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What is Presumptive Disability in SSDI Claims and How Does it Work?

What is Presumptive Disability in SSDI Claims and How Does it Work?

For those who have few assets, a low income and are disabled or blind, Social Security Income is a benefit paid monthly that can help pay the bills. To qualify as disabled, you must have a medical condition that prevents you from supporting yourself financially. Unfortunately, the process of obtaining disability payments can be long and sometimes complicated. This means that if you become disabled, it may be a long time before you would begin receiving the monthly payments. Yet, for those with certain disabilities, there may be the possibility of obtaining your benefits faster through Presumptive Disability payments, which can be paid up to six months while waiting for a claim to be approved. 

What Is Presumptive Disability?

A Presumptive Disability payment is ultimately a payment that is designed to provide you with the support you need while the Social Security Administration works to process your claim. To qualify for Presumptive Disability, there must be sufficient evidence that a disability claim will most likely be approved once all of the evidence-gathering processes have been completed. You must also fall into the required income limits as well, which will include all household income and assets. 

Conditions That Might Qualify Your for Presumptive Disability Payments

To possibly qualify for Presumptive Disability, you must first be diagnosed with a condition that has such severe impairment that it would be easy for the SSA to make the assumption that the result would be total disability. Some of the conditions that may qualify your for SSI payments under Presumptive Disability include:

  • AIDS or an HIV infection where you are showing symptoms
  • Complete blindness
  • Complete deafness
  • Amputation as long as it involves two limbs or a leg that has been amputated at the hip
  • A spinal cord injury that results in the inability to walk without the assistance of a device such as a walker or a wheelchair
  • A stroke that has occurred three months ago or longer and you are still having difficulties using an arm or hand, or walking
  • Muscular conditions that result in severe muscle atrophy leading to complications walking, speaking, or using hands, such as cerebral palsy or muscular dystrophy
  • End-stage renal failure that requires constant dialysis treatments
  • Amyotrophic Lateral Sclerosis
  • Low birth weight
  • A severe intellectual disability in an individual older than the age of seven
  • Confinement to a bed with the requires use of a wheelchair, crutches, or walker to be able to move
  • Terminal illnesses where you are expected to live less than six months and require hospice care

How to Apply for Presumptive Disability

You apply for Presumptive Disability payments at the same time you file your SSI paperwork with the Social Security Administration. They will review the condition, and for certain conditions, they may be able to make a determination for presumptive disability right at the field office. Most likely, in these cases, they will need to get some preliminary information before making a decision, such as information from a social worker, physician, or school staff who can attest to the condition or diagnosis. 

When cases cannot be made in the field office, they will be forwarded on to the Disability Determination Services. It is this office that will ultimately render all SSI Disability decisions. They also have the ability not only to make determinations on Presumptive Disability for the above-mentioned conditions but also ones that are not listed but may still qualify. 

If you qualify for Presumptive Disability payments after the review is complete, you will begin receiving your SSI payments while you are waiting for your application to be completely processed. There is also the chance that the determination may come back, not allowing you to receive cash payments until your application is completed, but allowing you access to Medicaid during the time. 

If you have a disability claim that has been denied and you have appealed the decision, you will not be able to request Presumptive Disability. All requests for Presumptive Diasbilait must occur at the initial stage of your Social Security Disability claim. If you do start receiving cash benefits, they will come for up to six months or the completion of your application and the rendering of the SSA’s decision, whichever comes first. It is important to note that if the Social Security Administration has not yet made a decision within the six month time frame, the Presumptive Disability payments will stop 

How Much Might You Receive From Presumptive Disability?

How much of a Presumtpvive Disability payment you are entitled to will largely depend on the amounts of both your household assets as well as all the income going into the household. It is important to understand that SSI is based on need. So even if you have a valid claim for disability pending application with the SSA, if your household income does not meet the income requirements, you will not be able to receive any Presumptive Disability payments and will have to wait until your claim is finalized. 

When it comes to how much you will receive with your Presumptive Disability case, most often, it will be equal to the amount of SSI you would receive when the application is approved. The range for SSI benefits in 2020 is between $800 and $1800 per month, with the average being around $1,258.

