Presumptive Disability Benefits

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How to Get Presumptive Disability Benefits?

A disabled person does not need to apply for presumptive disability payments separately from when they seek traditional benefits. An individual who is filing for Supplemental Security Income (SSI) with the Social Security Administration (SSA) will be considered to have applied for presumptive disability benefits, as well.

The Social Security field office will review all applications and then decide whether to award benefits to each individual. Disability Determination Services (DDS) and the state-level agencies responsible for administering benefits also can play a role in denying or approving applicants’ disability claims.

The SSA will award benefits only if a person meets all of the established requirements for disability. However, DDS has the flexibility to offer presumptive disability benefits, which include other impairments, as well. 

Presumptive DisabilityWhen the SSA considers an individual’s initial application for SSI assistance, potential payments for that person’s presumptive disability will be decided, too. However, a person seeking benefits would not receive these types of benefits when their case is on appeal. 

People who face disabilities may experience dire immediate financial need, which can include medical crises or imminent homelessness. People in this type of situation may be eligible to receive a one-time emergency advance payment from the SSA. This can occur when the person initially files for SSI benefits, within a period of 30 days. The money may be provided in installments or in a lump-sum payment, whichever is more convenient for the recipient.

What Is Presumptive Disability?

It can take many months for the SSA to process an individual’s disability application for SSI. For qualified applicants, the SSA offers monthly benefits for older people and disabled individuals who have low incomes and limited financial means. Applicants who are suffering from specified medical conditions may be eligible to collect advance payments while the decision is still pending with the SSA. 

The benefits designed for presumptive disability (PD) have been fundamentally structured to provide financial support to people for whom the SSA has approved to receive SSI benefits. This approval is based on the information and documentation that the applicant provided within their application. 

The payments could extend for up to six months, and a recipient would not have to repay the benefits received if the agency decides that the person does not meet the medical qualifications to receive the SSI disability benefits.

SSA presumptive disability benefits are designed to provide monetary help for people whom the SSA highly recommends gain approval for SSI benefits based on the facts and information that those individuals have provided within their applications for disability benefits.

Disabilities that Qualify for Presumptive Disability Benefits

The agency will base its decision regarding an individual’s presumptive disability on the type of condition they have, the impairment’s severity, and any medical evidence that the person provides within their initial application for disability benefits. This is why it can be valuable to consult with a knowledgeable attorney who has decades of experience handling disability matters that are similar to yours.

In many cases, a person or their legal representative may file a claim for SSI benefits that involves one or more of the following conditions:

  • Amputation of a leg at the hip
  • HIV or AIDS
  • Amyotrophic lateral sclerosis (ALS), which is also referred to as Lou Gehrig’s disease
  • Complete blindness
  • Complete deafness
  • Cerebral palsy
  • Muscular dystrophy 
  • Confinement to bed or immobility without crutches 
  • Down syndrome
  • Intellectual disability
  • Low birth weight in children younger than 1 year old
  • End-stage renal disease
  • Neurodevelopmental disorders, including autism, which may involve limitations in eating, dressing, or self-care activities
  • Spinal cord injuries that result in an inability to move without any apparatus or walker
  • Strokes, which can cause difficulty in walking or difficulty in using one’s hands or arms
  • A life expectancy of less than 6 months as a result of the individual’s condition

What Are the Criteria for a Low-Weight Baby to Qualify for Presumptive Disability?

Applying for SSI presumptive disability is often a complicated process that takes months for a person to receive an approval or denial of the claim. Babies who are born at a low birth weight are eligible for presumptive disability whether the baby was premature or not. For a low-weight baby whose legal guardians seek to qualify for presumptive disability, the baby must be six months old or younger and weigh:

  • 2,000 grams or 4 pounds and 6 ounces, when the born was born at 37 weeks or later 
  • 1,875 grams or 4 pounds and 2 ounces, when the child was born at 36 weeks
  • 1,700 grams or 3 pounds and 12 ounces, when the baby was born at 35 weeks 
  • 1,500 grams or 3 pounds and 5 ounces, for a baby who was born at 34 weeks 
  • 1,325 grams or 2 pounds and 15 ounces, when a child was born at 33 weeks
  • 1,200 grams or 2 pounds and 10 ounces, if a baby was born before 33 weeks of gestation

If any child meets the above-stated weight thresholds, then they will be eligible to receive SSI payments for six months, until their official disability benefits application is formally decided. The baby will also be able to access free medical care provided by Medicaid. An SSA representative will generally confirm the baby’s birth weight by contacting the doctor or the hospital where the baby was born before awarding the benefits for the presumptive disorder. 

People who have presumptive disabilities can apply for Medicaid if they are not applying for SSI. If you have a unique need that requires that the overall process of decision-making be sped up, there may be various options for you to expedite your claim. 

Compassionate allowances are designed for people who have been diagnosed with certain types of aggressive cancers and other similar conditions. The terminal illness program has been designed to benefit those individuals who are suffering from a terminal illness or people who are hospitalized. There is a quick disability determination program that is designed to help determine different disability cases by using a software program.

It can be a good idea to contact a Florida disability lawyer who is well-versed with the laws that govern disability benefits and has experience helping people secure the disability benefits they need for presumptive disorders.


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