Question about SSI/SSDI approval & payments

[SeaSpray]

Hi:

My DS23 applied for SSI and SSDI in mid-March of this year. Last week he got a letter in the mail saying that he wasn't medically approved yet, but that they wanted to start paying him "presumtively", and that he should choose a representative payee and both go to the local SS office. DS asked me to be his representative payee. (I had to look up online to find out what a representative payee was).

So this past Friday DS and I went to the SS office with the letter. The woman said that they want to get money to the people who need it right away, before being officially approved. She took my driver's license info and bank account info and said that DS's April and May payments would be deposited into my account by the end of this week. She also said that he'd be getting the June 1st payment either the end of this week or early next week, and then continue July 1, etc.

She at first was saying that they could set up the RP account for me/us, or we could go to any bank and set up the account. She then said that any account would be fine as long as DS wasn't on the account, so I told her about a second checking account that DH and I have that we don't really use, so she said we could use that account.

My concern is, why would they start making payments before knowing for sure that DS is approved? She said that they only do this in cases where they feel that they will approve the person, but it really surprised me because I've always heard how difficult it is to get approved for SS, and how usually you get denied initially, and how a lot of people have to hire lawyers, etc. This just seems too easy, you know??? Although I have to say that DS's doctor said that he felt that DS would get approved with no problems.

Have any of you, or your family members been approved as easily as this?? Oh, and she also said that DS will probably qualify for back payments, and that those funds would be deposited once he was officially approved.

I dont know, I'm just new to all of this. Any experiences with this would be greatly appreciated!


Edited to add: The word is "presumptively" not "preintuitively". I should've reread DS's letter.

 

[pershing]

Back payments are common as if you end up qualifying, your start date is the day they receive your application.

As for the eagerness, I haven't bumped into that. I have to go thru medical reviews to prove that my son still has autism. Seems they would like him to get off and not on.

Hope that helps.

 

[SeaSpray]

Back payments are common as if you end up qualifying, your start date is the day they receive your application.

As for the eagerness, I haven't bumped into that. I have to go thru medical reviews to prove that my son still has autism. Seems they would like him to get off and not on.

Hope that helps.

Thanks, Sue. The person at the SS office said last Friday that they'd be depositing April and May's payments this coming week. She said that the "back payments" could go back to when my son became "disabled" which they determined to be April 2008.

I've never had any dealings at all with Social Security, so I'm just surprised at how quickly this is being handled. I did not expect for him to even hear anything from SS until the end of the summer, let alone get payments already.

How old is your DS that they need to review whether he still has autism or not?? My younger DS20 has mild Asperger's (he's never really needed assistance, so we've never filed anything for him) and honestly, I don't see this as something that he'll outgrow, since he's had these tendencies since he was a toddler.

 

[WheelieBigDisFan]

I applied for SSI/SSDI in 2006, and was awaiting my denial (after all, doesn't "everyone" get denied the first time?) when I received a weird card in the mail. Low and behold, I was sent a Medi-Cal (California Medicaid) card. A week or two after that, I got money from the bank, and my balance was WAYYY more than I had in there. I checked my bank account online to find out I had received my first SS payment, including back pay to the date of my application. I assumed at that point that I had been approved, and about a week later got the actual approval in the mail.
Not everyone has a hard time getting approved the first time around. I think mine got approved so easily because I had a "referral" from the doctor recommending me for SS since I had just undergone my 3rd back surgery and would be "unable to work for at least a year." I had already stopped working at that point because of my back problems. I was also able to get all of my medical records for SS, so they had A LOT of documentation to base the decision on.
Congrats on getting this far so easily. Lets hope this is a GREAT sign for what is to come. Just remember that even after he is approved, he will go through reviews every so often (as little as 1 year as long as 5-7 years) to prove that he is still disabled and unable to work in ANY job. I am in a review right now.
Mandy

 

[SeaSpray]

I applied for SSI/SSDI in 2006, and was awaiting my denial (after all, doesn't "everyone" get denied the first time?) when I received a weird card in the mail. Low and behold, I was sent a Medi-Cal (California Medicaid) card. A week or two after that, I got money from the bank, and my balance was WAYYY more than I had in there. I checked my bank account online to find out I had received my first SS payment, including back pay to the date of my application. I assumed at that point that I had been approved, and about a week later got the actual approval in the mail.
Not everyone has a hard time getting approved the first time around. I think mine got approved so easily because I had a "referral" from the doctor recommending me for SS since I had just undergone my 3rd back surgery and would be "unable to work for at least a year." I had already stopped working at that point because of my back problems. I was also able to get all of my medical records for SS, so they had A LOT of documentation to base the decision on.
Congrats on getting this far so easily. Lets hope this is a GREAT sign for what is to come. Just remember that even after he is approved, he will go through reviews every so often (as little as 1 year as long as 5-7 years) to prove that he is still disabled and unable to work in ANY job. I am in a review right now.
Mandy

Thanks for sharing your experience, Mandy. I appreciate it. I actually did a little more searching and found the explanation for "presumtively" being paid benefits. Here's what I found:

The meaning of presumptive disability or presumptive blindness.

