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HOW TO WIN PRESUMPTIVE DISABILITY BENEFITS

Because applying for disability benefits can be a long process, the SSA has made temporary or presumptive disability benefits available for SSI applicants. These benefits are available for 6 months. You can receive these monthly benefits while the Social Security Administration processes your SSI claim. Presumptive disability payments are only available to SSI recipients. SSI is also known as Supplemental Security Income. Therefore, presumptive disability payments are not available for those who are applying for Social Security Disability benefits. Or, what is known as SSD.

You do not need to apply separately for presumptive disability payments. You are considered to be doing so when you file for SSI. The Social Security field offices that initially review applications will make the decision to award the payments. However, Disability Determination Services (DDS), the state agency responsible for approving or denying disability claims, can also do it.

This is also not a benefit that applies to everyone. Only the people who have certain disabilities can get it. The list of severe disabilities is found below. Once you read it, you will see why not everyone can get presumptive SSI benefits.

TEMPORARY SSI PAYMENTS

Presumptive disability SSI payments can last for up to six months. As soon as the Social Security Administration reaches a final decision about your disability claim, this type of disability payment will stop. Even if the SSA has not made a decision within six months, the presumptive disability payments will end. If the SSA denies your SSI claim, you are not responsible for paying this particular type of disability benefit back.

The reason you don’t have to pay the SSI money back is that the SSA assumes you qualify for the money. The SSA won’t give it to you if you don’t have a severe disability. The following are examples of SSI claims that immediately qualify for presumptive disability benefits.

PRESUMPTIVE DISABILITY EXAMPLES – SSI ONLY

  • amputation of a leg at the hip;
  • deafness; that is, no sound perception in either ear;
  • total blindness; that is, no light perception in either eye;
  • allegation of bed confinement or immobility without a wheelchair, walker, or crutches, due to a longstanding medical condition excluding recent accident and recent surgery;
  • cerebral palsy, muscular dystrophy, or muscular atrophy and marked difficulty in walking (for example the use of braces), speaking, or coordination of the hands or arms;
  • a physician confirms by telephone or in a signed statement that an individual has a terminal illness with a life expectancy of six months or less; or a physician or knowledgeable hospice official (for example, hospice coordinator, staff nurse, social worker or medical records custodian) confirms that an individual is receiving hospice services because of a terminal illness:
  • spinal cord injury producing an inability to ambulate without the use of a walker or bilateral hand-held assistive devices for more than two weeks with confirmation of such status from an acceptable medical source;
  • end-stage renal disease (ESRD) requiring chronic dialysis and the file contains a completed CMS-2728-U3 (End Stage Renal Disease Medical Evidence Report-Medicare Entitlement and/or Patient Registration).

PRESUMPTIVE DISABILITY BOY holding sign disability matters hiding face

CHILDHOOD PRESUMPTIVE DISABILITY EXAMPLES – SSI ONLY

  • Down syndrome;
  • intellectual disability or another neurodevelopmental impairment (for example, autism spectrum disorder) with complete inability to independently perform basic self-care activities (such as toileting, eating, dressing, or bathing) made by another person filing on behalf of a claimant who is at least 4 years of age;
  • child has not attained his or her first birthday and the birth certificate or other medical evidence shows a weight below 1,200 grams (2 pounds, 10 ounces) at birth:
  • child has not attained his or her first birthday and available medical evidence shows a gestational age (GA) at birth with these corresponding birth-weights:
  • – GA: 37-40 weeks; weight at birth: 2000 grams (4 pounds, 6 ounces) or less;
    – GA: 36 weeks; weight at birth: 1875 grams (4 pounds, 2 ounces) or less;
    – GA: 35 weeks; weight at birth: 1700 grams (3 pounds, 12 ounces) or less;
    – GA: 34 weeks; weight at birth: 1500 grams (3 pounds, 5 ounces) or less; or
    – GA: 33 weeks; weight at birth: at least 1200 grams, but no more than 1325 grams (2 pounds, 15 ounces) or less;
    – GA: 32 weeks; weight at birth; at least 1,200 grams (2 pounds, 10 ounces), but less than 1,325 grams (2 pounds, 15 ounces).

HOW TO APPLY FOR PRESUMPTIVE DISABILITY BENEFITS

You apply for presumptive disability benefits when you file your application for SSI at the local SSA office near you. For some conditions, the local SSA office is able to make a presumptive disability determination. In other cases, the Disability Determination Services (DDS), which is the agency responsible for making all SSI disability decisions, must look at your case. The DDS can make presumptive disability determinations as well. They can do so even for impairments that aren’t on the above list.

Please know that SSI payments are very different than SSD payments. The monthly amount of Social Security Disability payments is based upon your work history. In other words, you work and pay taxes. In return, if you become and disabled, then you receive SSD payments.  With SSD benefits, it doesn’t matter how much money you have in savings or how many expensive assets you own. For example, you could own a Lamborghini, a yacht, and a mansion and still get your SSD benefits.

