EXPEDITED PAYMENTS


We can start payments more quickly than usual in four different types of situations:

    small blue ballpresumptive disability (PD) or presumptive blindness (PB) payment;

    small blue ballemergency advance payment;

    small blue ballimmediate payment; and

    small blue ballexpedited reinstatement cases.


PRESUMPTIVE DISABILITY OR BLINDNESS PAYMENTS


If your claim is for Supplementary Security Income (SSI) benefits for disability or blindness, we may make PD or PB payments for up to 6 months while you are waiting for the Disability Determination Services (DDS) to make a final decision. Our decision to grant PD or PB payments is based on the severity of your condition and the likelihood that your claim will be ultimately approved, not on your financial need.

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NOTE
We will base the amount of these payments on your countable income. See our chapter on SSI INCOME for an explanation of countable income.

You may be eligible to receive SSI benefits right away on the basis of a PD or PB determination if you have one or more of the following medical conditions:

    small blue and black arrowamputation of a leg at the hip;

    small blue and black arrowallegation of total deafness; that is, no sound perception in either ear;

    small blue and black arrowallegation of total blindness; that is, no light perception in either eye;

    small blue and black arrowallegation of bed confinement and immobility without a wheelchair, walker, or crutches, due to a longstanding condition excluding recent accident and recent surgery;

    small blue and black arrowallegation of stroke (cerebral vascular accident) more than three months in the past and continued marked difficulty in walking or using a hand or arm;

    small blue and black arrowallegation of cerebral palsy, muscular dystrophy, or muscular atrophy and marked difficulty in walking (for example the use of braces), speaking, or coordination of the hands or arms;

    small blue and black arrowallegation of Down syndrome;

    small blue and black arrowallegation of severe mental deficiency made by another individual filing on behalf of a claimant who is at least 7 years of age;

    small blue and black arrowa child has not reached his or her first birthday and the birth certificate or other medical evidence shows a weight below 1,200 grams (2 pounds, 10 ounces) at birth:

    small blue and black arrowa child has not attained his or her first birthday and available medical evidence shows a gestational age (GA) at birth with these corresponding birth-weights:

    - GA: 37-40 weeks; weight at birth: less than 2000 grams (4 pounds, 6 ounces);
    - GA: 36 weeks; weight at birth; 1875 grams (4 pounds, 2 ounces) or less;
    - GA: 35 weeks; weight at birth: 1700 grams (3 pounds, 12 ounces) or less;
    - GA: 34 weeks; weight at birth: 1500 grams (3 pounds, 5 ounces) or less; or
    - GA: 33 weeks; weight at birth: at least 1200 grams, but no more than 1325 grams (2 pounds, 15 ounces);

    small blue and black arrowsymptomatic human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS); Form SSA-4814 or SSA-4815 is needed;

    small blue and black arrowa physician confirms by telephone or in a signed statement that an individual has a terminal illness with a life expectancy of six months or less; or a physician or knowledgeable hospice official (for example, hospice coordinator, staff nurse, social worker or medical records custodian) confirms that an individual is receiving hospice services because of a terminal illness;

    small blue and black arrowallegation of a spinal cord injury producing an inability to ambulate without the use of a walker or bilateral hand–held assistive devices for more than two weeks with confirmation of such status from an appropriate medical professional;

    small blue and black arrowallegation of end stage renal disease (ESRD) requiring chronic dialysis, and the file contains a completed CMS–2728-U3 End Stage Renal Disease Medical Evidence Report–Medicare Entitlement and/or Patient Registration;

    small blue and black arrowallegation of amyotrophic lateral sclerosis (ALS) known as Lou Gehrig's disease.

If we are not able to make a PD or PB determination, sometimes the DDS will make a PD or PB determination based on one of the medical conditions listed above, or on the basis of another severe condition, if a final approval seems likely.

WHAT HAPPENS TO PRESUMPTIVE DISABILITY OR BLINDNESS PAYMENTS IF WE LATER DENY YOUR SSI?


We do not ask you to repay these PD or PB payments, even if you are later found not to be disabled or blind. However, if you received an overpayment for other reasons, we may ask you to repay some of the PD or PB payments.


EMERGENCY ADVANCE PAYMENT 

We may be able to make an emergency advance payment to new applicants, who face a financial emergency and who are due SSI benefits that are delayed or not received. We can only pay one such advance payment. The maximum emergency advance payment you may receive is the smallest of:

    small blue and black arrowthe SSI Federal benefit rate (plus any federally administered State supplement);

    small blue and black arrowthe total amount of the benefits due; or

    small blue and black arrowthe amount requested for the financial emergency.

WHO CAN RECEIVE AN EMERGENCY ADVANCE PAYMENT?


    small blue ballPeople who are due SSI benefits (including PD or PB payments) that are delayed or not received; and

    small blue ballAre facing a "financial emergency"––which means they need money right away due to a threat to health or safety, such as not enough money for food, clothing, shelter or medical care.


HOW DO WE RECOVER AN EMERGENCY ADVANCE PAYMENT?


We will subtract the emergency advance payment from the payments already due you and pay you the difference. If you are not due past payments, we will subtract the emergency advance payment from your current monthly benefits in up to 6 monthly installments.


IMMEDIATE PAYMENT


We may be able to make an immediate payment to new applicants and those already receiving SSI whose benefits are delayed or not received and who face a financial emergency. The immediate payment cannot be higher than $999.00.


WHO CAN RECEIVE AN IMMEDIATE PAYMENT?


    small blue ballPeople who are initially applying for SSI benefits, or already receiving benefits; and

    small blue ballAre due SSI benefits (including PD or PB payments) that are delayed or not received; and

    small blue ballAre facing a "financial emergency"––which means they need money right away due to a threat to health or safety, such as not enough money for food, clothing, shelter or medical care.


HOW DO WE RECOVER AN IMMEDIATE PAYMENT?


We will subtract the immediate payment from the first regular payment due you.

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NOTE:
The decision to issue an immediate payment is up to us. You do not have formal appeal rights if we decide you are not eligible for any of these payments.


EXPEDITED REINSTATEMENT


If your benefits ended because you worked and had earnings, you can request to have your benefits started again without having to complete a new application. We call this process "expedited reinstatement".

You can request that your benefits start again if you:

    small blue ballstopped receiving benefits because of earnings from work;

    small blue ballare unable to do substantial gainful activity because of an impairment(s) that is the same as or related to the impairment(s) that allowed you to get benefits earlier; and

    small blue ballmake the request within five years from the month your benefits ended.

In order to reinstate your benefits under this provision we need updated medical information for the DDS to make their determination. A Social Secuirty representative will assist you with all the necessary forms.  If we approve your request for expedited reinstatement of your SSI benefits, your provisional (temporary) benefits will begin the month after your request. You may be eligible for Medicaid coverage.

We can give you provisional benefits for up to 6 months while we determine whether you can get benefits again. These benefits include Federal payments and Medicaid coverage.

If we decide that you cannot get benefits again, we usually will not ask you to repay the provisional benefits.


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