Important: We updated this article in August 2023 to make sure all info below is both current and correct. 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 (PD) program in place. It 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 medical condition qualifies for PD 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.
When Disability Determination Services (DDS) Steps In
If your local SSA office 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.
What Is the SSI Federal Benefit Rate for 2023?
In 2023, the maximum monthly benefit SSI applicants can receive is:
- $914 for each individual who lives alone
- $1,371 for each couple receiving SSI
However, depending on where you live, you may get additional financial support once your SSI benefits begin. This can mean money from a federally administered state supplement, SNAP, or TANF benefits. Learn more about state-level supplemental benefits here.
What to Know Before You File Your SSI Application
SSI benefits are based on financial need, not just your health problems. To qualify, you need to show the Social Security Administration you have very little income and own almost nothing. In 2023, the monthly income limit to qualify for presumptive disability SSI benefits is $1,470. You also cannot own more than $2,000 in total countable assets. For couples, that asset limit is $3,000 added together from both of you.
Important: Learn more about how the Social Security Administration reviews SSI applicants before giving them benefits.
How Long Do Presumptive Disability Benefits Last?
When the SSA grants you presumptive disability status, you can receive temporary SSI payments for up to six months. If Disability Determination Services doesn’t process your claim before that six-month period ends, your SSI benefits stop automatically.
Once the Social Security Administration approves your application, your monthly PD or PB payments convert to regular SSI. But if the SSA denies your claim, don’t worry — you won’t have to return any presumptive SSI benefits. 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 past payments you received.
What Medical Conditions Qualify for Presumptive Disability Benefits?
According to the SSA, these medical conditions may qualify for presumptive disability:
- 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), which counts for presumptive blindness benefits
- Bed confinement due to a long-standing condition that results in immobility without using a wheelchair, walker, or crutches (this excludes those who have temporary problems walking or standing after a recent surgery or accident)
- Stroke that happened at least three months ago and resulted in marked difficulty walking or using one hand and/or arm
- Cerebral palsy, muscular dystrophy (MD), 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 hospice official confirms your life expectancy is 6 months or less
- Spinal cord injury that prevents you from walking without using a mobility walker or similar handheld device
- End-stage renal disease (ESRD) that requires chronic kidney dialysis
- Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease
How the Social Security Administration Defines “Terminal Illness”
It’s not always obvious what the SSA counts as a terminal illness (TERI) for presumptive disability claims. Here are some presumptive disabilities that get disability claims flagged for faster processing as TERI cases:
- Brain, liver, pancreas, esophagus, or gallbladder cancer
- Any other stage 4 cancer or one that’s already metastasized
- Chronic heart failure if you need around-the-clock medical care
- Pulmonary failure in your lungs where you need constant oxygen
- Anyone in a coma for at least 30 days
- Newborn babies born with fatal genetic or congenital birth defects
- You’re waiting on a liver, lung, heart, or bone marrow transplant
- Lou Gehrig’s disease
- Anyone who receives hospice services at home or at an inpatient facility
Important: This list doesn’t include everything that may qualify as a presumptive disability under the TERI designation. Your DDS office can make a final decision on who gets PD or PB payments once they receive your medical records.
How Children Can Get Supplemental Security Income (SSI)
In some cases, children (including preemie babies) may qualify for presumptive disability benefits from Supplemental Security Income (SSI). Presumptive disabilities for low birth weight children and other minors include:
- Severe intellectual disability in children who are at least 7 years old (allegation must be made by another individual filing for SSI for that child)
- Any child less than 1 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
Important: You cannot file an SSI claim online for your child. Instead, you must call or visit your local Social Security office to apply for Supplemental Security Income.
Does Social Security Disability Insurance Offer Presumptive Disability Benefits?
Unfortunately, no. But if you have a qualifying disability on the Compassionate Allowances (CAL) list, you can start receiving benefits from SSDI in 30 days or less! One condition that qualifies for expedited payments from SSI and SSDI is Lou Gehrig’s disease.
I’m Having a Financial Emergency and Need an Advance Payment Now. Help!
If you are due SSI benefits that haven’t begun and need money now, the SSA can make a one-time emergency advance payment. The maximum emergency advance payment amount is currently $999. If there’s not enough money to pay for these things, then you can request an immediate payment from your local SSA office:
- Medical care
You can also request this financial emergency payment only once if something or someone threatens your safety.
Get Free Expert Help Filing Your Disability Claim
People initially applying for benefits with a Social Security attorney are almost 3x more likely to get payments right away. In addition, people who apply on their own without a lawyer often wait 2+ years for their first payment. Since these lawyers work on contingency, you owe $0 if you don’t win benefits. And if you succeed, then you’ll only pay one small fee.
Want to speak to a local expert about your own situation for free? Click the button below now to start your free online benefits quiz and see if you may qualify:
Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues.