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What Does Presumptive Disability Mean for Social Security?

Closeup of person hand with pen filling Social Security blank.

Supplemental Security Income (SSI) benefits are available for disabled and elderly people with low incomes to help pay for their medical expenses and general needs. Obtaining benefits, however, can be a chore; government agencies can take months to review an application before deciding whether to approve or deny an application. Certain applicants, however, may be eligible for a fast-track program offering temporary benefits while the application is still pending. Read on to learn about presumptive disability benefits, and call an educated Social Security Disability benefits attorney for help obtaining SSI or Social Security Disability Insurance (SSDI) benefits, or responding to a Social Security denial.

What is Presumptive Disability?

Typically, it can take the Social Security Administration (SSA) several months to process an application for disability benefits. Applicants who hope to start collecting SSI benefits may find themselves in financial hardship while they await the SSA’s review of their application. Applicants who have certain medical conditions, however, can start obtaining benefits almost immediately.

Presumptive Disability (PD) benefits are meant to help provide financial support for people who are very likely to have their application for SSI benefits approved. The SSA can grant PD benefits immediately after receiving the application; the applicant can start receiving benefits just weeks or even days after applying. Applicants are automatically considered for PD when applying for SSI benefits; no separate application is needed. PD payments can last up to six months, meant to cease once proper SSI benefits start.

The SSA will make a finding of presumptive disability when the applicant demonstrates they suffer from a sufficiently severe impairment. Typically, the SSI claim must be made based on one of several specific conditions in order to qualify for PD.

Conditions Considered Presumptively Disabling

The SSA will authorize PD benefits when an applicant has an impairment severe enough that the SSA feels comfortable “presuming” they are disabled, even before conducting a full review of the application. A number of conditions are considered presumptively disabling, including:

  • Total blindness
  • Total deafness
  • Symptomatic HIV or AIDS
  • Down syndrome
  • Severe intellectual disorder, such as autism, causing an inability to perform basic daily and self-care activities
  • Spinal cord injury leading to inability to move without a walker or other apparatus
  • Terminal illness with a prognosis of less than six months to live
  • Amputation of a leg at the hip
  • Muscular dystrophy, cerebral palsy, or muscular atrophy
  • End-stage renal disease
  • ALS
  • Low birth weight
  • Confinement to bed or required use of a wheelchair/walker/crutches due to a long-term condition
  • Stroke that occurred at least three months prior and has led to difficulty walking or using other extremities

Sufficiently impairing conditions outside of those listed may also qualify. Additionally, the applicant must show the requisite financial need for SSI benefits.

What if Your Claims Are Ultimately Rejected?

Presumptive disability allows you to receive benefits while your application for SSI benefits is under review. If the SSA denies your claim for reasons other than your medical condition, or if they decide that your presumptive benefits amount was incorrect, you may have to repay some or all of the amounts you were paid. In most cases, however, the payments do not need to be repaid even if the SSA ultimately determines the applicant does not qualify for disability benefits.

Get the California Disability Benefits You Need

For help collecting disability benefits in southern California or statewide, call the compassionate and knowledgeable Social Security Disability Insurance and Supplemental Security Income (SSD/SSI) attorneys Drake & Drake at 818-914-4055.

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Drake & Drake, P.C., is located in Calabasas, CA and serves clients in and around Woodland Hills, Wilmington, Harbor City, Carson, Torrance, San Pedro, Long Beach, Compton, Gardena, Paramount, Lynwood, Bellflower, South Gate, Los Angeles, Hawaiian Gardens, Artesia, Huntington Park, Cerritos, Bell, Norwalk, Maywood, Santa Fe Springs, Pico Rivera, Whittier and Los Angeles County.

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