EXPEDITED PAYMENTS

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

presumptive disability (PD) or presumptive blindness (PB) payment;

emergency advance payment;

immediate payment; and

expedited reinstatement cases.

PRESUMPTIVE DISABILITY OR BLINDNESS PAYMENTS

If your claim is for Supplemental Security Income (SSI) benefits for disability or blindness, we may make presumptive disability (PD) or presumptive blindness (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, the evidence available at the time, and the high likelihood that your claim will be ultimately approved, and is not based on your financial need.

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:

amputation of a leg at the hip;

allegation of total deafness; that is, no sound perception in either ear;

allegation of total blindness; that is, no light perception in either eye;

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

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

allegation 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;

allegation of Down syndrome;

allegation of intellectual disability or another neurodevelopmental impairment (for example, autism spectrum disorder) with complete inability to independently perform basic self-care activities (such as toileting, eating, dressing, or bathing) made by another person filing on behalf of a claimant who is at least 4 years of age;

a child has not attained their first birthday and the birth certificate or other medical evidence shows a weight below 1,200 grams (2 pounds, 10 ounces) at birth:

a child has not attained their 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: 2000 grams (4 pounds, 6 ounces) or less;
- 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) or less;
- GA: 32 weeks; weight at birth; at least 1,200 grams (2 pounds, 10 ounces), but less than 1,325 grams (2 pounds, 15 ounces);

symptomatic human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS); Form SSA-4814-F5 or SSA-4815-F6 is needed;

a 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;

allegation 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 acceptable medical source;

allegation 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); or

allegation 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, (for example, excess income, SGA, or resources), 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 claimants 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:

the SSI Federal benefit rate (plus any federally administered State supplement);

the total amount of the benefits due; or

the amount requested for the financial emergency.

WHO CAN RECEIVE AN EMERGENCY ADVANCE PAYMENT?

People who:

Are due SSI benefits (including PD or PB payments) that are delayed or not received.

Are 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 claimants 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?

People who:

Are initially applying for SSI benefits, or already receiving benefits.

Are due SSI benefits (including PD or PB payments) that are delayed or not received.

Are 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 to you.

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 (EXR)

If your benefits terminated because of excess earned income or a combination of earned and unearned income, 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:

Are unable to work at the SGA level due to your medical condition.

Are unable or become unable to perform substantial gainful activity in the month of the EXR request.

Have a current impairment(s) that is the same as, or related to, your original disabling impairment(s).

Request EXR within five years from the month your benefits stopped.

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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