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How to Apply for SSI and Determining Your Eligibility

By / February 18, 2018 / Benefits of Supplemental Security Income / 22 Comments

Do you have questions about how to Apply for SSI Disability benefits? We answer them in this second section of a two-part report on Supplement Security Income.

Ready to begin your application for benefits? Let’s get started! When you apply for SSI, you will need to provide proof that you are eligible, including the following:
• Your Social Security card or, at least, your Social Security number.
• Your birth certificate or other proof of age (e.g., driver’s license).
• Proof of U.S. citizenship or SSI-eligible non-citizen status.
• Information about your residence: address and phone number; mortgage document or rental lease with landlord’s contact information; proof of living arrangements with names, birth dates, and medical assistance or Social Security numbers for all household members; property tax bill; costs of utilities, food, etc. Information about your income: paycheck stubs, self-employment records, income tax return, bank statements, etc.
• Information about your resources: real estate, personal property, vehicles, insurance policies, cash, stocks, bonds, CDs, burial funds, money owed you, etc.
• Also, if disabled or blind: contact information for medical service providers.

If you don’t have all of these items, the SSA invites you to apply anyway. They may be able to help you obtain some of the information (e.g., copies of the tax forms you filed).

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How to Apply for SSI in 3 Steps

Step 1: Fill out the SSI application, so the SSI can see if you meet the basic financial eligibility requirements and also evaluate any current work activities. Then your application is sent to the Disability Determination Services office in your state.

Step 2: DDS doctors and disability specialists ask your doctors for specific information about your disability. They will study the medical evidence from your doctors, hospitals, clinics and other facilities where you have been treated, to find out:

  • What your medical condition is, exactly.
  • When your medical condition began.
  • How it limits your past, current and future activities.
  • What your medical examinations and tests have shown.
  • What treatment you have received, and its effectiveness.

They will also ask for information about your ability to do work-related activities, such as walking, sitting, lifting, carrying and remembering instructions. Your doctors will not be asked to decide if you are disabled; that’s the job of the DDS. If more information is needed, the DDS may ask you to visit your doctor or one of theirs for a special examination, at SSA’s expense. After the investigation is completed, a disability determination is made by a two-person adjudicative team: a medical or psychological consultant and a disability examiner.

Step 3: When the DDS reaches a decision on your case, you will receive a letter from the SSA. If your application is approved, the local office will calculate your benefit amount and release payment and will send you the letter will show the amount of your monthly benefit and when your payments will begin. If your application is not approved, the letter will explain why and tell you how to appeal the decision if you do not agree with it.

Keep in mind that you may become eligible for SSI even you are not blind or disabled, as long as you meet the other criteria: age 65 or older, have few financial resources, earn less than the limit, and need financial assistance. For more detailed information, visit other Disability Advisor articles on SSI.

Determining Disability

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However, if blindness or disability is a factor, then the five-step isability determination process begins:

Step 1: Are you performing substantial gainful activity (SGA)? If you are working and being paid at the SGA level, you are not disabled as defined by Social Security law and your claim will be denied unless your work pay can be reduced to below SGA level by Impairment Related Work Expenses (IRWE’s), Blind Work Expenses, or the value of employer subsidy. In 2018, SGA is generally $1,180 gross wages or net profit from self-employment, although work hours and duties will also be evaluated in the case of self-employment.

Step 2: Is your physical or mental disability “severe”? If you are not working at SGA level earnings average the current limit or less, the DDS then looks at your medical condition. For the DDS to decide that you are disabled (whether for SSI or SSDI), your medical condition must significantly limit your ability to perform basic work activities—walking, sitting, remembering instructions, etc.—for at least the next 12 months. If your medical condition is not that severe, you are not considered disabled. However, if it is that severe, the determination process continues.

Step 3: Is your medical condition on the SSA’s List of Impairments? It lists medical conditions that are considered so severe, that if you have one or more it may automatically mean you are disabled as defined by law. The conditions for adults are listed under these 14 categories: Musculoskeletal System • Special Senses and Speech • Respiratory System • Cardiovascular System • Digestive System • Genitourinary Impairments • Hematological Disorders • Skin Disorders • Endocrine System • Impairments that Affect Multiple Body Systems • Neurological • Mental Disorders • Malignant Neoplastic Diseases • Immune System Disorders. The children’s list is the same, plus: Growth Impairment.

