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What Qualifies for Presumptive Disability when Filing for SSI

Published on December 26th, 2017

Sometimes, when a person is in need of Social Security benefits, it can be necessary to start receiving payments before the application is approved. When it’s fairly certain that an applicant has the onset of a qualifying disability then the Social Security Administration (SSA) may grant presumptive disability benefits. What that means is that it is presumed that the disability is covered before the application has been approved.

Presumptive disability benefits can be paid for six months from the time of application. If the SSA takes longer than six months to make a decision, then the payments will stop at that point until an approval has been reached. Generally, if the application is denied but the claimant was receiving presumptive disability benefits the claimant won’t be expected to return the payments.

The SSA has two main programs for providing benefits, but only the Supplemental Security Income (SSI) program can pay the presumptive disability benefit.

Types of Disabilities that Qualify

Eligibility for presumptive disability payments is generally granted for the following conditions:

– Amputation of two limbs

– Amputation of one leg at the hip

– Symptomatic HIV/AIDS

– Down syndrome

– Severe mental retardation of a person at least seven years old

– Complete blindness

– Total deafness

– Low birth weight

– Immobility or bed confinement

– Amyotrophic Lateral Sclerosis (ALS)

– Severe stroke causing immobility without use of medical aid devices

– Spinal cord injury causing immobility without use of medical aid devices

– Cerebral palsy, muscular atrophy or muscular dystrophy that causes the loss of use of hands or arms, difficulty walking or difficulty speaking

– Terminal illness diagnosis with less than six months left of life

– End Stage Renal Disease (ESRD) requiring chronic kidney dialysis

How to File

Local SSA field offices can generally make the determination for presumptive disability eligibility. The field office may require verification of the disability from a doctor, school personnel or social worker before authorizing the benefit. If the field office declines to provide the presumptive benefit, and the application is declined, during the appeal process the Disability Determination Service (DDS) may be able to authorize the benefit then. The DDS also has authority to grant presumptive disability for other conditions as well. Filing for the benefit is completed at the same time as the SSI application. Legal assistance from an experienced attorney can help the process move more swiftly and help get the benefits needed with less stress on the claimant.


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