ssi_hearing_redesign

DESCRIPTION

Under the Supplemental Security Income (SSI) disability redesign, an SSI hearing is requested following the denial of the SSI 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.

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.

RESULTS

Upon 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.

SSIAP Home | SSI Advocate Guidelines
Last Updated February 2005