 |
|
|
An Introduction to Supplemental Security Income
(SSI)
SSI is a monthly benefit for persons who are blind,
have severe disabilities, or are at least 65 years old and have
limited income and resources.
|
Tips:
>Review
SSI's Relation to Other Programs
>Understand
the Distinction Between SSI and SSDI
>Rehabilitation and Employment Services
Are Available
>Begin Documenting Your
Client's Inability to Work Immediately
>Understand the Definition
of Disability
>Get to Know the Disability Benefits
Application Forms
>Create
a Detailed List of Your Client's Disability
>Have
Your Client Take the Disability List to SSA When Applying
>Help Your Client File an Appeal
>Make
Sure Your Client Signs the Authorization to Disclose Information
When Applying
>Assist with the Collection of
Medical Records
>Become
Your Client's Representative
>Make
Sure Your Client Signs a Release of Information
>Find
Out the Name of the Disability Examiner
>Act as a Point of Contact for
the Disability Examiner
>Make
Sure Your Client Attends the Consultative Examination if Scheduled
>Provide Functional Information
to Determine Disability
>Become
Your Client's Representative Payee
For more detailed information on SSDI, scroll down.
Supplemental
Security Income (SSI)
Review SSI's Relation to Other Programs
In most states, people receiving
SSI Benefits will automatically be eligible to
receive Medicaid, the Federal/state health insurance
program for low-income persons with disabilities
and others.
If your client is eligible for SSI benefits, he/she may also be eligible
to receive food stamps in every state except California.
Understand
the Distinction Between SSI and SSDI
SSI and SSDI have the same disability
requirement, but are different in other respects. Your clients who are
homeless may be
eligible for one or both programs if they have a physical or mental problem
that keeps them from working and is expected to last at least one year
or result in death, and if they are blind, or at least 65 years old.
To qualify for SSDI, your client also must have worked and paid Social
Security taxes. The SSI program has no specific work requirements, but
your clients must meet the income and resource limits to qualify for
SSI payments.
Rehabilitation and Employment Services Are Available
The Ticket to Work program provides SSI SSDI beneficiaries
a "ticket" that may be used to obtain
rehabilitation and employment services from either
public or private service providers in their communities.
For more information about this program, visit
www.socialsecurity.gov/pubs/10060.html.
Begin Documenting Your Client's Inability to Work Immediately
The most critical thing you can do as a
case manager is to immediately begin documenting
your client's inability to do work. If you
believe your client has a disability that will
prevent him/her from working for at least 12 months
or longer, start case notes with observations
related to the disability, (e.g., Mr. X has significant
difficulty staying focused on tasks at hand).
In addition to your own case notes about your
client, you should seek independent medical verification
as soon as possible.
Understanding
the Definition of Disability
The definition of disability
is very strict. The lack of proper medical documentation,
the complexity of the process, or the applicant's
inability or unwillingness to go through the disability
determination process can result in the denial
of benefits. Patience is required to succeed in
receiving SSI or SSDI benefits. Click here for
the Social Security Administration's definition
of disability.
Get to Know the Disability Benefits Application Forms
You should become familiar with the various disability application forms
and assist your client in completing these forms. Incomplete or inaccurate
application information may lead to incomplete or inaccurate decisions.
Many individuals with mental impairments, for example, fail to mention
these when they apply because they fear the stigma, or have cognitive
disorders and poor recall. Ensuring that the application is complete
and accurate may contribute to a more efficient process.
Create
a Detailed List of Your Client's Disability
If you are unable to accompany your client who is homeless to SSA, you
should sit down with your client prior to the interview and make a list
of all prior treatment sources and approximate dates.
Have Your Client
Take the Disability List to SSA When Applying
If you are unable to complete SSA's "Disability
Report for Adults," Form
SSA-3368 with
your client, then he/she should bring the detailed
list of his/her disability that you created together
to the interview appointment at SSA. Your client
can use this detailed list to complete the "Disability
Report for Adults" form required in the
application process. You should make and keep
copies of any
forms/information your client provides to SSA.
This can be used as a reference for assisting
with information collection and can be sent in
if the original is misplaced.
