Supplemental Security Income

As a family that includes a young person with Cerebral Palsy begins to build their lives, a steady stream of income is required to maintain a desirable quality of life. When that income isn’t sufficient, Supplemental Security Income can usher in much-needed resources and reinforcements.

What is supplemental security income?

Supplemental Security Income is an entitlement program created to provide a steady, reliable stream of income for people that are deemed to be disabled under guidelines set forth by the Social Security Administration.

When a person has disabilities, finding a source of work that is sustainable and can provide an income that supports a high quality of life can be a challenge. Supplemental Security Income, or SSI, is a benefit that can provide that income if a person’s condition prevents him or her from earning a sufficient income through employment.

However, applying for SSI – or any government aid, for that matter – can be a long process. Because most applications are initially denied, it’s crucial that an applicant has all of the necessary paperwork filled out properly, and be able to provide supporting information required, when an application is submitted.

Why was SSI created?

SSI is a government program that’s central purpose is to provide economic stability to Americans or legal aliens that meet pre-determined definitions of disability, are blind or are age 65 or older. SSI payments are funded by U.S. Treasury funds – a chief difference between it and another source of income for people with physical or developmental challenges, Supplemental Security Disability Income, or SSDI.

The SSI program was enacted in 1972 with the intention of replacing inconsistent state programs that served elderly and disabled persons. The provision was incorporated into the federal Social Security law and the SSI program began paying out benefits in 1974.

One of the advantages of the SSI program for applicants coping with severe disabilities is the ability to receive compensation is not contingent on having paid into any fund. SSDI is based on work credits, which means that if someone has never had the ability to work, or a parent has worked very little, it can be difficult to draw benefits. With SSI, an applicant needs only to prove that he or she meets the requirements to receive assistance.

The drawback of the program is that in some cases, because payments are not based on work credits, the amount provided to applicants may not be as much as it would be under SSDI.

If a person is deemed not capable of managing their financial affairs, payments may be made to a caretaker or parent, who should then pay the applicant’s bills and make sure all of his or her needs are met.

SSI funds can be used to meet several expenditures, including:

• House payments or rent
• Utility payments
• Living expenses
• General expenses
• Clothing costs

Often, if a person qualifies for SSI, he or she may qualify for the Supplemental Nutrition Assistance Program, as well. Also, SSI recipients will be enrolled in Medicaid so that a majority of their medical costs will be covered. It’s also possible that a SSI recipient may be eligible for housing aid.

Who administers the SSI program?

The SSI program is administered by the Social Security Administration, who will also handle the application process for the SSI program.

The Administration will determine:

• Whether a person should apply for SSI or SSDI
• If a person’s disability affects his or her ability to work; i.e., his or her functional capacity
• What amount an enrollee will receive monthly
• How salaries and assets will affect an application for SSI aid

How does a person qualify for SSI assistance?

To qualify for SSI assistance, an applicant will not only have to meet or exceed provisions designed to determine if he or she is disabled under the law, but he or she will also have to undergo an income and asset assessment that can make, or break, an application.

The general requirements an applicant with disabilities will need to meet to collect SSI benefits include:

• Be a citizen or legal resident of the United States
• Be able to demonstrate that he or she has a physical or mental condition that prevents them from engaging in Substantial Gainful Activity (adults)
• Be able to demonstrate limited physical or mental abilities (children)
• Be able to show there is no work for which an applicant can be trained
• Qualifying medical condition will last more than 12 months
• Be able to present medical evidence that the condition exists
• Have limited money, and limited assets

Under blindness provisions, an applicant will need to prove that he or she or his or her child has vision no better than 20/200 acuity. If an applicant or the child has other visual impairments, and is otherwise disabled, he or she may still qualify for assistance.

For the purposes of submitting an SSI application, the following will be considered income:

• Salary from work
• Unearned income, such as veteran’s benefits, worker’s compensation, or unemployment compensation

The following will be considered assets:

• Savings
• Stocks, bonds, and US savings bonds
• Personal property
• Vehicles
• Retirement benefits
• Temporary Assistance for Needy Families, or TANF
• Anything that can be converted to cash

Disability Determination Services, which has contracted with the federal government to render decisions about applications for SSI, will make a determination as to whether an applicant’s situation fits into existing SSI guidelines. These organizations are state agencies that follow all federal rules.