Since it may take months after approval for the first SSI payment to arrive, to speed initial payments to severely disabled persons the SSA recently expanded a list of 225 conditions that qualify for fast-track “Compassionate Allowances.” Among them are general or specific types of: Alzheimer’s disease, cancer, dementia, leukemia, muscular atrophy, muscular dystrophy, and various other diseases, tumors and syndromes affecting adults and/or children. For a current list, visit the SSA website at https://www.ssa.gov/compassionateallowances/conditions.htm.

Step 4: Can you do the work you did before? If your disability does not prevent you from continuing to work at your occupation, the DDS will decide that you’re not eligible for SSI. However, if your disability prevents you from performing that kind of work, then the DDS goes on to the final step.

Step 5: Can you do any other type of work, even with your physical or mental disability? The DDS or SSA evaluates your medical condition, age, education, work experience, skills, personality, location, etc., to try and find some other substantial gainful activity you could engage in. If they can, your application for SSI will be denied. However, if they cannot, your application will be approved. Either way, the DDS will return your case file to the SSA field office in your area for appropriate action.

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If you are officially determined to be disabled, the SSA will compute your benefit amount so you can start receiving monthly payments. If you are found to be not disabled according to their definition, your file will be retained in the field office in case you decide to contest the determination.

Four Levels of Appeal When Denied SSI Benefits

How to contest a denial of SSI benefits, whether or not disability is a factor
Generally, there are four levels of appeal:

  1. Reconsideration (if still available in your state) is a complete review of your claim by someone other than the person(s) who took part in the initial decision. You need not be present. Your original application, the evidence presented with it, and any new evidence are all reviewed, to determine if a denial was the correct decision. If not, it’s reversed and your claim is approved. Or…
  2. If your denial is upheld after reconsideration, you can request a hearing. The hearing is conducted by an administrative law judge (ALJ) who did not take part in either the original decision or the reconsideration. To help prove your case, you may be asked to provide, in advance of the hearing, more evidence and/or clarification of specific information you provided. If possible, the hearing will take place within 75 miles of your home, or it may be a video conference. Either way, you can choose whether or not to attend, and you can invite witnesses (e.g., medical or vocational experts) and/or an attorney with SSI experience to appear with you or on your behalf. After the ALJ makes a decision, you will receive a letter from the SSA with full details.
  3. If the ALJ upholds the denial of SSI benefits, you may request a review by the SSA’s Appeals Council. After reviewing details presented at your hearing, the Council may deny your request for review if it believes the hearing decision is correct. Or, if it decides to review your case, it will either decide your case itself or return it to a different ALJ for further review. Either way, the services of an attorney with SSI and courtroom experience is highly recommended. Then the SSA will send you a letter stating the Council’s decision and the reasons for it.
  4. If the Appeals Council decides not to review your case, or if the Council or an ALJ review it but your claim for SSI benefits is still denied, you have one more opportunity to contest the denial. You can file a lawsuit against the SSA in a federal district court. It makes sense to be represented by an attorney with SSI experience and who is also qualified to represent clients in federal court.

Visit the SSA’s Understanding the Appeals Process: https://www.ssa.gov/ssi/text-appeals-ussi.htm

SSI “Work Incentives” and How They Affect Your Benefits
If you receive Supplemental Security Income benefits because you have a disability, you may be interested in the programs offered by the SSA to disabled persons who would like to become financially independent…and still receive some or all of their disability benefits. These programs include the following…

You may be eligible for other benefits.
Whether or not you are eligible for SSI, you may be able to get other types of financial assistance, via:

  • The Supplemental Nutrition Assistance Program (SNAP), formerly and commonly known as food stamps. (These days, debit cards often replace food stamps.)
  • Medicaid, to help pay doctor and hospital bills.
  • Medicare premiums, paid by your state (perhaps).
  • Medicare Rx program premiums, co-pays and annual deductibles.
  • Social Security retirement benefits, if you are 62 or older and have enough work credits (i.e., you’ve paid into the system long enough); your family members may also qualify.
  • Social Security disability benefits, if you qualify for SSDI

For full details on any of the above, please visit the SSA website: https://www.ssa.gov/ssi/text-other-ussi.htm

Want to know if you’re likely to be approved for SSI benefits? Read more of our SSI articles.

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How to Apply for SSI and Determining Your Eligibility
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