Transcript Assisting Disabled TANF Participants to Apply for Social Security Benefits Mary Hanley Ramsey County, Minnesota July 11, 2007

Assisting Disabled TANF
Participants to Apply for Social
Security Benefits
Mary Hanley
Ramsey County, Minnesota
July 11, 2007
Overview of Social Security
Disability Programs
SSI
SSDI/RSDI
Similarity and difference between the 2
programs.
Criteria for Disability
Diagnosis meeting or equal to “Blue Book” listings
Unable to work at Substantial Gainful Activity
(SGA) -- $900 per month gross income in 2007
Duration of one year or expected to last one year or
result in death
Functional Impairment in 2 of 4 areas
How Eligibility is Decided
Non-medical information
Role of Disability Determination Services (DDS)
Consultative Exams (CE)
Work History
Function Reports
Third Party Reports
Important Information Sources
The applicant and significant others
Service providers
Vocational programs
Longitudinal evidence
Work attempts
One time psychological and cognitive assessments
Medical tests such as Xrays, MRIs, EKGs etc.
Functional assessment
Benefits of SSI Advocacy
Once approved, participants receive increased income and
medical benefits
Lengthy appeals are avoided
Participants gain access to disability programs that can be a
path to employment, training, reasonable accommodations,
job coaching, etc. that limited TANF funds don’t cover,
including work incentives programs exclusive to SSI/RSDI
TANF agencies can focus on providing services to parents
that are more job ready and caseloads decrease
Housing agencies are able to collect additional rent and can
provide more subsidies
States recover interim reimbursement and can pass some of
the funds on to SSI advocacy programs to offset the cost of
advocate salaries
Why Do TANF Participants get
Denied??
IT is NOT because everyone
gets denied the 1st time!!
This commonly held myth
leads to complacency!
Appeals can be avoided!
So…Why are TANF Participants
Denied so Often?
Complete the applications themselves
Overestimate their abilities and underestimate their
impairment
Reporting discrepancies
Denial of disability by TANF recipient
Family and community members reinforce the
denial
Have diagnosis or low IQ score, but don’t meet
severity criteria for functional impairment
Why …..Denied? (2)
Go to medical appointments alone and aren’t able
to communicate needs effectively
Don’t show up for scheduled appointments with
us or their treatment providers
Co-occurring disorders
No treatment history or insufficient treatment
history
Evidence Disability Determination Services
(DDS) needs is not obtained in a timely manner
How Can SSI Advocates Help?
Conduct home visits
Become the applicant’s authorized representative
Discover and explain context of co-occurring chemical
dependency disorders
Communicate the severity of functional impairment to the
often too busy medical providers and to DDS
Persuade applicant to follow through with treatment for
their illness(es)
Attend the Consultative Exam (CE) and talk with the
examiner directly to provide collateral functional
information
How can SSI Advocacy Help? (2)
Fill out all Adult Function Reports and Third Party forms
with the applicant and family members
If history of Special Education in school, attempt to obtain
school records
Have all information at time of application and hand it off
to the SSA staff member taking the application
Accompany to all appointments from the application to the
award appointment and all medical appointments
Do the legwork of obtaining medical records
Necessary Components for SSI
Advocacy Programs
Agency and supervisory support
Thorough knowledge of the process
Comprehensive training
Communication with SSA and DDS
Adequate time and resources
History/Overview of the Ramsey
County’s SSI Advocacy Program (1)
Intensive Integrated Intervention (III) program for
TANF recipients nearing the time limit
Intensive case managers with caseloads of 25 assisted
clients who were disabled with obtaining SSI benefits.
43% of III closed TANF cases closed due to approval
for SSI benefits
Funding ended in 2003, unable to continue this
intensive advocacy due to increased caseloads
History/Overview of the Ramsey
County’s SSI Advocacy Program (2)
Temporary SSI advocacy program started in 2004
4 social workers/advocates
Goals:
• increase the number of successful first time applications for
TANF participants who we thought were disabled
• develop a process that decreased waiting time for benefits
Unexpected Success
• In just 6 months, 39 referred participants were approved for
benefits on first time applications
• Estimated there were 1600 possible additional disabled
participants
History/Overview of the Ramsey
County’s SSI Advocacy Program (3)
Response to RFP from MN DHS for SSI
Advocacy for TANF Recipients
County contracted with Goodwill Easter Seals to hire
8 full time, permanent advocates to provide the
services
State reimburses the county $2500 for each successful
first time application (SSI only)
If the application is denied, but is later approved on
appeal, the county gets $500 and the legal services
attorneys collect $2000
Ramsey County is the most successful county in the
state for obtaining reimbursement for advocacy
services
How the Current Ramsey County
Project Works
The Referral process
All employment counselors are able to refer any participants or their
household members who they suspect are disabled through a centralized
intake coordinator
Certain participants are mandatory referrals: IQ below 70, Severe and
Persistent Mental Illness (SPMI), children with Severe Emotional
Disturbance (SED), and individuals ill and incapacitated for one year or
more
The Advocacy Process
Initial home visits to begin the process
Advocate sees the participant through every step of the application
process
• accompanies them to the initial application
• assists with gathering all necessary documentation to prove disability
• obtain necessary evaluation and treatment for the participant’s
disabling conditions, usually including functional assessment.