Filing for Presumptive Disability Benefits

Supplemental Security Income, or SSI, is a monthly cash benefit paid to people with low incomes, few assets, and medical conditions that prevent them from working and supporting themselves. Because applying for SSI disability benefits can be a long process, the Social Security Administration (SSA) has made temporary benefits available for some disabilities. These benefits are called "presumptive disability benefits."

If you qualify, you can get presumptive disability benefits to tide you over while Social Security processes your SSI disability claim. Here's what you need to know to apply for and get presumptive disability payments from Social Security.

What Is Presumptive Disability and How Does It Work?

Presumptive disability payments are designed to provide you with support while Social Security completes its review of your SSI application and disability claim. You can't get presumptive disability payments if you're only applying for Social Security Disability Insurance (SSDI). And you must have a qualifying medical condition to get these benefits.

Medical Conditions That Qualify for Presumptive Disability

Social Security can grant you immediate SSI payments, or presumptive disability (PD) pay, if you meet the PD criteria. Some examples of conditions that qualify easily as presumptive disabilities would be:

• total deafness or blindness
• Down syndrome, or
• cerebral palsy (if you have difficulty walking, speaking, or using your hands or arms).

But these aren't the only conditions that qualify. The SSA will "presume" that you're disabled, and start paying you presumptive disability, if you have any of the following conditions :

• symptomatic HIV infection or AIDS
• amputation of two limbs or of one leg at the hip
• spinal cord injury with the inability to walk without a walker or similar device
• stroke (that happened more than three months ago) and caused you to have difficulty walking or using one of your hands or arms
• muscular dystrophy or muscular atrophy, with difficulty walking, speaking, or using your hands or arms
• severe intellectual disorder (for SSI applicants who are seven years old or older)
• end-stage renal (kidney) disease (ESRD) requiring chronic dialysis
• amyotrophic lateral sclerosis (ALS), also known as 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.

What Conditions Won't Qualify for Presumptive Disability?

To qualify for presumptive disability, you must have a medical condition that's very likely to meet the requirements of one of Social Security's listed impairments (called the Blue Book) or that prevents you from working even the least demanding jobs—and you have the medical evidence to back that up.

If your disability isn't severe enough or if it doesn't meet a listing, you probably won't qualify for presumptive disability payments. Some common impairments that might qualify you for SSI disability benefits but not presumptive disability payments include:

• carpal tunnel syndrome
• celiac disease
• degenerative disc disease
• fibromyalgia, and
• migraine headaches.

In short, any medical condition that's not clearly and severely disabling would not be considered a presumptive disability.

If you apply for SSI disability because you have multiple impairments that keep you from working, but none of your impairments is severe enough to qualify for disability on its own, you won't get presumptive disability benefits.

Non-Medical Eligibility for Presumptive Disability

Because presumptive disability is for SSI applicants, you must have limited income and few financial resources. In other words, you must meet the SSI income and asset limits set by Social Security.

To be eligible for presumptive disability benefits, you must have applied for SSI disability, and Social Security must be in the process of considering your initial claim. You can't get presumptive disability payments while you appeal a denied claim.

How Long Does It Take to Get Presumptive Disability?

Presumptive disability benefits are intended to help you while you wait for Social Security to process and approve your application for SSI disability benefits, so if you have a presumptive disability, you can get immediate approval after you apply. Once approved, you could start getting presumptive disability payments from Social Security in a few days or weeks.

If you're facing an immediate financial crisis (like a lack of shelter or food), you might be eligible for a one-time "emergency advance payment" from Social Security. But this is only a loan, and you must repay it with your presumptive disability benefits.

How Long Do Presumptive Disability Payments Last?

Monthly presumptive disability SSI payments can last for up to six months. If Social Security hasn't made a decision on your claim within six months, your presumptive disability payments will stop.

Presumptive disability benefits will also end as soon as Social Security reaches a final decision regarding your disability claim, even if that's less than six months. If your application for SSI benefits is approved, your PD benefits will stop, and your regular SSI disability payments will begin.

If Social Security denies your disability claim, the SSA will immediately stop sending you presumptive disability payments. But you're not responsible for repaying money received because of the presumptive disability. (Note, however, that Social Security might ask you to repay some money if you were paid more than you should have been based on your income or resources.)

What Is the Process of Filing for Presumptive Disability Benefits?

You apply for presumptive disability benefits when you file your application for SSI at your local Social Security office. For some conditions, the local SSA field office itself can make a presumptive disability determination. But to do so, Social Security might need to get confirmation of your condition from a reliable source, like one of the following:

• a doctor
• a social worker, or
• school personnel.

When your local SSA office can't make the determination, your file will move on to the Disability Determination Services (DDS), the state agency responsible for making all SSI disability decisions. DDS can make a presumptive disability determination as well, even for impairments other than those listed above.

Other Expedited Social Security Disability Programs

The SSA has several other programs that speed up decision-making on certain types of claims. You might qualify for a Compassionate Allowance if you have a certain type of cancer or some other serious illness that's easily diagnosed and assessed. The Terminal Illness program, or TERI, is available for those with terminal illnesses or who are in hospice. And the Quick Disability Determination program identifies easily determined disability cases through a software program.

Learn more about what it takes to win your Social Security disability case faster.

_{Updated November 28, 2022}