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According to the Social Security Administration’s own statistics, it currently takes about six to eight months for the agency to make an initial determination of eligibility for Supplemental Security Income (SSI) benefits. The decision is made by the Disability Determination Services (DDS) in your state. However, if your disability is categorized as a “presumptive disability”, the SSA will make expedited payments. In fact, Social Security may pay you presumptive disability benefits even before your SSI claim is decided. If Social Security later finds you don’t meet disability standards and denies your SSI claim, you won't have to repay any presumptive disability payments you received unless they find that you were never financially eligible for SSI.
Financial eligibility is a key component of SSI because eligibility is based on financial need. The Social Security Administration says, “It is designed to help aged, blind, and disabled people, who have little or no income.” To be eligible for SSI, your assets must be less than $2,000 for an individual and less than $3,000 for a married couple. However, not all assets count towards the resource limits. The Social Security Administration lists 44 resource exclusions. The major exclusions include:
- Your home
- One automobile
- Household goods (furniture, etc.)
- Personal effects (jewelry, art work, etc.) as long as the SSI claimant is actually using the items.
- Up to $100,000 in an ABLE account
- Assets in a special needs trust
In addition to asset limitations, there are non-medical requirements plus earned income and unearned income limits that you may not exceed. If you exceed the asset or income limits, Social Security may reduce or even potentially terminate your benefits.
Presumptive disability only applies to SSI cases not to Social Security Disability Insurance (SSDI) cases. To qualify for immediate SSI benefits, you must have a medical condition that's severe enough for Social Security to presume you'll meet the SSA's definition of disabled.
What Conditions Are Considered Presumptive Disabilities?
There are several disabling conditions that can be considered presumptive disabilities and thus qualify you for the immediate payment of SSI benefits. They include these conditions:
- Leg amputation at the hip
- Total deafness or blindness
- Bed confinement or immobility without a wheelchair, walker, or crutches if this immobility occurs due to a long-standing condition rather than a recent surgery or accident
- Stroke that occurred more than three months ago and that still causes difficulty walking or using an arm or hand
- Cerebral palsy, muscular dystrophy, or muscular atrophy causing substantial difficulty walking, speaking or coordinating arm or hand movements
- Down syndrome
- Intellectual disability or neurological impairments resulting in difficulty performing self-care independently
- Cerebral palsy, muscular dystrophy or muscular atrophy
- Very low birth weight for children under age one
- A terminal illness with a confirmed life expectancy of six months or less
- End stage renal disease requiring chronic dialysis
- ALS
- HIV or AIDS
There may be other severe conditions which will lead SSA to presume you are disabled and initiate payments immediately.
However, it is not enough just to say you have one of these impairments. You must prove that your medical condition (or combination of conditions) prevents you from sustaining a job. The SSA relies on accurate and complete medical records and statements from doctors, clinics, and hospitals to determine how severe a physical or mental condition is. That means that if you want the very best chance of winning presumptive disability benefits you will need to keep complete, accurate, and detailed records of all your medical treatments and all your healthcare providers. An experienced disability lawyer can help you to provide the necessary evidence to convince the Social Security Administration that you have a presumptive disability.
Presumptive Disability Versus Compassionate Allowance Condition
Presumptive disability allows SSI payments to begin immediately if you qualify, but it is not the only way to get expedited Social Security Disability benefits. You may also have a disability benefits claim approved more quickly if you have a specific condition called a Compassionate Allowances (CAL) Condition.
The Compassionate Allowances program is for disabled workers who have medical conditions that are so serious that it’s plainly obvious they would qualify for benefits. Under this program, called “CAL” for short, Social Security fast-tracks disability determinations to certain qualified applicants. The average processing time for Social Security to process a Compassionate Allowance case is 19 days, and it is possible to receive a decision awarding benefits in as little as ten days after filing an application.
This program only applies to a narrow list of severe impairments. For example, a person can qualify for a Compassionate Allowance if they can document they have inoperable cancer which cannot be completely removed, or has spread to other parts of their body. Other conditions which may be eligible for Compassionate Allowance consideration include ALS, some types of muscular dystrophy and muscular atrophy, early-onset Alzheimer's disease, certain adult brain disorders, and a number of rare disorders that affect children. (You can find a complete list of Compassionate Allowances Conditions online.)
While Compassionate Allowances can mean a faster disability determination, beneficiaries, for the most part, still must wait five months after their disability onset date to begin receiving benefits and 24 months after their onset date before Medicare benefits kick in. CAL Conditions are the same for both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), while presumptive disability benefits only help SSI applicants receive immediate payments.
You can also improve your chances of getting disability benefits by hiring an experienced professional to help fill out the forms and order medical records. Hire an attorney to help you with your claim…someone who is familiar with disability law. Hire a local attorney who is familiar with the procedures at the local Social Security offices and the doctors in the community.
Better yet, contact Cuddigan Law. We will help you throughout the entire process. We will order your medical records for you, help you fill out the forms they send you, request a letter from your doctor, represent you in your hearing, and we will fight to help you get the benefits you have rightfully earned.
To get started, call us for a free evaluation of your case. At Cuddigan Law you have a dedicated team of professionals in your corner who understand the system and who will fight for your rights.
