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Presumptive payment and Supplemental Security Income (SSI)

What is a presumptive payment?

Many disability applicants have heard the disability process can takes weeks, months or even years to be approved and win Supplemental Security Income (SSI). The good news is the Social Security administration has made some temporary benefits available to certain qualifying disability applicants. These benefits are called a presumptive payment and they are available to qualifying SSI applicants for six months while the SSA determines if you are disabled. Social Security Disability Insurance (SSDI) applicants are not eligible for SSI benefits.

What is Supplemental Security Income?

Supplemental Security Income (SSI) is offered to the blind, disabled and aged (65 years and older) who are unable to perform substantial gainful activity. You must be unable to work for at least 12 continuous months and you must have limited income and resources.

When can I get Presumptive Payment?

A presumptive payment is paid to support a claimant who has limited income and resources while the SSA reviews the disability applicants SSI application. To win presumptive disability benefits you will have to have a serious impairment that the SSA “presumes” to be disabling.

What are the conditions which are considered automatically disabling?

There are some common conditions which the SSA considers automatically disabling and which may be eligible for a presumptive payment. These conditions include total deafness, blindness, Down syndrome, cerebral palsy, symptomatic HIV infection, severe mental retardation, low birth weight, spinal cord injury with an inability to walk with a walker, muscular dystrophy, stroke (with no recovery after 3 months), amyotrophic lateral sclerosis, terminal illness with six months or less to live and amputation of two limbs or one leg at the hip.

How long can I get temporary payments for a presumptive disability?

A presumptive payment is paid each month for up to 6 months. After six months whether or not the SSA has made their disability determination the payments will be terminated. The good news is if your case is denied you will not have to repay the presumptive disability benefits.

Contact the SSA to complete an application, and if you meet the qualifications outlined above for presumptive payments notify the SSA. The SSA may need to gather additional medical evidence to review your case.

Is presumptive disability the only way to expedite my SSI payments?

No, there are other ways you can speed up the disability process. The SSA has a list of Compassionate allowance conditions which are considered automatically disabling, and they also expedite claims for wounded warriors and claimants who have terminal cases. If you have a terminal condition talk to the SSA about the Terminal Illness program or TERI.

Hiring a disability lawyer

If you have a condition which is considered automatically disabling and is either a presumptive condition or on the Compassionate Allowance list you should not need legal help to win SSI benefits.  If you are denied benefits it most likely will be because you either do not have sufficient medical evidence to prove you are disabled or your income and resources were too high to get SSI benefits.

If you simply need more medical evidence you can appeal your denial. If your income and resources are too high you will continued to be denied until they meet the program’s limits.
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