Help Your Client File An Appeal
If your client’s application is denied, he/she can appeal. You
should make sure that the time deadlines are met, that any new available
information is requested and sent, and that copies of all appeal requests
and additional letters are kept.
Make Sure Your
Client Signs the Authorization
to Disclose Information When Applying
SSA will ask your client to sign an Authorization to Disclose Information
when he/she applies for benefits. Make sure your client understands that
the signed authorization is necessary to obtain proof of his/her disability.
Assist with the Collection of Medical Records
You can assist in the medical records collection by alerting agencies
that provide services to your client that he/she is applying for benefits.
Let these agencies know what information from the chart should be sent
to the Disability Determination Services (DDS) including any and
all evaluative information, as well as progress notes if the treatment
is ongoing.
Become
Your Client's Representative
By being your client's representative, you can
assist your client with the application process,
provide information to SSA for your client's
application, receive information from SSA about
your client's
application, and review the SSA DDS file if your
client is denied so that you can help him/her
prepare a more effective appeal. In order for
you to be his/her representative, your client
should fill out the SSA-1696 form, Appointment
of Representative.
This is not the same as
being your client's representative
payee.
Make Sure Your Client Signs a Release of Information
If you are not your client's representative, then
you should have your client sign a Release of
Information form to be turned in when he/she applies.
This form allows SSA to provide you with information
regarding your client's application. It is important
that you are aware of the new Health
Insurance Portability and Accountability Act of
1996 (HIPAA) rules, which can be found at
www.hhs.gov/ocr/hipaa/,
regarding the sharing of information and ensure
that this is addressed so that the totality of
information is included.
Find Out the
Name of the Disability Examiner
Approximately two weeks after the application has been submitted, you
should contact your local DDS office and find out who the Disability
Examiner is for your client. The Disability Examiner makes the initial
disability determination based solely on the written information provided
and never
meets your client. The better you can help your client create a picture
of his/her disabling condition(s), the more successful the process
will be.
Act as a Point of Contact for the Disability Examiner
You should call and provide the Disability Examiner
with your name and phone number as a contact
for
information for your client, even if you are
not your client's representative. If you are
not your
client’s representative, it is still helpful
to create a relationship with the claims examiner
so you can assist with the process as needed.
You should contact the Disability Examiner periodically
to find out whether additional information is
needed or if there are any questions you can
answer. Use the Client
Benefit Worksheet in the
Tools & Resources section of this CD to help
manage your relationship with the claims examiner.
Make Sure Your Client Attends the Consultative Examination if Scheduled
Sometimes the Disability Examiner may schedule
your client for a consultative examination if
additional information is needed. Your client's
treating physician is the preferred source to
do this examination, but sometimes the examination
may be done by one of the consulting physicians
or psychologists for Disability Determination
Services (DDS).
Provide Functional Information to Determine Disability
Your client's disability will be determined based
upon his/her diagnosis or illness, the length
of time he/she has had the diagnosis or illness,
and perhaps most importantly, his/her ability
to function independently as a result of the
diagnosis or illness. As a case manager, it
is important
for you to document your client's level of functioning
through behavioral observations and provide
details
about this ability. For example, you cannot say
that your client has a difficult time getting
out of bed in the morning. Rather you must show,
for instance, that your client feels so depressed
and has so little energy and motivation that,
at least three days a week, he/she does not
even
get out of bed. This documentation should be
written as soon as possible after your client's
application
is filed, given the fact that DDS has time pressures
within which to make disability determinations.
This documentation should be presented in a letter
co-signed by a physician or a psychologist.
Be
sure to keep a copy! Click
here for the Social Security Administration's
definition of Disability.
Become Your Client's
Representative
Payee
Once your client is approved to receive benefits, he/she may need a representative
payee to manage his/her benefits. You should consider developing a representative
payee program, as this is an extremely critical need. Click here for more
information about Becoming Your Client's Representative.
> More
information on Supplemental Security Income:
Benefits Your Client May Receive
What Makes Your
Client Eligible
What Your Client Needs
to Apply
If Your Client is an
Immigrant
Contact Information
Training Materials
for Case Managers
SSI Program Q & A
SSI
Fact Sheet
|