What to Expect if Your Claim is Denied

Even though you wouldn’t be granted Presumptive Disability unless you had a strong case for disability benefits, there is always the chance that your claim could eventually be denied. Many people are afraid to file for Presumptive Disability because they believe that they will be required to pay the funds back to SSA in the event that their disability claim comes back denied. This is not typically the case. If the case comes back denied for a medical reason, you will not be required to repay the money that you had received in Presumptive Disability payments. Yet, if your claim has been denied because of filing errors or discrepancies that were found in your household assets and income, you may be required to make repayment. Because of this, it is critically important to be completely honest about all income and assets coming into the household. 

Who Is Most Likely to Qualify for Presumptive Disability?

Not everyone who applies for disability will be eligible for Presumptive Disability payments, even if there is a strong medical case. Since Presumptive Disability is need-based, you will need to prove that your income is severely limited. Even if you are not eligible for Presumptive Disability, you may still qualify for regular disability after the application process is complete. 

Other Expedited Social Security Disability Programs Are Available

If you do not qualify for Presumptive Disability and are still in need of expedited Social Security Disability programs, there are others available. The SSA may provide Compassionate Allowances, which would help to quickly identify diseases and medical conditions that would meet Social Security’s standards, such as cancer and brain disorders. Once identified, a Compassionate Allowance may push forward the application more quickly. There are also ways to file for emergency advance payments, immediate payments, and immediate reinstatement. 

What Is an Emergency Advance Payment?

An emergency advance payment is a one-time payment as an advance on SSI payments in the event a new applicant is facing a financial emergency, and the benefits have been delayed. The most you can receive in the emergency advance payment is:

  • The SSI Federal benefit rate
  • The total amount of benefits that would have been due
  • The amount requested to cover the financial emergency.

Once regular SSI payments are being made to you, the emergency advance payment amount will be subtracted from the amount before the funds are dispersed to you. If there are no payments to you that are past due, the amount will be broken up into six monthly installments and subtracted from the monthly benefit amount. 

What Is an Immediate Payment?

Another option for an expedited payment is an immediate payment that new applicants may qualify for if their benefits are delayed, and they are facing financial issues. The payment cannot exceed $999.00 and is only available to those who have applied and are due benefits for SSI but have not yet received their payments. The money will be deducted from the first check when benefits start.

What Is Expedited Reinstatement?

If you had been receiving benefits and they ended due to earnings, you may be able to have your benefits restart without reapplying if your financial situation changes. To qualify, you will have to prove that you cannot engage in gainful activity due to the impairments that previously qualified you for benefits. You must also make the request within five years of when the original benefit ended. To facilitate your reinstatement, you will need to provide updated medical information. If the request for an expedited reinstatement is approved, you could begin receiving your SSI benefits as soon as a month after your initial request. These provisional benefits can be granted for up to six months while the case is reviewed, and if it is determined that you are not able to receive benefits again, you will not likely have to repay the benefits. 

The process of obtaining SSDI can be long and difficult, meaning you may have to wait months to obtain benefits. But if you are in a financial bind and have a good case for disability, then you can take advantage of the expedited payment options offered by the SSA, such as Presumptive Disability. Need advice on how to get your claim started? The professionals at Lilac City Law can help. Contact us today to discuss your disability case. 

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Randi L. Johnson, Lilac City Law, Estate Planning, Social Security Disability, VA Disability