If you are applying for supplemental security income benefits on the basis of disability or blindness, we may pay you benefits before we make a formal finding of whether or not you are disabled or blind. In order to receive these payments, we must find that you are presumptively disabled or presumptively blind. You must also meet all other eligibility requirements for supplemental security income benefits. We may make these payments to you for a period not longer than 6 months. These payments will not be considered overpayments if we later find that you are not disabled or blind.

So that explains it. LOL And at least I know that we don't have to worry about paying back the payments if the final decision is not in DSs favor. I'd like to take him for new glasses as soon as the payments start.

 

[zurgswife]

My son applied sometime in Feb/March and we are still waiting...It would be wonderful to get excepted the first time but I'm definately not counting on that.

Glad you got the preapproval sort of....

 

[SeaSpray]

My son applied sometime in Feb/March and we are still waiting...It would be wonderful to get excepted the first time but I'm definately not counting on that.

Glad you got the preapproval sort of....

Thanks. I'll update when DS gets his approval or denial letter. I hope that your DS hears something soon.

 

[DVC96]

We had a relatively easy time applying and getting SSI for our daughter who is 18. Our appt. with SS was on Nov. 12 and I received a phone call from the local office less than a month later saying she was approved. I believe I read somewhere that a diagnosis of CP (which is what my DD carries) is rarely denied. Possibly that was the reason it came through so quickly. Good luck to all who are applying!

 

[SeaSpray]

Hi everyone:


DS got a letter in the mail on Saturday from SSDI and it said "Notice of Award" at the top, then goes in to say what date he became disabled. It also says that they will pay him benefits going back 1 year, since they don't pay any farther back than that.

Then it says how much he'll get a month. This is where we are confused because the monthly amount that he just got, which supposedly contained SSDI and SSI, is less than what this letter is saying that he'll be getting. Also, apparently this is only SSDI. Will SSI send a separate letter?? In the end, we don't know how much he'll really be getting.

Is it possible that he will only get the SSDI amount, which is higher than that SSDI/SSI combined amount?? Well either way, he and we are very thankful for the assistance. We've been fully supporting him and this money will cover new glasses which he really needs, clothes (hasn't had new clothes in a very, very long time, except for a t-shirt here and there), the co-pays for his medications, etc. It really feels like a weight has been lifted. The disability is still there, money can't make that go away, but the money will make his life easier and that can lead to him making progress in the future. So I finally feel optimistic.

I think I'm rambling now.

Oh yeah... I thought the letter was supposed to say "approved" "partially approved" or "denied"?? I don't see those words anywhere on this letter, just the words that I said above, that say that they found him to be disabled as of 2008.

 

[WheelieBigDisFan]

Getting SSDI can be a double edged sword. If your DS's SSDI payments are greater than $2000 a month, or he has a balance in his bank account of greater than $2000 at any one time he may not be eligible for SSI. Since SSI is a needs based program, he must meet the financial needs requirement to receive this benefit. Also, any stocks/bonds in his name are used towards this $2000 limit. If he has more than one car, more than one house (not likely, LOL), etc these count against him also.
SSI and SSDI are paid separately as SSI is a state based program and SSDI is federal. They have different payment amounts and are paid on different days. If he qualifies for both SSI/SSDI he will receive two separate deposits in his account each month.
Mandy

 

[SeaSpray]

Getting SSDI can be a double edged sword. If your DS's SSDI payments are greater than $2000 a month, or he has a balance in his bank account of greater than $2000 at any one time he may not be eligible for SSI. Since SSI is a needs based program, he must meet the financial needs requirement to receive this benefit. Also, any stocks/bonds in his name are used towards this $2000 limit. If he has more than one car, more than one house (not likely, LOL), etc these count against him also.
SSI and SSDI are paid separately as SSI is a state based program and SSDI is federal. They have different payment amounts and are paid on different days. If he qualifies for both SSI/SSDI he will receive two separate deposits in his account each month.
Mandy

Thanks, Mandy. Since I am DS's representative payee, I called Social Security yesterday (the 800 #) and asked someone to clarify what the letter was saying, and whether he'd be getting SSDI only, or also SSI. She told me that he'll be receiving only the SSDI amount that was mentioned in the letter. She said he will not be receiving any SSI.

