What Is Presumptive Disability, and How Can It Fast-Track Your SSI Claim?

Social Security Disability: A Waiting Game

When a person is unable to work and financially support themselves, they may be entitled to government benefits. Veteran benefits, Social Security Disability Insurance (SSDI), and Supplemental Security Income (SSI) are all potential options. Unfortunately, securing benefits can take a long time.

If you have worked and contributed to the Social Security system for 20 out of the last 40 quarters you have become insured for Social Security disability purposes. If you have lost your insured status, don’t have enough quarters of coverage or have never worked, you might be eligible for SSI benefits.     

There are crucial differences in each program. For example, only an SSI applicant is eligible for presumptive disability benefits if they have certain medical conditions. On the other hand you might be eligible for SSI and/or SSDI if your  medical condition meets the Compassionate Allowance medical criteria.    

Without expedited processing, applicants often find themselves waiting years for approval. During this time, they’ll frequently face financial difficulties as bills continue to pile up. Still, millions of people face this waiting game every year. In some instances, applicants have even had to wait more than  two and even three year before receiving benefits — often due to benefit denials based on common and avoidable mistakes. 

Properly filing your paperwork with the Social Security Administration (SSA) will certainly make things go smoother, but with presumptive disability, it’s possible to fast-track your SSI claim.. 

When you apply for SSI benefits for disability or blindness, you can receive temporary payments for up to 6 months for eligible applicants, while SSA reviews the application. SSA’s decision to grant presumptive disability (PD) will depend on the nature of and severity of the medical condition, the evidence SSA has when it makes its decision and the likelihood that your SSI benefits will ultimately be approved.  

Understanding the Basics of Presumptive Disability

Presumptive disability is a type of government program that allows disabled individuals to receive benefits faster than normal. The Veterans Administration and SSA are two agencies that offer this option, but their program requirements may vary. For the Social Security Administration, presumptive disability is only  offered for Supplemental Security Income. 

Fortunately, there is no additional process you have to go through to qualify. When your  application is reviewed, it will automatically be considered for presumptive disability if you have a presumed medical condition.. Conditions that can result in these expedited benefits include:

• Cerebral palsy, muscular atrophy, or muscular dystrophy 
• Leg amputation at the hip 
• Total blindness or deafness 
• Stroke that still causes certain difficulties at least three months after the event 
• Down syndrome 
• Immobility without a wheelchair or bed confinement 
• Terminal illnesses with a life expectancy of six months or less 
• Low birth rate 
• End-stage renal disease that requires chronic dialysis 
• Neurological impairments or intellectual disability

If your disability is related to any of these or other severe impairments, the Social Security Administration may approve presumptive disability. However, it’s not possible to secure presumptive SSI benefits if you only qualify for SSDI benefits. If  you have a presumptive disability and are approved, you’ll receive immediate financial assistance in the form of temporary money payments. 

If you don’t believe you qualify for SSI, it wouldn’t hurt to speak with a disability attorney to be certain. Fortunately, applying and qualifying for SSI isn’t the only way to speed up the process.

What Is a Compassionate Allowance Condition?

Since presumptive disability benefits are only available to SSI applicants, it’s important to understand other options you may have. After all, being unable to support yourself financially is a difficult reality — regardless of whether you qualify for Supplemental Security Income or Social Security disability.

Fortunately, you may qualify for expedited processing under a Compassionate Allowance (CAL) Condition.

With presumptive benefits for SSI, financial support begins almost immediately. You may see payments within a few weeks rather than months or years. Not so with SSDI benefits.

Unfortunately, Compassionate Allowance Conditions do not result in immediate benefits The Compassionate Allowance program will only expedite your claim so that you may receive approval in a much more timely manner. You won’t be paid any benefits until a determination is made on your claim. When you can’t work, days truly matter.

CAL Conditions can fast-track both SSI and SSDI applications. Don’t forget that if you have a disability insurance policy, CAL qualifying conditions may not be the same as LTD qualifying conditions, yet your LTD policy probably requires you to apply for SSDI. This is why it’s important to understand what you may qualify for, how to apply, what evidence you must include, and other important factors when seeking disability benefits.

What Happens if Your Presumptive Claim Is Denied?

Benefits denials play a unique role in presumptive disability. For instance, these benefits are not available if you’re appealing a denied claim. Since presumptive disability only lasts six months, this could mean you’ll face a significant amount of time without support if your claim is denied. This is why it’s important to understand all your disability options and provide appropriate evidence to support your claim.

The major advantage of presumptive benefits for SSI is that you don’t have to repay them if your claim is later denied. The issuance of these benefits is based on the likelihood that your claim will be approved. This is a decision by the Social Security Administration, so it wouldn’t be fair to require repayment from a person dealing with serious injuries or conditions. However, you may need to repay excess benefits based on your income.

Understanding what may or may not have to be paid back can get complicated. That’s why it never hurts to discuss your case with a legal professional.

By the way, if your claim for SSI or SSDI is denied at the initial application stage, you must file an appeal, called a Request for Reconsideration within 60 days of the denial or start all over again.

How to Expedite Your SSI Claim

To fast-track your SSI claim for presumptive benefits, you need to file for SSI benefits. This means you must meet income and asset limits for SSI.. However, Compassionate Allowance Conditions may also help you speed up the process. CALs are the same for both SSI and SSDI. The great thing about accessing these expedited processes is that you don’t have to fill out any additional forms.

When the Social Security Administration reviews your paperwork, you’re automatically considered for the Compassionate Allowance Program and presumptive disability program if you have a qualifying medical condition to fast-track an SSDI and SSI applications. However, you can further speed things up by making sure you provide appropriate medical evidence to support your claim. This will minimize the potential for denied claims and interruptions to benefits.

To make sure you’re handling the SSI and SSDI application process in the most efficient way, it’s advisable to speak with a Social Security disability lawyer. An experienced legal professional can help you better understand your options, including filing for both SSI and SSDI, and how to best move forward. At The Law Office of Nancy L. Cavey, we’re here to help. Contact us at 727-291-0363to schedule your free consultation.