Form), you can request a copy of the claimant’s previous and current files, which include the medical records SSA and DDS received with the application. These documents are generally provided on a CD. This is allowed under the Privacy Act (5 USC § 552a (b)) “An individual may give SSA written consent to disclose his/her personal information to a third party of his/her choosing.”

Note: When using the SOAR process, staff will want to collect the medical records and submit them to DDS rather than the other way around. The reason for this is to ensure that the DDS receives all pertinent information. However, obtaining a CD from DDS can be useful when you assist an individual who has already applied and been denied.
Source: https://secure.ssa.gov/poms.NSF/lnx/0203305001

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Question:
At my client's hearing, the judge said that as the applicant's Appointed Representative, I can't submit the SSA-3380 - Third Party Function Report. Is this correct?

At the hearing level, many Administrative Law Judges (ALJs) will invoke ‘Rule 3.7: Lawyer/Advocate as Witness’.  Under the advocate-witness rule, you cannot serve as both advocate (via the SSA-1696) and witness.  The ‘witness’ is required to testify on the basis of personal knowledge, while an advocate is expected to explain and comment on evidence given by others. This dual role can give rise to a conflict of interest.

In your case, the ALJ viewed the 3rd Party Function Report you completed as ‘providing witness testimony’ which can prejudice the ALJ’s decision. Often, the ALJ will recognize that the SOAR case worker is not familiar with this rule, and educate them on their options.  When there is other evidence in the file and the SOAR case worker does not need to testify themselves, they will remain the official 1696 representative. By doing so, they are able to cross examine expert witnesses and directly examine the applicant (i.e. ask them questions in front of the judge during the hearing).

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