Disability Redesign SSI Hearing
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DESCRIPTION
Under the Supplemental Security Income (SSI) disability redesign, an SSI hearing is requested following the denial of the SS I application. The SSI hearing remains the final step in the SSI Assistance Program. After the SSI application is denied, unless the participant chooses other/self-representation, the participant is referred to the County's contracted SSI hearing representative who represents the participant at a hearing with Social Security's Office of Hearings and Appeals.
Previously, participants denied at SSI application filed a request for reconsideration (which is a case review). Under the disability redesign, the first appeal of a denied SSI application is a hearing. Unlike the request for reconsideration, the SSI hearing is a face-to-face hearing with an Administrative Law Judge who reviews the case, discusses with the participant the effect of the disability on his/her day-to-day functioning, and decides if the SSI disability requirements are met.
KEY POINTS
- When an SSI application has been denied:
- In the last 60 days, an SSI hearing is requested; or
- More than 60 days ago, a new SSI application is completed.
- Once the SSI application is denied,
case management is transferred from the SSI Advocate to the contracted
hearing representative.
- Even if the GR case is later terminated,
the contracted hearing representative continues working with the
participant through the end of the SSI hearing process.< /li>
- The contracted hearing representative
follows up with the participant, obtains any update on the participant's
disabling condition and supporting medical documentation, and requests
the SSI hearing.
- The contracted hearing representative
informs the participant of the date/time/location of the hearing (which
the participant must attend as a condition of aid).
- Following the hearing, the contracted
hearing representative follows up with SSA's Office of Hearings and
Appeals to obtain the results.
- If SSI is denied, the hearing representative
reviews the decision with the participant, advising that the participant
can (independently or with a private attorney) file an appeal with
the Appeals Counsel.
SSI ADVOCATE DUTIES
Upon notification of denial of the SSI application:
- Contacts the participant, explaining
the SSI hearing process, informs the participant of the option
to have other/self-representation, but points out the advantages
of having the County's contracted attorney be the representative,
particularly that there is no cost to the participant.
- Provides the participant with the
contracted hearing representative's name and phone number.
- Explains
that the hearing process can take a long time, but that
the contracted hearing representative
will continue to work with the participant all through the process,
even if the participant goes off GR.
- Explains the next steps to the participant, including his/her reporting responsibilities and the requirement
for him/her to attend the SSI hearing.
- Assesses any supportive
services needs, making any appropriate referrals and/or
authorizing any needed transportation funds for medical and/or
SSI-related appointments.
- Records all participant contacts/SSIAP
case activity on the ABPSSI 16, SSIAP Activity Record.
- Updates
LEADER and transfer case management to the contracted hearing
representative.
RESULTSUpon denial of SSI applications, the outcomes
should include:
- The participant has the contracted hearing
representative's name and phone number (in addition to the SSI Advocate's
name and telephone number).
- The participant understands the next
steps in the process, including his/her reporting responsibilities
and obligation to attend the SSI hearing.
- Any necessary supportive
services referrals were made or transportation funds were issued.
- The ABPSSI 16 and LEADER were updated.
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