I can tell you that he does not have anything worth $2000. at all. He does own a car (which needs repairs to get it back on the road), but that's it. No house, no cash, no bonds, no other property. And I can tell you that the SSDI payments each month are well below $750. Do you think this is something that I should look into?

Oh, the only other thing I can think of is that they will be giving him back payments in one lump sum which will be over $2000. Do you think they are counting that? I guess that's possible.

Anyway, thanks everyone for the replies. This is all new to us, so we're still learning the ropes, so to speak!

 

[jking6]

Congrats to all those that get quick approval. Here is a sad story my dad applied he had lung cancer. well the day we buried him my mom got a letter from NYS stating that his illness was not life threatening and he was denied...
hopefully they learned something and this kind of thing does not happen to another person.

 

[SeaSpray]

Congrats to all those that get quick approval. Here is a sad story my dad applied he had lung cancer. well the day we buried him my mom got a letter from NYS stating that his illness was not life threatening and he was denied...
hopefully they learned something and this kind of thing does not happen to another person.

I'm really sorry to hear that. I know that I have read on the socialsecurity.gov web site that for certain illnesses there is no longer a waiting period involved.

I think that my DS got a "quick" approval because everything that he has gone through during the last 2 1/2 years has been documented by hospitals, several doctors, etc. Also, since 2008 he has been under a doctor's care and seeing them very regularly, to this day.

We didn't realize it at the time, but Social Security says that he actually became disabled, according to their policies, in September 2008. I guess theoretically he could've applied for disability long before now, but it really did not occur to him or to us to do so. But they will go back 1 year from the time he applied, so they will give him benefits back to March 2010.

Again, I'm really sorry that they took so long with your dad, and that he passed away.

 

[WheelieBigDisFan]

To my knowledge they do not use back pay when determining whether your DS is eligible for SSI. I would definitely look into receiving SSI benefits for your DS. With his Social Security he will be eligible for Medicare (maybe even right away since they determined he was disabled in 2008, although there is usually a 2 year wait from the time he is approved) and if he is eligible for SSI he can also qualify for Medicaid. Between Medicare and Medicaid he should be able to get 100% coverage for most doctors appointments, equipment, etc. and only have a small co pay for any medications required.
Medicare pays 80% of the billed amount, and without Medicaid he would be responsible for the remaining 20% co-insurance. Since I have Medicare and Medi-Cal (California Medicaid) Medi-Cal picks up the 20% co-insurance so I have no out of pocket costs for doctors visits (assuming that the doctor takes both insurances). I have seen doctors before who do not participate in Medi-Cal, and if you ask them to write off the co-insurance many times they will, or generously reduce the charges. My co-pay for a generic medication with the Medicare Part D coverage I have is $1.10 and for brand name medications it is $3.30.
Mandy

 

[SeaSpray]

Hi Mandy:

Well today in the mail there was a letter telling DS that he'll be getting SSI. So again I called the 800# and they said that he will NOT be getting SSI, he'll only be getting SSDI. The person said that new letters will be arriving in the mail. I just want to make sure that they don't send us any money in error that we'll have to send back.

Fortunately right now DS is still covered under our medical insurance through DH's work. From what I understand, the new laws state that he can be covered until he's 26 years old. (He's 23 now). At that point, he'll either be eligible for Medicare, OR maybe he'll progress to the point where he can work and get his own benefits. Also, here in Massachusetts there is something called "MassHealth" for people without traditional medical benefits.

 

[unique123]

Thanks, Sue. The person at the SS office said last Friday that they'd be depositing April and May's payments this coming week. She said that the "back payments" could go back to when my son became "disabled" which they determined to be April 2008.

I've never had any dealings at all with Social Security, so I'm just surprised at how quickly this is being handled. I did not expect for him to even hear anything from SS until the end of the summer, let alone get payments already.

How old is your DS that they need to review whether he still has autism or not?? My younger DS20 has mild Asperger's (he's never really needed assistance, so we've never filed anything for him) and honestly, I don't see this as something that he'll outgrow, since he's had these tendencies since he was a toddler.

. sooo sorry I don't know where to post
hello everyone I new, first I must say this site is so helpful, here is question: got bench approval, receive so may confusing letters within 2 weeks after approval, went to SS office to bring documents and she sign me up for direct express card.the lady said I might not get Ssi BC of wife income, but I will get back payments, and that was a month and 2 days ago she told me that, on Aug 3, I receive first ssdi payment or 1000, my first payment,, I check status of direct express which I sigh up for a month ago its said sent out July 2, but since I waited a moth to get the card will back payment be on there?? I did receive award letter last moth also with all payments and back payments info on the letter