By contrast, SSI payments are tied to your assets. For example, if you have $10,000 in your savings accounts at the bank, it would make you ineligible for SSI benefits. SSI benefits are for people who have never had a job. Or, they are for children with disabilities. And, for those who have low incomes even though they had a job, like a waitress who mostly relies on tips for income.

presumptive disability veterans day soldier in front of flag

WHAT IS “PRESUMPTIVE” SERVICE CONNECTION FOR VETERANS?

Presumptive service connection is different for Veterans than it is for Social Security Disability claimants. The Veterans Administration presumes certain disabilities were caused by military service. This is because of the unique circumstances of a specific Veteran’s military service. If a Veteran has a diagnosed condition and they were in a certain location or serving within a certain group, then they may be awarded disability compensation. This is because the VA presumes that the Veteran’s disabling condition was caused by service.

WHAT ARE “PRESUMPTIVE CONDITIONS” FOR VETERANS?

If you are a Veteran you may be eligible for compensation if you have a presumptive condition. A presumptive condition is when you are diagnosed with a chronic disease within one year of active duty release. In order to obtain disability compensation, however, you have to apply for it. Examples of chronic disease include: arthritis, diabetes or hypertension.

Veterans in the following groups may qualify for “presumptive” disability benefits:

Former prisoners of war who have a condition that is at least 10 percent disabling

Vietnam Veterans who were:

  • Exposed to Agent Orange
  • Served in the Republic of Vietnam or on a vessel operating not more than 12 nautical miles seaward from the demarcation line of the waters of Vietnam and Cambodia between Jan. 9, 1962 and May 7, 1975

Atomic Veterans exposed to ionizing radiation and who experienced one of the following:

  • Participated in atmospheric nuclear testing
  • Occupied or were prisoners of war in Hiroshima or NagasakiServed before Feb. 1, 1992, at a diffusion plant in Paducah, Kentucky, Portsmouth, Ohio or Oak Ridge,Tennessee
  •  Served before Jan. 1, 1974, at Amchitka Island, Alaska

Gulf War Veterans who:

  •  Served in the Southwest Asia Theater of Operations
  •  Have a condition that is at least 10 percent disabling by Dec. 31, 2021

Gulf War Deployed Veterans who:  Served in the Southwest Theater of Operations during the Persia

Gulf War Veterans Who:  Served in Afghanistan, Syria, Djibouti or Uzbekistan on or after September 19, 2001

If you served in one of these groups, you may have a presumptive disability. And, you may be eligible for compensation from the Veterans Administration. To learn more about whether you qualify there is a table or factsheet that outlines the specific presumed conditions for these groups at the VA Benefits site.

CANNON DISABILITY CAN HELP YOU APPLY FOR SSI BENEFITS

If you think your SSI claim qualifies for you for disability payments, contact Cannon Disability Law now. We can often tell you over the phone if we can help you. And, calling us is free. That is right. We offer a free consultation. Also, we promise not to pressure you to become our client.

You should apply for SSI now. It is important to apply for benefits as soon as possible. You can apply on Social Security’s website. Especially, if you have one of the above medical conditions. You should apply immediately, because every day you wait to apply, is a day you lose benefits. In other words, you simply aren’t eligible for SSI benefits until you apply. Do you need to know more? This SSA POMS site has more information about presumptive disability.

There is no back pay period for SSI payments. So, even if you have a disability now, the SSA will not pay you if you have not put in an application. If you don’t apply, you cannot get any benefit. SSI benefits only start from the day you apply.  If you need help with your application or any other Social Security Disability matter, call us for free. We offer a free consultation and will answer your questions for no charge.

WHY HIRE CANNON DISABILITY LAW?

In the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Our specialists can help you apply for SSI disability benefits using the SSA’s website. However, we will need your help to apply for SSI benefits. Why? Because only you know your personal information. But, we can explain how to apply. Likewise, if you need an appeal, we can help you do that too. There are also many forms that will need to be filled out. Don’t worry. If you have questions about these forms, we will answer them. Call us today. We want to be your disability legal team.

It doesn’t cost anything to call us. We offer a free consultation. It also doesn’t cost you any money to hire us. Why? Because you only pay us an attorney fee if we win your case. This is a contingency fee. It means if we win, you pay out of your back benefits. If you do not win, there is no attorney fee to pay.

If there are costs in your case, then you pay those. But the costs in most cases is less than $100. Also, most cases take 1.5 to 2 years. This is from start to finish. So, we will work for you for up to two years for free. Of course, we hope to win. Once we win, we are paid from your back benefit. But, to hire most lawyers, you have to pay upfront. We don’t work like that. You don’t have a job. So, the only way to pay us, is for us to win your case. That is our goal. Call today. See what we can do for you.

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