Refugee and newcomer clients may be eligible for Supplemental Security Income (SSI) depending on their age or health condition. However, applying for SSI is a long and complicated process. With contributions from Kara Friesen, Bayle Conrad, Dr. Andrea Green, and Dr. Meera Siddharth, this blog post answers some of the most common FAQs about SSI among providers serving refugees and other newcomers.
What is SSI and who is eligible?
SSI is a government program that provides monthly payments to adults and children who:
- Are age 65 and up, or blind, or disabled
- Are a U.S. citizen or lawfully admitted noncitizen (e.g., refugee/asylee, Special Immigrant Visa holder)
- Have limited income and resources
A person is not required to have prior work history in the U.S. to be eligible for SSI.
In most states, people eligible for SSI are also automatically eligible for Medicaid health insurance.
For those who are age 65 and older, or who are blind, it is relatively simple to apply and be approved for SSI. For those with disabilities, the process can be much more difficult. Clients’ first SSI applications are often denied, and even when clients appeal, SSI approval is not guaranteed.
What does SSI mean by “disabled”?
The Social Security Administration (SSA), which administers SSI, defines “disabled” as:
- An adult whose physical or mental condition/disability will prevent them from being able to work for at least a year, or whose condition is expected to result in death.
- A child whose physical or mental condition/disability results in severe functional limitations expected to last at least a year, or whose condition is expected to result in death.
Are there conditions that are more likely to be approved?
SSI examines each application on a case-by-case basis and makes decisions based on the information provided, as compared to SSA’s list of accepted impairments. Conditions that are more often, but not always, approved include the following:
- Deafness that cannot be improved with hearing aids
- Down syndrome
- Major amputations
What is the difference between SSI and SSDI?
People sometimes think that SSI and Social Security Disability Insurance (SSDI) are the same. It is important to know that they are two separate programs with different eligibility requirements. SSDI is for individuals who are disabled and who have U.S. work history, either their own employment or that of a parent or spouse. Because of the work history requirement, most refugee and newcomer clients do not qualify. The National Council on Aging has a helpful chart on the differences between SSI and SSDI.
When a client applies for SSI, their application will automatically be submitted for SSDI too. They will receive a denial letter for SSDI. It is helpful to inform clients about this when applying.
How long does the application process take?
It can take at least six months from when a person submits their application to receive notice of a decision. Also, the COVID-19 pandemic and other pressures have resulted in delays in states’ processing of disability applications, with some states reporting wait times of a year or longer.
What are Compassionate Allowances (CAL)?
If a client has a very serious disability and/or a diagnosed terminal illness (for example, cancer stage III–IV or AIDS), apply for SSI as soon as possible. For terminal illnesses, note on the initial SSI application that the condition is expected to result in death. Then call the Social Security office to schedule an interview and request CAL. Diagnoses such as these are flagged for expedited processing. View the SSA website for more information, including a list of CAL conditions.
SSA also has a category known as Presumptive Disability or Presumptive Blindness. This is where a client can start receiving up to six months of SSI payments while their claim is under review, until the state agency makes a final decision. This is done when SSA decides, or the client provides documentation, that the condition is so severe that the client is very likely to be approved. These payments do not have to be repaid if the client is ultimately denied SSI.
What is the process for applying for SSI?
For those age 65 and older
The application process for those age 65 and older is less complex. To see the forms required, visit Get Started to Apply for SSI or Social Security Forms on the SSA website. Key forms include the following:
- SSA-8000 SSI Application
- SSA-8240 Wage and Employment Information Authorization
- SSA-8510 Authorization for SSA to Obtain Personal Information
For adult and child disabilities
The SSA website has information about the application process, forms to complete, and what information or documents a person will need. For adult and child disability SSI applications, the steps generally include, but may not be limited to, the following:
This form can be completed online or later during the interview, but it is recommended to complete it with clients prior to the interview. Otherwise, the local office worker will need to complete the disability report, and they do not typically have time to input enough detail that would be helpful to the client’s case. This form can take multiple hours to complete, as it asks for personal and demographic information, education and job history, medical conditions, medications, medical tests, hospitalizations, and health care providers. The SSA provides this checklist for reference.
Tip: Make sure to list all U.S. medical providers clients have seen and accurate contact information. Providers will be contacted about the client’s application. The less medical information included, the more likely the application is to be rejected. It may be useful to add how long the client has been in the U.S. and why they may not have medical records from prior to their arrival date.
Overseas medical records can be included if they are translated.
2. Application appointment with local Social Security office
- Clients or service providers must call 1-800-772-1213 to schedule an appointment. This appointment may be conducted by phone or in person.
- Remember to ask for an interpreter, if needed, when scheduling. The SSA will provide a free interpreter.
- The appointment will cover many financial questions, as well as the Adult or Child Disability Form if it was not filled out beforehand. Clients will also need to complete forms authorizing SSA to obtain their personal information.