Randi and her team are professional, helpful and know their stuff! I felt comfortable and cared for working with them!
Kristen Saccomanno
Kristen Saccomanno
22:59 06 Oct 20
The knowledge, compassion, and attention to detail are only a few of the reasons I love Lilac City Law. We had previously done a will that was basically fill in the blanks. Our experience at Lilac City Law was so different than our fill in the blank experience. Death isn't always easy to talk about, but it was made easier because of Randi and her staff. We were walked through the whole process, and if we had any questions, they were right there to answer them. With care and compassion. Thanks so much LCL!
Cindy Cole Vanhoff
Cindy Cole Vanhoff
22:15 06 Oct 20
I highly recommend everyone at Lilac City Law. They helped me through every step of the SSDI process. Thank you so much!!
Scott Poe
Scott Poe
00:24 02 Jul 20
I don’t know really where to start in order to cover the magnitude of professionalism, understanding, persistence and compassion Lilac City law showed me. From Randi to each one of her staff-they worked very hard on my case and pushed me to keep fighting in the midst of several set backs from disability. They were always atop of communicating with me and all others involved. I highly recommend them and not just because I received a favorable decision but because of the plan they executed; so even if the results were unfavorable-I would still not hesitate knowing I chose the right practice. Thank you for you compassion and patience😊
Joyce Kelly
Joyce Kelly
22:01 02 Jun 20
Randi serves humanity with compassion and grace in dealing with all matters of life and death. I would highly recommend her for all the services she offers.
Sarah Boban
Sarah Boban
20:14 16 Apr 20
I wholeheartedly recommend these people. I had a crazy case and at times I was a mess. My team, Randy, Pam, David, and, Marissa always treated me with kindness and compassion. Thank you guys so much for the huge difference you've made in my life.
Jenni Boo
Jenni Boo
23:24 12 Mar 20
I had my hearing yesterday for Social Security Disability. I was very nervous , but we won my case. Randy and the whole team at Lilac Law was very supportive and understanding! They truly want to help people win the benefits they deserve and I highly recommend them!
Tiffani Pelella
Tiffani Pelella
17:38 03 Mar 20
Initial meeting with David Morris went well. He treated me with respect and understanding. I felt that I was listened to. Even accommodated me when I arrived 1 hour early. Highly recommended.
Tom Richardson
Tom Richardson
18:09 06 Feb 20
The staff is so great, it was really great to work with them all, and they were able to help me tremendously! Thank you for a great experience!
Becki Lynn
Becki Lynn
23:43 28 Jan 20
Don't remember exactly when I first met with them, but they were absolutely amazing to work with and only took a few months for my disability claim to be approved.I highly recommend Lilac City Law.
Matt Napora
Matt Napora
17:46 06 Jan 20
Everyone needs to take care of their estate and make sure their family is well taken care of. Randi and her team will take very good care of you and protect you and your family’s future. You cannot go wrong using their services. Client service is their top priority!
Kim Benjamin
Kim Benjamin
21:52 02 Nov 19
Randi is a terrific lawyer and a terrific person. I wish we lived closer so that we could work with clients together more often.
Meghan Freed
Meghan Freed
17:31 02 Nov 19
They really CARE about their clients and work with passion! Highly recommend!!!
Jamile Moraes Pellicer
Jamile Moraes Pellicer
00:36 30 Oct 19
Randi and her team are knowledgeable, compassionate, and very helpful with their clients. I highly recommend Lilac City Law!
Connie Kaplan
Connie Kaplan
18:36 29 Oct 19
Excellent firm. They really care about their clients. You cannot go wrong with Randi and her team.
John Nachlinger
John Nachlinger
12:27 18 Oct 19
What a great place! Thanks again!
S Binks
S Binks
22:39 01 Oct 19
Randi and her Team helped me through my disability claim and they were there through every question I had. Great Customer Service! Timely returned calls and emails, very knowledgeable and helpful the entire time and even afterwards! Will definitely be working with Randi and her Team in the future!
Ronda Wheatley Ives
Ronda Wheatley Ives
17:02 21 Aug 19
Wow, these guys were so nice and easy to work with. It ended up that they couldn’t help us with what we needed, but the gentleman we worked with went above and beyond my expectations, and more. I could tell that they really care about people there, not just cases. He was super patient in explaining things to me when I didn’t understand, it wasn’t a stressful experience as I thought it would be. Thanks for everything guys!
Melanie S
Melanie S
06:09 21 Aug 19
