Getting approved for disability benefits can be a long and difficult process. For some people, the waiting period alone can cause financial hardship. That’s why the Social Security Administration (SSA) has a presumptive disability program in place. Presumptive disability makes immediate payments for up to six months to those most likely to qualify for Supplemental Security Income.
How the SSA Grants Presumptive Disability Status to Applicants
When you apply for SSI, they’ll immediately check to see if your condition qualifies for presumptive disability payments. (Only certain disabling conditions are likely to automatically qualify.) This presumptive disability decision usually occurs at your local SSA office.
Sometimes, your local SSA office asks a reliable source to confirm that you meet all presumptive disability requirements. This can include a doctor, social worker, school personnel, nurse, hospice director, medical records coordinator, or other knowledgeable medical professionals. If your local SSA claims representative cannot confirm a presumptive disability, your application moves on to Disability Determination Services (DDS). Your state’s DDS office has much more leeway in granting presumptive disability status than the local SSA office.
How Long Do These Payments Last?
When the SSA grants you presumptive disability status, you can receive temporary SSI payments for up to six months. If the DDS doesn’t make a determination decision before that six-month period ends, your payments stop automatically. Once the DDS approves your application, your monthly presumptive disability payments convert to regular SSI. But if the SSA denies your claim, don’t worry — you won’t have to return any presumptive disability payments. There is, however, one very important exception to this rule. If you’re denied for having too much income or available assets, you’ll have to repay all the money you received.
What Conditions Qualify for Presumptive Disability?
According to the SSA, these conditions may qualify for presumptive disability payments:
- Amputation of two limbs or one leg at the hip
- Complete deafness (cannot hear sound in either ear)
- Total blindness (cannot see light in either eye)
- Bed confinement due to a long-term condition that results in immobility without using a wheelchair, walker, or crutches (this excludes those who cannot temporarily walk or stand after a recent accident or surgery)
- Stroke that happened at least three months ago and resulted in ongoing difficulty walking or using a hand and/or arm
- Cerebral palsy, muscular dystrophy, or muscular atrophy that makes walking, speaking or using your hands or arms extremely difficult
- Down syndrome
- Symptomatic human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS)
- Terminal illness in which your doctor, hospital or a knowledgeable hospice official confirms you have six months or less to live
- Spinal cord injury that prevents you from walking without using a mobility walker or similar handheld device
- End-stage renal disease (ESRD) requiring chronic kidney dialysis
- Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease
Are Children Eligible?
In some cases, children (including preemie babies) may qualify for presumptive disability payments:
- Severe mental deficiency in applicants who are at least seven years old (allegation must be made by another individual filing for SSI on the claimant’s behalf)
- Any child less than one year old whose birth certificate lists a birth weight below 1,200 grams (2 lbs, 10 oz.)
- Children younger than one year old who were born at 37-40 weeks and weighed 2,000 grams (4 lbs, 6 oz.) or less at birth
- Any child under a year old who was born at 36 weeks and weighed 1,875 grams (4 lbs, 2 oz.) or less at birth
- Children younger than one year old who were born at 35 weeks and weighed 1,700 grams (3 lbs, 12 oz.) or less at birth
- Any child younger than one who was born at 34 weeks and weighed 1,500 grams (3 lbs, 5 oz.) or less at birth
- A child younger than one year old who was born at 33 weeks and weighed 1,325 grams (2 lbs, 15 oz.) or less at birth
You May Qualify for Legal Assistance
People who have a Social Security attorney file their claims are almost 3x more likely to get benefits right away. In addition, people who apply on their own without a lawyer typically wait 2+ years for their first payment. Since these lawyers work on contingency, you owe $0 for legal assistance if you don’t win benefits. And if you do win, then you’ll only pay a small, one-time fee.
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Mandy Voisin is a freelance writer, blogger, and author of Girls of the Ocean and Star of Deliverance. As an accomplished content marketing consultant, mom of four and doctor's wife, Mandy has written hundreds of articles about dangerous drugs and medical devices, medical issues that impact disabled Americans, veterans' healthcare and workers' compensation issues since 2016.