disabled person holding railing

What Is Presumptive Disability for SSI Benefits?

The process for applying for SSI benefits can be lengthy in and of itself. Gathering the necessary documentation and properly filling out all of the forms can feel like an endless task. Once you have completed your application, however, the wait time can also be extensive. It is not uncommon for the Social Security Administration to take several months to process an SSI disability benefits application. Meanwhile, applicants are left financially struggling as they wait on word of their status for qualifying for these much-needed benefits. SSI is, after all, a program designed for disabled individuals and other qualifying individuals who have low enough incomes to be granted benefits under this need-based program. The good news may be that certain medical conditions may qualify an applicant for advance payments while their application is pending. These are referred to as presumptive disability (PD) benefits.

What Is Presumptive Disability for SSI Benefits?

When an applicant for SSI benefits has a certain qualifying medical benefit and seems more likely than not to be approved for SSI benefits, he or she may be granted presumptive disability benefits which are advance payments made while the official decision on the application is being made. These payments can go on for up to 6 months and usually do not have to be repaid. Even when an applicant who receives presumptive disability benefits ends up being found not medically qualified to receive SSI benefits, it is not usually required that he or she repay the presumptive disability benefits.

A determination that an applicant should be awarded presumptive disability benefits is made based on the severity of the impairment claimed as well as the strength of the medical evidence provided in the disability benefits application. Certain conditions that often merit presumptive disability benefits include:

  • Amyotrophic lateral sclerosis (ALS), commonly referred to as Lou Gehrig’s disease
  • Cerebral palsy
  • Spinal cord injury that requires the use of a walker or similar mobility assistance
  • Terminal illness with a less than six months life expectancy
  • Total blindness
  • Total deafness

In order to receive presumptive disability benefits, there is no need to file a separate application. The determination will be made right from your SSI application filing. Once your application is filed, the initial review will be conducted by a Social Security Administration field office and it is this office that will usually make the presumptive disability benefits determination. Disability Determination Services (DDS), however, are ultimately responsible for either approving or denying disability claims and are also empowered to render decisions on presumptive disability benefits. While field offices are usually limited to granting presumptive disability benefits to applicants with conditions such as those listed above, DDS is granted broader discretion and can award such benefits to applicants with other conditions or impairments. 

Presumptive disability benefits will cease once the SSA has rendered a decision on your SSI application or in six months, whichever comes sooner.

Disability Attorney

If you have disability benefits questions, Roeschke Law is here to help. Contact us today.