SSI DISABILITY REDESIGN

DESCRIPTION

A Supplemental Security Income (SSI) application is completed during the initial interview between the SSI Advocate and participant. A series of required forms, making up an SSI application package, is completed by the participant and/or SSI Advocate. The information provided describes the disability, gives sources of medical records to document the disability, and allows the participant to explain how his/her disability prevents him/her from working. The application package is sent to the Social Security Administration (SSA), which sends the disability portion to the State's Disability and Adult Programs Division (DAPD) for a disability determination.

KEY POINTS

An SSI application is completed for individuals who are screened as SSI eligible and who:

Have had a disability evaluation in the last 90 days; or
Had a request for reconsideration denied more than 60 days ago.

When interviewing the participant, an assessment/observation is made as to how the disability impacts the participant's day-to-day ability to function. Therefore, questions are posed in a way to solicit responses that assist in this assessment/observation.
When completing the application forms, responses to questions should clearly document/convey the severity/duration of the disability to ensure SSA's definition of disability is met (i.e., the disability will result in death or has lasted or will last for at least 12 months). The protected filing date recorded on the ABPSSI 15, if any, is written in the box on page one of the SSA 8000, Application for Supplemental Security Income, or SSA 8001, (Short Form) Application for Supplemental Security Income.
Supportive services needs are assessed and appropriate referrals are made to the Department of Mental Health (DMH), the General Relief Health Care Program (GRHCP), and/or needed transportation funds are authorized.
Following completion of the SSI application, the next steps are explained to the participant.

He/she will hear from SSA directly. SSA may send additional forms for completion, an appointment to see a doctor or a request for a conference prior to a decision on the SSI application. The participant needs to contact the SSI Advocate when he/she is contacted by SSA.
If SSA/DAPD requests a pre-decision conference, he/she is required to attend. If a pre-decision conference request is received, the SSI Advocate forwards the participant's signed request for a participant conference to the DAPD analyst.
If the SSI application is denied, the participant will receive a formal notice from SSA.
If SSI is denied, he/she is required to file an appeal.

SSI ADVOCATE DUTIES

Completes all required SSI application forms, ensuring all required signatures have been obtained from the participant.
Ensures any protected SSI application date, as recorded on the ABPSSI 15, is recorded on page one of the SSI 8000 or SSA 8001.
Obtains a signed request for a pre-decision conference. Requests a face-to-face pre-decision conference when participants are homeless, Needs Special Assistance (NSA) or do not have a telephone. Explains the next steps to the participant, including his/her reporting responsibilities.
Explains that the application for SSI is being processed under the new disability redesign. If SSA/DAPD feels that there is insufficient information in the disability file to approve SSI, the participant will receive a request for a pre-decision conference.
Emphasizes the following to the participant:

The pre-decision conference is a contact with DAPD's disability examiner, who will make the disability decision.
The conference is not an administrative hearing; however, the disability examiner will use the information obtained in the conference to make the final disability decision.
The participant should immediately call his/her SSI Advocate when any correspondence from SSA or DAPD is received.
When a request for a conference is mailed to the participant, a copy is mailed to the SSI Advocate. SSA/DAPD allows the participant approximately 10 days to contact DAPD's disability examiner to arrange the conference.
The SSI Advocate forwards the participant's signed request for a pre-decision conference to the DAPD analyst if a conference is requested. If a face-to-face conference is not possible, the SSI Advocate will arrange for a telephone conference.
The participant is required to participate in the pre-decision conference.
If SSI is denied, an SSI hearing request must be filed within 60 days.

Assesses any supportive services needs, making any appropriate referrals and/or authorizing any needed transportation funds for medical and/or SSI-related appointments.
Forwards the SSI application to SSA (within 60 days of the initial interview) including the ABP 2012 and/or GRHCP health history questionnaire with the disability report.
Records all participant contacts/SSIAP case activity on the ABPSSI 16, SSIAP Activity Record.
Updates LEADER and Case Comments with new or changed information.
Retains the pre-decision conference request in the SSI folder until contacted by DAPD. If a pre-decision conference is necessary, forwards the signed request to the DAPD analyst.
Coordinates and attends the pre-decision conference with DAPD.

RESULTS

Upon conclusion of the SSI application, the outcomes should include:

The participant completed/signed the SSI application package of forms, including the request for a pre-decision conference, understands the next steps in the SSI application process and his/her reporting responsibilities.
Any needed supportive services referrals were made or transportation funds were issued.
The participant has the SSI Advocate's name and telephone number.
The participant understands the importance of regularly contacting the SSI Advocate.
The participant understands he/she must immediately call the SSI Advocate when any telephone calls or correspondence are received from SSA or DAPD.
The participant understands he/she must attend a pre-decision conference if requested by SSA or DAPD.
The participant understands that if the SSI application is denied, he/she has only 60 days to file a request for an SSI hearing.
The SSI application was forwarded to SSA within 60 days of the initial interview.
The ABPSSI 16 and LEADER were updated.

SSIAP Home| SSI Advocacy Guidelines
Last Updated February 2005