SSI Facilitation - Introduction
DSHS Home Page
 
Search     for:

SSI Facilitation - Introduction


Revised October 30, 2013



Supplemental Security Income (SSI)

Social Security Disability Insurance (SSDI)

Benefits of receiving SSI

Social Worker Responsibilities

Links


CLARIFYING INFORMATION

Supplemental Security  Income (SSI)
  1. SSI is administered by the Social Security Administration (SSA).
  2. SSI (Title 16) is a Federal assistance program that provides cash and medical benefits to people who:
    1. Do not have qualifying work quarters for Social Security Disability Insurance (SSDI, Title 2),
    2. Meet the same disability criteria as SSDI, and
    3. Meet financial resource and income limits set by SSA.
  3. When SSI is approved, and a valid agreement 18-235 is established, SSA reimburses the state for assistance provided to ABD cash recipients while the SSI application is pending (interim assistance).

Social Security Disability Insurance (SSDI)

  1. SSA determines SSDI eligibility for every person who applies for SSI.
  2. A concurrent claim means that a person has applied for both SSI and SSDI.
  3. To be eligible for SSDI, a person must have worked and contributed to Social Security for a required number of work quarters.
  4. States do not receive interim assistance reimbursement for SSDI payments.

Benefits of Receiving SSI

  1. ABD cash or TANF recipients who are approved for SSI typically receive:
    1. Increased income,
    2. Access to vocational retraining programs and supported work programs; and
    3. Long term eligibility for cash and medical assistance.
  2. DSHS benefits through recovery of interim assistance and reduced caseloads.
  3. Households receiving TANF receive higher income because SSI payments are not counted as income to the rest of the household.

Presumptive Disability

SSA may find that persons who meet certain severe disability criteria are presumptively disabled. The list of allegations that meet SSA Presumptive disability criteria are maintained on the SSA website.


WORKER RESPONSIBILITIES

1.   When a client appears to meet SSA presumptive disability criteria:

a.  Refer the client directly to SSA for presumptive disability determination.

b.  Pend an ABD application for two weeks while SSA processes the presumptive disability application.

2.    A client who meets SSA presumptive disability criteria may receive SSI benefits for up to six months prior to a review.

a.    Division of Disability Determination Services (DDDS) continues to process the case to make a disability determination during the six months.

b.    Presumptive payments may end if DDDS is unable to make a determination.

c.    DDDS continues to process the case until a final determination is made after presumptive payments end.

3.   The person needs to claim financial hardship. SSA considers presumptive disability to be emergency and not interim assistance, so it is critical to track the person's payment status.

4.    Notify financial services to terminate ABD recipient's benefits when the person begins receiving presumptive SSI benefits.


Compassionate Allowances

  1. Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards.

  2. SSA processes compassionate allowance claims within 10 working days with minimal medical evidence. (A diagnosis from a doctor)

  3. The list of Compassionate Allowances diagnoses are maintained on the SSA website. 


WORKER RESPONSIBILITIES

When a person appears to meet SSA compassionate allowance criteria:

a.  Refer the client directly to SSA for a compassionate allowance determination.

b.  Pend an ABD application for two weeks while SSA processes the  application.

c.  Notify financial services to terminate an ABD cash recipient's benefits when the person begins receiving  SSI benefits.


Disability Listings

  • SSA refers to their disability criteria as the "Listings" and publishes them in Disability Evaluation Under Social Security.
  • SSA considers the person disabled when the medical disorder meets or equals the listed disability criteria.

Disability Decision

The Division of Disability Determination Services (DDDS):

1.    Decides if a person applying for SSI, SSDI, or Non-Grant Medical Assistance (NGMA) meets disability criteria,

2.    Uses a sequential evaluation  similar to the ABD cash process  to determine the effect of the physical and/or mental impairment and the combined effect of multiple impairments, and

3.    Considers the effect of the following on the person’s ability to work:

a.    Current and past work activity.

b.    Severity of impairment.

c.    Residual functional capacity.

d.    Age.

e.    Education.

 

 


WORKER RESPONSIBILITIES

1.         Assist ALL ABD cash or TANF recipients who appear to be eligible for SSI.

              Assistance includes:

a.    Assessing client needs and appropriateness for SSI facilitation.

b.    Helping complete SSA application forms.

c.    Tracking SSA applications.

d.    Coordinating services.

2.      Provide facilitation services to All:

a.     ABD cash  recipients who meet citizenship SSA requirements.

d.    TANF recipients who appear to meet SSI disability criteria.

3.     Develop professional working relationships with:

a.      Social Security District Office (SSADO).

b.      Division of Disability Determination Services (DDDS).

c.       Home and Community Services (HCS).


NOTE: Clients who are aged (over 65), terminally ill (TERI cases), compassionate allowances, and those that meet presumptive listing criteria should be immediately sent directly to SSA. For applicants, pend ABD cash benefits and don’t submit an SSI application. SSA must process these claims.

      4.    Provide Equal Access (EA) assessment, planning, and services as appropriate.

      5.    Adhere to the following timeframes and procedures:

a.   Assist the person with filing the initial SSI application within 60 calendar days of an ABD cash approval and within 90 days of the date a person receiving TANF is referred for facilitation services.

b.   Meet filing deadlines for reconsideration requests and hearings.

c.   Verify that a current DSHS 18-235, Interim Assistance Reimbursement Authorization (IARA) is on file with Social Security Administration (SSA) within 10 working days after approval for ABD cash or 30 days after the date the form is signed by the person (whichever date comes first).


Links

Social Security:

Social Security Listings

Evidentiary Requirements

      Social Security Administration

SSDI

Social Security Employment Programs

 

Search IESA Clarification Database

Modification Date: October 30, 2013