An Introduction to Social Security Disability Insurance (SSDI) SSDI pays cash benefits to persons with severe disabilities who have worked and paid Social Security taxes for a specified period of time. SSDI also provides benefits for family members.

Tips:

>Understand SSDI's Links to Other Programs
>Know Your Client Will Have a Five-Month Waiting Period
>Understand the Distinction Between SSI and SSDI
>Rehabilitation and Employment Services Are Available
>Begin Documenting Your Client's Inability to Work Immediately
>Understand the Definition of Disability
>Get to Know the Disability Benefits Application Form
>Create a Detailed List of Your Client's Disability
>Have Your Client Take the Disability Check List to SSA When Applying
>Help Your Client File an Appeal
>Make Sure Your Client Signs the Authorization to Disclose Information When Applying
>Assist with the Collection of Medical Records
>Become Your Client's Representative
>Make Sure Your Client Signs a Release of Information
>Find Out the Name of the Disability Examiner
>Act as a Point of Contact for the Disability Examiner
>Make Sure Your Client Attends the Consultative Examination if Scheduled
>Provide Functional Information to Determine Disability
>Become Your Client's Representative Payee

For more detailed information on SSDI, scroll down.

Understand SSDI's Links to Other Programs
SSDI provides a link to Medicare, which is a Federal health insurance program. Your client will be able to benefit from Medicare after approximately two years of receiving SSDI's monthly benefits.

Know Your Client Will Have a Five-Month Waiting Period
There is a five-month waiting period to receive SSDI benefits to permit most temporary disabilities to be corrected or for your client to show signs of recovery and to ensure that SSDI benefits are provided only to clients with long-term disabilities.

Understand the Distinction Between SSI and SSDI
SSI and SSDI have the same disability requirement, but are different in other respects. Your clients who are homeless may be eligible for one or both programs if they have a physical or mental problem that that keeps them from working and is expected to last at least one year or result in death and if they are blind or at least 65 years old. To qualify for SSDI, your client also must have worked and paid Social Security taxes. The SSI program has no specific work requirements, but your clients must meet the income and resource limits to qualify for SSI payments.

Rehabilitation and Employment Services Are Available
The Ticket to Work program provides SSI and SSDI beneficiaries a "ticket" that may be used to obtain rehabilitation and employment services from either public or private service providers in their communities. For more information about this program, visit www.socialsecurity.gov/pubs/10060.html.

Begin Documenting Your Client's Inability to Work Immediately
The most critical thing you can do as a case manager is to immediately begin documenting your client's inability to do work. If you believe your client has a disability that will prevent him/her from working for at least 12 months or longer, start case notes with observations related to the disability, (e.g., Mr. X has significant difficulty staying focused on tasks at hand). In addition to your own case notes about your client, you should seek independent medical verification as soon as possible.

Understanding the Definition of Disability
The definition of disability is very strict. The lack of proper medical documentation, the complexity of the process, or the applicant's inability or unwillingness to go through the disability determination process can result in the denial of benefits. Patience is required to succeed in receiving SSI or SSDI benefits.

Get to Know the Disability Benefits Application Form
You should become familiar with the various disability application forms and assist your client in completing these forms. Incomplete or inaccurate application information may lead to incomplete or inaccurate decisions. Many individuals with mental impairments, for example, fail to mention these when they apply because they fear the stigma, or have cognitive disorders and poor recall. Ensuring that the application is complete and accurate may contribute to a more efficient process.

Create a Detailed List of Your Client's Disability
If you are unable to accompany your client who is homeless to SSA, you should sit down with your client prior to the interview and make a list of all prior treatment sources and approximate dates.

Have Your Client Take the Disability Check List to SSA When Applying
If you are unable to complete SSA's "Disability Report for Adults" (Form SSA-3368) with your client, then he/she should bring the detailed list of his/her disability that you created together to the interview appointment at SSA. Your client can use this detailed list to complete the "Disability Report for Adults" form required in the application process. You should make and keep copies of any forms/information your client provides to SSA. This can be used as a reference for assisting with information collection and can be sent in if the original is misplaced.

