Close Menu

HOW TO WIN PRESUMPTIVE DISABILITY BENEFITS

Because filing for SSI benefits can be a long process, it is possible to get temporary benefits in some circumstances. The SSA has made temporary or presumptive disability benefits available for those who claim Supplemental Security Income benefits. These benefits are available for 6 months. You receive these monthly benefits while the Social Security Administration processes your SSI claim. Read more about SSI asset limits.

Presumptive disability payments are only available to SSI recipients. SSI is also known as Supplemental Security Income. Therefore, presumptive disability payments are not available if you are filing for Social Security Disability benefits. Or, what is known as SSD. Find out more about the amount of your SSD payment.

You do not need to file separately for presumptive disability payments. You are doing so when you file for SSI. The Social Security field offices that initially review SSDI and SSI applications make the decision to award payments. However, DDS, the state agency responsible for granting or denying claims, can also do it.

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

TEMPORARY SSI PAYMENTS

Presumptive SSI payments can last for up to six months. As soon as the SSA reaches a final decision about your disability claim, the presumptive payment will stop. Even if the SSA has not made a decision within six months, the presumptive payments will end. If the SSA denies your SSI claim, then you are not responsible for paying this particular type of 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 medical condition. If you are eligible for SSI benefits, then you are also eligible for Medicaid benefits. Learn more information about Medicaid benefits. 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; no sound perception in either ear;
  • total blindness; that is, no light perception in either eye;
  • being confined to bed or immobility without a wheelchair, walker, or crutches, due to a longstanding medical condition, which does not include recent accident and recent surgery;
  • cerebral palsy, muscular dystrophy, or muscular atrophy and marked trouble walking (for example the use of braces), speaking, or coordination of the hands or arms;
  • a doctor confirms by telephone or in a signed statement that you have a terminal illness with a life expectancy of six months or less; or a doctor or hospice official (for example, staff nurse, social worker or medical records custodian) confirms that an individual is receiving hospice services because of a terminal illness:
  • spinal cord injury making it so you cannot ambulate without the use of a walker or bilateral hand held assistive device for more than two weeks with confirmation of such status from an acceptable medical source;
  • end stage renal disease (ESRD) that requires 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

MEDICAL EVIDENCE FOR PRESUMPTIVE BENEFITS

When you file for SSI benefits, the SSA may provide presumptive disability payments while the full benefit decision process is ongoing. These payments provide financial support to those who would qualify for SSI benefits once their case is officially decided. Therefore, you still must prove your case. For that, you will need medical evidence:

  1. MEDICAL CONDITIONS: The SSA has a list of medical conditions that qualify for presumptive payments. These conditions are severe enough that the SSA believes they will meet the rules for SSI benefits. Some common examples include certain types of cancer that will result in death. Additionally, some severe mental conditions and end stage renal disease are on the list.
  2. MEDICAL EVIDENCE: To receive presumptive payments, you must provide medical evidence of your severe medical condition. This evidence might include notes from your doctor, medical test results, hospital records, and any other evidence that confirms your condition.
  3. INCOME AND RESOURCE LIMITS: In addition to meeting the medical listing for a presumptive disability condition, you must also meet the income and asset limits for SSI.

It is important to state that presumptive payments are not a guarantee that you will qualify for SSI benefits after a full review of your case by the SSA.

CHILDHOOD PRESUMPTIVE DISABILITY BENEFITS

  • Down syndrome;
  • intellectual disability or another neurodevelopmental condition (for example, autism spectrum disorder) with complete inability to independently perform basic self care activities (such as going to the toilet, eating, dressing, or bathing) made by another person filing on behalf of a child who is at least 4 years of age;
  • child has not reached 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 reached his or her first birthday and available medical evidence shows a gestational age (GA) at birth with these 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. For some conditions, the local SSA office is able to make a decision. In other cases, DDS, which is the agency responsible for making all SSI decisions, must look at your case. DDS can make presumptive decisions as well. They can do so even for medical conditions that aren’t on the above list.

Please note that SSI payments are 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 cannot work due to a severe medical condition, 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. You can still get SSDI benefits on a monthly basis.