Lilac City Law is an incredible firm! I had the pleasure of working with the amazing team at Lilac City Law for nearly 2 years. Their team is absolutely remarkable! They are extremely knowledgeable, helpful, and overall compassionate when it comes to working with their clients. I sought their assistance nearly 2 years ago and have continued to work with them. I had a great deal of interaction with more than just one member of the Lilac City Law team and therefore can attest to the fact that this group of individuals is absolutely unparalleled. Attorney, Randi Johnson, is an exceptionally skilled lawyer as well as an overall remarkable woman! Her support staff is incredible as well, including Cassandra, Pam, Marissa, David, etc. with all of them by your side you have been blessed and are going to receive the best results possible. I would absolutely recommend seeking assistance from this law firm, as they have the ability to change lives; they definitely did mine. Thank you all so, so much!
Torrey Tolmie
Torrey Tolmie
17:03 22 May 19
Lilac City Law went above and beyond to help my partner get her SSI. My partner had been trying to win for 12 years and finally won. We can't say thank you enough. Thank You Randi and team for all you have done.
Malick Darian White
Malick Darian White
21:33 29 Apr 19
Randi and team are amazing! We previously had our will and other documents prepared by another firm in the Seattle area where we are from. I met with Randi to update areas of my trust and was soooooo impressed with how much more she provides than the firm who first helped me. I love the short term care directive that she provides and think it is amazingly thoughtful!! Thank you so much Randi Johnson!!
Noah Gross
Noah Gross
17:36 01 Feb 19
I had a great experience with Randi and her team this past year when we worked with them to create our first-ever wills and trust. Planning for your untimely death and discussing personal finances aren't always fun topics, but we were appreciative of Randi's approach to these potentially uncomfortable conversations and especially liked the recorded legacy interview she conducted with us. Total 5-star experience!
Tine Reese
Tine Reese
20:39 30 Jan 19
I had a great experience with Randi and her team this past year when we worked with them to create our first-ever wills and trust. Planning for your untimely death and discussing personal finances aren't always fun topics, but we were appreciative of Randi's approach to these potentially uncomfortable conversations and especially liked the recorded legacy interview she conducted with us. Total 5-star experience!
Tine Reese
Tine Reese
20:37 30 Jan 19
My husband and I worked with Randi and her team to complete our last will and testament, advanced directive, and health care proxy in the summer of 2018. Randi, and her team, as well as David Morris, were exceptionally kind, very professional, and thorough. We had several meetings to go through the important stuff - the financial info, heirlooms, and disposition of my husband's motorcycle. At each meeting, Randi and her team listened to our intentions and concerns. At the signing ceremony, we got a huge binder with our info and a data stick for safekeeping. Included in our will is a review which will take place every other year. We also got a document which states who can take our children to give our babysitter in case something bad happens to us when we were out. I'm very satisfied with Lilac City Law, and their work. I would recommend them without qualification to anyone.
Anna Marie Martin
Anna Marie Martin
23:52 29 Jan 19
Parents are so intentional about so many aspects of their children's lives. Few will forgo putting together a will. But, what if you don't die? What if you are just incapacitated? Are you prepared for the unexpected? Are you leaving your children at risk? If someone else does raise them, do you know that they will be raised according to your wishes? Have you even thought through what your wishes are? All these questions and more will be covered in the process of completing a Family Protection Plan with Randi Johnson at Lilac City Law. Having our Family Protection Plan in place gives me an incredible sense of comfort and peace of mind. I highly recommend Randi and the staff at Lilac City Law. Hopefully you never need her services, but isn't it better to be prepared than to leave things to chance?
Marchauna Rodgers
Marchauna Rodgers
03:16 22 Jan 19
My Husband and I were fortunate to work with Randi on his disability case-she mindfully guided us through that process -we were so pleased with the results that Lilac City Law was of course our choice to have when producing our family trust. Again a very professional, heartfelt experience that made what seems to be a difficult process very easy thanks to Randi and her staff. We always recommend Randi to our community of friends and family. Pat and Patty Murphy
Patty Murphy
Patty Murphy
20:05 12 Jan 19
