By Marian Bland, Margaret Flanagan and Caroline Bolas

1. ASSISTING CLIENTS THROUGH THE SSI/SSDI APPLICATION PROCESS HOME Conference September 16, 2010 Presented By: Marian V. Bland, LCSW-C Margaret Flanagan, MSW Caroline Bolas, MSW, MS

3. WELCOME and INTRODUCTIONS Please tell us : Your Name Work Location and Role One sentence about your experience with completing SSI/SSDI applications

20. Two Brothers Video

21. The Disability Programs

22. Social Security Disability Insurance (SSDI) Supplemental Security Income (SSI) I - 3 Federal disability program, administered by SSA, that provides benefits to blind or disabled individuals who are “insured” based on contributions paid into the Social Security trust fund, as authorized by the Federal Insurance Contributions Act (FICA) Federal disability program, administered by SSA, that provides benefits to low income people who are disabled, blind, or elderly

23. Disability Impairments must affect a person’s ability to work. “ inability to engage in any substantial gainful activity (SGA)…”

24. A Brief History of SSA Disability Programs 1935 - Law establishes Social Security 1937 - Benefit payments for retirement begin 1942 - Monthly payments begin 1956 - SSDI signed into law 1965 - Medicare established, officially begins on July 1, 1966 1972 - SSI is established

26. SSA– The Differences between SSI and SSDI Supplemental Security Income (SSI) Social Security Disability Insurance (SSDI) Benefit for disabled, elderly, and blind individuals who have very low income Benefit for insured individuals (or certain relatives) Benefit amount is the Federal Benefit Rate (FBR), plus available State supplement Benefit amount based on FICA contributions Limits on assets/resources No limits on assets/resources Living arrangement may affect benefit amount and eligibility Living arrangement has no effect on benefit amount or eligibility Medicaid eligibility usually comes with SSI Medicare eligibility usually comes after two years of SSDI benefits Eligibility usually begins the 1 st of the full month following the date of application Eligibility generally dependent on date of onset of disability Work incentives usually apply immediately after work begins Work incentives allow for 9-month Trial Work Period (TWP) during which full benefits are received

27. The Application Process Non-Medical and Medical Information and Eligibility Criteria

28. The Application Process Individual files application SSA determines non-medical eligibility SSA sends medical information and releases to DDS, where a disability examiner is assigned DDS processes claim and makes disability determination Applicant’s folder is returned to initiating SSA office SSA notifies applicant of decision by letter Individual establishes protective filing date III - 2

29. Social Security Administration SSA Disability Determination Services DDS

32. 6 Steps to Completion Receive referral for individual Conduct initial meeting Call SSA for appointment (establish protective filing date) Accompany applicant to appointment at SSA, if possible Complete evaluation and assessment Complete and file Medical Summary Report Maintain contact with clinical treatment team Gather information Track dates info sent and received Track responses III - 8

34. SSA-8000 Application (for SSI) ISBA Internet Social Security Benefits Application (preferred method) SSA-16 Paper Application (for SSDI) SSA-1696 Appointment of Representative (supplemental form) SSA Application Forms – Non-Medical

35. Medical Information Individual files application SSA determines non-medical eligibility Applicant’s folder is returned to initiating SSA office SSA notifies applicant of decision by letter SSA sends medical information and releases to DDS, disability examiner is assigned DDS processes claim and makes disability determination SSA-3368 Disability Report SSA-3369 Work History Report (can be included in Medical Summary Report) SSA-827 Authorization to Disclose Information to SSA (can be completed online)

38. IV - 9

39. SSA-3368 Disability Report

44. Areas of Functional Information I II III IV Marked restrictions of activities of daily living Marked difficulties in maintaining social functioning Marked difficulties in maintaining concentration, persistence, and pace (as they relate to the ability to complete tasks) Repeated episodes of decompensation (each of extended duration)

45. Sequential Evaluation Step 2 – Does person have a severe impairment? Step 3 – Does impairment meet or equal the listing requirements? Step 4 – Does impairment allow for past relevant work to be done? Step 5 – Can person do any other work, considering age, education, work history? Impairment does not meet or equal the listing requirements. Impairment meets or equals the listing requirements. Person can do past work. Person cannot do past work. Yes No Denied Denied Denied Denied Approved Approved Step 1 – Is person working? Person is not working or is working at less than SGA level. Person has no severe impairment. Person has severe impairment. Person is working at SGA level.

49. Collecting the Medical Evidence

55. The New and Improved Process

61. Interviewing and Assessing

62. Helping the Interview Process History Environment Language Process

66. VIDEO (Mental Health History)

67. Questions 1. What were some general strategies used by the interviewer? 2. Were there specific phrases that struck them as useful that might fit with your style?

68. Functional Information

69. ? DDS’s Main Question Does this illness (or illnesses) keep the person in question from being able to engage in substantial gainful activity?

70. The Assessment Process Meet and begin to engage new person Obtain history, observe behavior Obtain information from collateral sources Discuss observations with supervisor and other clinicians Continue to add information to assessment Conclude whether severe impairment causes functional limitations and disability

71. Areas of Functional Information I II III IV Marked restrictions of activities of daily living Marked difficulties in maintaining social functioning Marked difficulties in maintaining concentration, persistence, and pace (as they relate to the ability to complete tasks) Repeated episodes of decompensation (each of extended duration)

73. Functional Descriptions

78. Medical Summary Report

90. SSI/SSDI Work Incentives Incentive Program SSDI SSI Income Exclusion  Trial Work Period (TWP)  Impairment-Related Work Expenses (IRWEs)   Extended Period of Eligibility (EPE)  Plan to Achieve Self-Support (PASS)  Subsidy 

101. Presenters’ Contact Information Marian V. Bland, LCSW-C Director, Office of Special Needs Populations, Mental Hygiene Administration (410) 724-3242 Email [email_address] Margaret Flanagan, MSW Baltimore City SOAR Project Manager Health Care for the Homeless (410) 703 1347 Email: [email_address] Caroline Bolas, MSW, MS Data and Evaluation Consultant Office of Special Needs Populations, Mental Hygiene Administration (410) 724 3210 ext. 2176 Email: bolasc @ dhmh.state.md.us