For example, you could own a Lamborghini and a yacht and still qualify for SSD benefits. Find out more here about how the SSA defines work. Likewise, SSD benefits have an important date called the date last insured. Find out more here about how the date last insured can impact your SSD benefits. There is also a five month waiting period in almost all SSDI cases.

SSI payments, however, are tied to your assets. For example, if you have $10,000 in your savings accounts at the bank, you cannot get SSI benefits. SSI benefits are for people who have never had a job. Or, they are for children with severe medical conditions. Also, they are for those who have low incomes who had a job. For example, a job like a baggage handler 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 those seeking SSD benefits. The Veterans Administration knows certain medical conditions were caused by military service. This is because of the unique circumstances of a specific Veteran’s military service.

If a Veteran has a medical condition and they were in a certain location or serving within a certain group, then they may be awarded compensation.  That type of benefit is service connected Veteran’s benefits. This type of benefit is only for Veterans when the VA agrees that the Veteran’s medical condition was caused by service.

You can learn more information about how you can get both veteran benefits and SSDI benefits.

WHAT ARE “PRESUMPTIVE CONDITIONS” FOR VETERANS?

If you are a Veteran, then you may be able to get compensation if you have a presumptive condition. A presumptive condition is when you have a chronic disease within one year of active duty release. In order to obtain compensation, however, you have to apply for it. Examples of chronic disease include: diabetes or multiple sclerosis.

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 radiation and who experienced one of the following:

  • Participated in atmospheric nuclear testing
  • Occupied or were prisoners of war in Hiroshima or Nagasaki
  • Served 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

Also, 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

And, Gulf War Deployed Veterans:  That served in the Southwest Theater of Operations during the Persian Gulf War

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 paid compensation from the Veterans Administration. To learn more about whether you can get benefits from the VA, there is a table  that lists the specific conditions for these groups at the VA Benefits site.

WE CAN HELP YOU FILE AN APPLICATION FOR SSI BENEFITS

If you think you have a medical condition that keeps you from working, contact us 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 review of your case. Also, we promise not to pressure you to become our client.

You should apply for SSI today. It is important to apply for benefits as soon as possible. It is easy. 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 cannot get SSI benefits until you file an application. 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, the SSA will not pay you back pay prior to your application date. 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, call us for free. We offer a free review of your benefits. Also, we will answer your questions for no charge.

WHAT WE DO TO HELP YOU WIN SSD BENEFITS 

You do not need to try to win SSD benefits by yourself. We can help file your SSD application. Also, we can help you appeal every SSA denial. For example, our attorneys and staff can:

If you file your application for benefits online at Social Security’s website, then you have 6 months to complete the application. Try not to take that long to finish it. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. If you need help to file your application, we will help you.

THE EXPERT LAWYERS AND STAFF AT OUR FIRM

You are seeking the best SSD attorney to represent you in your benefit case. You need a law firm you can trust. If you want to learn more about the lawyers at our law firm, then read our About Us page. There you will find more information about us. For example, Andria Summers can help you with your Medicare plan. Likewise, she has also won thousands of SSDI and SSI cases.

Dianna Cannon has many years of legal experience helping her clients win benefits. She has been an attorney for thirty years. Ms. Cannon also has law licenses in a number of states. For example, she has a law license in California, Utah, Nevada, and Washington State.

Additionally, Brett Bunkall has experience helping people obtain their SSI and SSD benefits. He has won thousands of SSD hearings. Mr. Bunkall is a Social Security law expert. Similarly, all of our lawyers are experts. You can trust us to help you win your claim and help you with presumptive disability benefits.

WHY HIRE CANNON DISABILITY LAW?

In the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Our experts can help you apply for SSI 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, then we will answer them. Call us today. We want to be your legal team.

It doesn’t cost anything to call us. We offer a free review of your case. 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 means if we win, then you pay the attorney fee out of your back benefits. If you do not win, then there is no attorney fee to pay.

If there are costs in your case, then you pay those. But costs are usually less than $100 and consist of paying for copies of medical records. 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, in the end we hope to win.

Once we win, we are paid an attorney fee from your back benefit. In order 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 if we can help you receive presumptive disability benefits.

Facebook Twitter LinkedIn
Contact Form Tab

Quick Contact Form