I became ill over two years ago now,at the age of 29.. I experienced seizure like movements that lasted for hours or even days at a time. The doctors were at a loss for a diagnosis so they called it a mental disorder. As I was unable to care for myself most days or work, I applied for social security and was denied. I sought the help of Lilac City Law, and was immediately greeted with compassion and action. My case was a hard one to win or prove. Amy Santa helped me and explained everything to me step by step.. She ALWAYS answered my questions and showed immense sympathy for all I was going through. My case went to trial and Amy was amazing in court and won me the benefits I so desperately needed. This process was so difficult and overwhelming on my own.. I couldn’t have done it without these amazing people and thanks to them I can focus on improving my health,and not worry about my family struggling. I’m thankful and very blessed to have had them on my side! Sincerely, Ashley Schauble
Ashley Baldwin
Ashley Baldwin
01:33 11 Jan 19
Lilac City Law did an amazing job with my estate plan, which was something I had 'thought' about doing for a long time, but avoided... Fortunately, Randi and her team made the process very easy and approachable. I now feel relief knowing everything is in order for my two daughters in the (hopefully unlikely!) event something were to happen to me. Thank you Lilac City Law for helping me sleep better at night! :)
Amber McKenzie
Amber McKenzie
03:30 09 Jan 19
This has been an awesome experience from beginning to end. Randi and her team were super helpful in helping us wrestle through all the aspects of our estate plan. Randi’s knowledge of estate and wills were very obvious from the beginning and we are thankful for her and her staffs expertise. Thank you so much!
Kevin Bunce
Kevin Bunce
17:22 12 Dec 18
This firm is the go-to for family planning and protection your children. Randi and her team are excellent!
Melinda Grimaldi
Melinda Grimaldi
01:49 20 Nov 18
I needed to get my husband's advanced health directive for a procedure he was having and it was so easy to find in our perfectly tabbed out legal binder. I found it right away, made a copy and stored it right back in the binder. Thanks for making us get it, and for making it easy to find and understand.
Jessica Gruver Koefod
Jessica Gruver Koefod
19:40 12 Oct 18
I highly recommend this law firm. They have the experience and skills to help people with their plans and their future. From their work with others, they take a pragmatic approach to law and don't over complicate things unnecessarily. With that said, if a matter is complex they are very capable of handling it.
Christine Matus
Christine Matus
09:29 05 Sep 18
Randi demonstrates a beautiful balance of expertise and compassion while dealing with difficult circumstances. I'm very thankful we had her in our corner! I can't reccomend her strongly enough.
Darin Pike
Darin Pike
16:47 25 Jul 18
Randi and her staff are the best! They help you with your case and are there if you have any questions.I highly recommend them!
Tammy Reedy
Tammy Reedy
21:56 18 Jul 18
Randi did a wonderful job of asking simple questions to help us determine exactly what type of trust we needed to match our goals. Thank you so much, Randi, for taking time out of your busy schedule to get us were we need to be!
Michelle Darnell
Michelle Darnell
02:52 17 Jun 18
Such a great meeting today with Randi. Tell me who wants to talk about wills and final arrangements, right? Well, my husband and I did this today and Randi, you made it easier than we expected. What a blessing to work with such talent and know you have our backs. Between you and Cary Wong. We will be sitting pretty, no matter what life brings us. THANK YOU!
Missy Schaaf
Missy Schaaf
01:20 31 Mar 18
Vincent Adolph
Vincent Adolph
13:30 26 Feb 18
Randi and her staff are great to work with - no surprises, and she made it all so easy. Now we have a will and health directives, so our children won't be burdened when the time comes. I highly recommend!
Sharon Robertson
Sharon Robertson
18:04 05 Feb 18
Randi and her team do amazing work. Thank you very much for what you do.
Erin Whitney-Neher
Erin Whitney-Neher
20:18 23 Jan 18
Randi are her staff are amazing! They are all very knowledgable, helpful and passionate about serving others. Every step of services are explained clearly and follow-up exceeded expectations. In addition, Randi is active in the community and regularly volunteers her time and talents putting on presentations focusing on educating others on specific topics. She has a passion for assisting those with special needs or situations. For legal assistance with heart, Lilac City Law is highly recommended!
Nadine Burgess
Nadine Burgess
18:14 25 Apr 17
Excellent staff. Very knowledgeable and go out of their way to get the job done! Would recommend to anyone looking for services they offer!
Jason Spade
Jason Spade
02:17 19 Oct 16
Randi was an excellent attorney. Her staff was excellent as well. I was treated with kindness, compassion and dedication towards winning my complex and difficult case, which ultimately happened. I am very happy that I chose Lilac City Law to represent me. I would highly recommend them!!!
Richard D. Seibert
Richard D. Seibert
15:56 03 Oct 16
Melanie Jason Carter
Melanie Jason Carter
06:46 01 Sep 16
Mia Martinez-Bermudez
Mia Martinez-Bermudez
04:22 30 Jul 16

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