- Clients must remember to provide all required documents, such as their Social Security card, photo ID, SNAP/TANF benefit letter, copy of lease, I-94, and an individual financial ledger from the resettlement agency.
Tip: Sometimes Social Security staff assisting with the application are not aware that certain categories of noncitizens are allowed to apply for SSI. You can refer workers to SSA guidance about noncitizens’ eligibility or ask to speak with a supervisor.
3. Client assigned to case examiner. This person is the key point of contact for the application. The client will receive a notice with the case examiner’s contact information.
4. Additional information
- Medical records will be requested from all health care providers listed on the Adult or Child Disability Form.
- Letters will be mailed to the client stating whether the reviewers need more information.
- This often includes the Adult (SSA-3373) or Child (SSA-3376-3379) Function Report, a form that asks questions about a person’s daily activities and how their condition impacts those activities. Sometimes a third person is asked to complete a Function Report (SSA-3380) such as a teacher, spouse, case manager, etc.
- Clients may also be asked to complete a form providing more information about their past job activities.
- The reviewers may also request that clients have more medical exams called Consultative Examinations. The SSA arranges these examinations, which are very important not to miss.
- Clients will be asked to provide financial documents to prove income and resources.
– If a client’s medical situation changes—for example, they are diagnosed with a new condition, need surgery, are hospitalized, or begin seeing a new provider—this information should be sent to their case examiner.
- Each SSI case is examined by a state agency called Disability Determination Services (DDS), who are medical examiners and medical professionals trained to review cases based on the information provided and in line with SSA’s disability policies.
- A letter is sent to the client with the decision and next steps.
What happens if the SSI claim is denied?
SSA has two types of reconsideration: medical and non-medical. Both can be requested online.
A client has 60 days from the denial letter date to appeal at each of four possible appeal levels. Individuals have the option to ask a lawyer for help with appeals. While many law firms may charge for this service, there are free options available, such as AARP and local and state Legal Aid.
– If clients are incorrectly denied due to immigration status, start the reconsideration process by visiting the SSA reconsideration page. Select “Request non-medical reconsideration.” This is sometimes more effective than calling over the phone to contest the denial. When submitting this request, upload a copy of the applicant’s I-94 and/or travel document as proof of immigration status.
– If the applicant is continually incorrectly denied based on status, despite referring to the SSA guidance, identify local pro bono legal organizations that may be able to provide additional advocacy support.
Is there a time limit to SSI?
Yes. For noncitizens such as refugees and other newcomer categories, SSI can only last for up to seven years from the date of entry. Clients (or the client’s parents) must have at least their green card to have SSI continue. However, for some categories such as Afghan and Ukrainian humanitarian parolees, there is an even shorter period of time that they are eligible for SSI. Visit the SSA website for more information.
Also, depending on the medical condition, the SSI examiners may review the case over time to see if the client is still medically eligible.
Additional Application Tips
The case manager’s role
- It can vary by organization, but generally it is helpful for case managers to assist clients with the SSI application because it is such a challenging process. This assistance may include using an interpreter and writing down clients’ responses to the application questions, helping clients provide as much detail as possible, accompanying clients to relevant appointments, and talking with key stakeholders such as medical providers and the Social Security case examiner about the client’s application.
- Case managers can work with clients to manage expectations. While clients may know of others with similar conditions approved for SSI, that does not mean they will be approved. The lengthy application process and denials also can be understandably frustrating.
- If clients consent, it can be helpful for the caseworker to complete an authorized representative form (SSA-1696). This allows case managers to closely follow the claim as it moves through the process. Being the client’s authorized representative should allow case managers to also receive any notices in the mail and to call monthly for updates to make sure there are no outstanding documents SSA needs in order to continue processing the claim.
- The function report and other forms have to be submitted within a short time. It can be helpful to call the assigned examiner listed on the form and let them know when they can expect the report and why it may be late.
Working with medical providers
- Health conditions vary in severity. For example, one person with diabetes may experience few symptoms, while another person may have uncontrolled diabetes that significantly impacts their daily living. If clients have a complex condition, it helps to build a case through medical records. The more specialists clients can see, the better.
- Some advise starting the SSI application process immediately, while others advise waiting until clients have established care in the U.S. (particularly for clients whose health concerns are unclear/not straightforward). Overall, clients should start the SSI application process as soon as possible and in consultation with their case manager and medical providers. They can visit local health departments, free clinics, or their established health care providers to strengthen their medical records.
- If clients have established care with a primary care provider and/or specialist, they should let their doctors know before applying that they are planning to apply and ask for advice. If necessary, clients should schedule an appointment to discuss why they feel they cannot work due to their medical conditions.
- A letter written by the client’s doctor(s) saying how the client’s condition limits their daily life is very helpful. If the health care provider uses the SSA’s medical language for adults and children, their letter will be even more helpful.