Help Your Client File An Appeal
If your client's application is denied, he/she can appeal. You should make sure that the time deadlines are met, that any new available information is requested and sent, and that copies of all appeal requests and additional letters are kept.

Make Sure Your Client Signs the Authorization to Disclose Information When Applying
SSA will ask your client to sign an Authorization to Disclose Information when he/she applies for benefits. Make sure your client understands that the signed authorization is necessary to obtain proof of his/her disability.

Assist with the Collection of Medical Records
You can assist in the medical records collection by alerting agencies that provide services to your client that he/she is applying for benefits. Let these agencies know what information from the chart should be sent to the Disability Determination Services (DDS) including any and all evaluative information, as well as progress notes if the treatment is ongoing.

Become Your Client's Representative
By being your client's representative, you can assist your client with the application process, provide information to SSA for your client's application, receive information from SSA about your client's application, and review the SSA DDS file if your client is denied so that you can help him/her prepare a more effective appeal. For you to be his/her representative, your client fills out the SSA-1696 form, Appointment of Representative. This is not the same as being your client's representative payee.

Make Sure Your Client Signs a Release of Information
If you are not your client's representative, then you should have your client sign a Release of Information form to be turned in when he/she applies. This form allows SSA to provide you with information regarding your client's application. It is important that you are aware of the new Health Insurance Portability and Accountability Act of 1996 (HIPAA) rules, which can be found at www.hhs.gov/ocr/hipaa/, regarding the sharing of information and ensure that this is addressed so that the totality of information is included.

Find Out the Name of the Disability Examiner
Approximately two weeks after the application has been submitted, you should contact your local DDS office and find out who is the Disability Examiner for your client. The Disability Examiner makes the initial disability determination based solely on the written information provided and never meets your client. The better you can help your client create a picture of his/her disabling condition(s), the more successful the process will be.

Act as a Point of Contact for the Disability Examiner
You should call and provide the Disability Examiner with your name and phone number as a contact for information for your client, even if you are not your client's representative. If you are not your client's representative, it is still helpful to create a relationship with the claims examiner so you can assist with the process as needed. You should contact the Disability Examiner periodically to find out whether additional information is needed or if there are any questions you can answer.

Make Sure Your Client Attends the Consultative Examination if Scheduled
Sometimes the Disability Examiner may schedule your client for a consultative examination if additional information is needed. Your client's treating physician is the preferred source to do this examination, but sometimes the examination may be done by one of the consulting physicians or psychologists for Disability Determination Services (DDS).

Provide Functional Information to Determine Disability
Your client's disability will be determined based upon his/her diagnosis or illness, the length of time he/she has had the diagnosis or illness, and perhaps most importantly, his/her ability to function independently as a result of the diagnosis or illness. As a case manager, it is important for you to document your client's level of functioning through behavioral observations and provide details about this ability. For example, you cannot say that your client has a difficult time getting out of bed in the morning. Rather you must show, for instance, that your client feels so depressed and has so little energy and motivation that, at least three days a week, he/she does not even get out of bed. This documentation should be written as soon as possible after your client's application is filed, given the fact that DDS has time pressures within which to make disability determinations. This documentation should be presented in a letter co-signed by a physician or a psychologist. Be sure to keep a copy!

Become Your Client's Representative Payee
Once your client is approved to receive benefits, he/she may need a representative payee to manage his/her benefits. You should consider developing a representative payee program, as this is an extremely critical need. Click here for more information about Becoming Your Client's Representive.

> More information on Social Security Disability Insurance:

Benefits Your Client May Receive
What Makes Your Client Eligible
What Your Client Needs to Apply
If Your Client is an Immigrant
Contact Information
Sample Application
Training Materials for Case Managers
SSDI Program Q & A
SSDI Fact Sheet