What is the application process to receive SSI benefits?

Applying for SSI benefits takes place at an applicant’s local Social Security Administration office, or, he or she may request that forms be sent to their home by calling the hotline at 800-772-1213. Unlike most other government benefits, there is no online application available for SSI.

Many people apply for SSI for a variety of reasons, but in most cases, a first application is denied. However, this can be avoided if an applicant assembles the correct information with his or her initial application. That doesn’t mean an application will be approved, but it gives the applicant a best shot at avoiding what can be a long, frustrating process.

However the process works out, an applicant needs to be willing to discuss and provide evidence of his or her disability. The more verifiable information a representative has in-hand, the greater the likelihood is that an application will be approved.

Some of the documentation that will be needed includes:

• Birth certificate
• Social Security card
• Utility bill, or something with the applicant’s address printed on it, unless an applicant lives in an emergency facility such as a shelter
• Proof of assets and savings, such as bank statements, financial or investment statements, real estate deeds, mortgage papers, vehicle titles
• Rental leases
• Past medical records
• Employment documentation, if applicable
• A child’s Individual Education Plan
• Names and contact information for former employers
• Names and contact information for physicians and therapists

Applicants will be asked to show proof of income, which includes some government benefits.An applicant will need to bring paperwork if they receive any of the following:

• Earned income, such as pay stubs and statements
• Unearned income, such as rental payments, entitlement benefits
• Income information for individuals an applicant may live with who contributes to household expenses
• Financial gifts and in-kind income

Benefits that will not affect an applicant’s income level include:

• Supplemental Nutrition Assistance Program (food stamps)

Generally, an applicant will receive a letter stating whether he or she is approved or denied, unless an application is fast-tracked for approval. Payments are made retroactively back to the applicant’s filing date.

What happens if an SSI application is denied?

If an application is denied, an applicant will be notified via mail. The letter sent by the Social Security Administration will explain why the application was denied. An applicant may file an appeal within 60 days if he or she does not agree with the determination.

Filing an appeal is typically a long process; it can take up to a year for the process to reach a conclusion. As part of this process, an applicant will likely have to provide more back-up information; these documents should address any of the outstanding questions that led to the applicant’s denial. When an application is denied, it’s often because there was insufficient evidence of a disability submitted as part of the initial application.

Once an application is denied, the applicant will need to file for redetermination. This starts the process that will allow a Social Security Administration representative to re-examine the evidence presented – and any new evidence – to see if an applicant meets the requirements for SSI assistance. The applicant must file for reconsideration within 60 days of receiving a denial letter.

If the redetermination in denied, an applicant can request to appear in front of an administrative law judge. At the hearing, the applicant, his or her advocate, and Social Security Administration representatives will present evidence and answer questions about his or her physical or developmental condition. During this hearing, an applicant may have witnesses speak on his or her behalf. Once the evidence is presented, the judge will render a decision about the application.

If the judge denies the application, an applicant can request that the decision be reviewed by an appeals council. The council will review the entire process to determine whether the facts of an applicant’s case were properly considered. The council will either uphold the judge’s decision, or send it back to the judge.

The final method of recourse available to an applicant, if the council upholds a denial, is a review by the federal court. Generally, the chances of having a decision reversed at this level are not high; cases are typically resolved before this step.

Should an applicant seek legal representation?

The Social Security Administration is legally obligated to address applications for SSI aid if a person’s medical conditions are so severe that they would obviously meet disability standards. Under the compassionate allowances provision, the Social Security Administration can approve applications quickly if they have adequate medical information on which they can base a decision.

However, not all cases of Cerebral Palsy fit into this category. There is a list of 200 conditions that can be approved quickly; Cerebral Palsy is on this list, which makes it likely that an application will be improved if a physician certifies that an applicant cannot work for at least a year.

Seeking the advice of an attorney before the application process can help a person present their case in the most favorable light, but once an application is denied, it’s a good idea to have an advocate.

Attorneys that specialize in SSI are experts that know what evidence will be sought by Social Security Administration representatives. Not only do they know what evidence will best make an applicant’s case, they know how to present the facts so an application will be approved early in the process.

Because fees that attorneys can charge to assist and applicant are currently capped, an applicant assumes little risk when they seek and advocate.