Filing for Presumptive Disability Benefits
Presumptive disability payments provide you with support while the SSA completes its review of your disability claim.
Supplemental Security Income, or SSI, is a monthly cash benefit paid to low-income and low-asset individuals who are blind or disabled; that is, they have a medical condition that prohibits them from working and supporting themselves financially. Because applying for SSI disability benefits can be a long process, the Social Security Administration has made temporary benefits available for some disabilities. These benefits are called presumptive disability benefits, and are available for the first six months while the SSA processes your disability claim. Presumptive disability payments are not available to SSDI applicants.
Presumptive disability payments are designed to provide the claimant with support while the SSA completes its review of the applicant's file and the disability claim.
Conditions That Qualify for Presumptive Disability
The SSA has the authority to grant immediate SSI payments, or presumptive disability (PD), if the claimant meets the PD criteria. Conditions that qualify easily as presumptive disabilities are such serious impairments that the applicant is "presumed" to be disabled, such as total deafness or blindness, Down syndrome, or cerebral palsy. The following conditions are eligible for presumptive disability.
- symptomatic HIV infection or AIDS
- total blindness
- total deafness
- Down syndrome
- amputation of two limbs or of one leg at the hip
- spinal cord injury with inability to walk without walker or similar device
- stroke, more than three months ago, with difficulty walking or using a hand or arm
- muscular dystrophy, cerebral palsy, or muscular atrophy, with difficulty walking, speaking, or using hands or arms
- severe mental retardation (seven years old or older)
- end-stage renal (kidney) disease (ESRD) requiring chronic dialysis
- amyotrophic lateral sclerosis (ALS), a.k.a. Lou Gehrig’s disease
- low birth weight
- confinement to bed and required use of a wheelchair, walker, or crutches due to a longstanding condition, and
- terminal illness, in hospice, with six months or less to live.
Non-Medical Eligibility for Presumptive Disability
You must also have limited income and financial resources according to standards set by the SSA to be eligible for SSI payments due to a presumptive disability.
Monthly presumptive disability SSI payments can last for up to six months. As soon as the SSA reaches a final decision regarding the disability claim, the presumptive disability benefits will end. If the SSA has not made a decision within six months, the presumptive disability payments will stop. If the SSA denies the disability claim, you are not responsible for repaying money received because of the presumptive disability.
How to Apply for Presumptive Disability
You apply for presumptive disability benefits when you are filing your application for SSI at the SSA office. For some conditions, the SSA field office is able to make a presumptive disability determination (sometimes needing to get confirmation from a reliable source of information, such as a doctor, a social worker, or school personnel). In other cases, your file will move on to the Disability Determination Services (DDS), the agency responsible for making all SSI disability decisions. The DDS is able to make a presumptive disability determination as well, even for impairments that aren't on the list above.
Other Expedited Social Security Disability Programs
The SSA has several other programs that speed up decision making on certain types of claims. Compassionate Allowances is available for many cancers and some other illnesses that are easily diagnosed and assessed. The Terminal Illness program, or TERI, is available for those with terminal illnesses or who are in hospice. Finally, the Quick Disability Determination program identifies easily determined disability cases through a software program.