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Social Security Disability: What is a Presumptive Disability?

A physical disability or psychological impairment that prevents full-time work can put a tremendous amount of pressure on a person and their family. Social Security disability benefits (SSD) benefits) can serve as a desperately needed financial lifeline. Unfortunately, qualifying for SSD benefits can sometimes prove to be challenging. 

However, in some cases, the Social Security Administration (SSA) will deem an applicant “presumptively disabled” based on their financial circumstances and their medical condition. Within this article, our Phoenix Social Security disability lawyer explains the key things to know about the term “presumptive disability” and how it could impact your case.  

What is a Presumptive Disability (for the Purposes of SSD Benefits)

Presumptive disability (PD) is a provision within the Supplemental Security Income (SSI) program that allows individuals with certain severe medical conditions to receive benefit payments before their disability claim is fully processed. The reality is that it can take some time to process a disability claim. It is not uncommon for the SSA to take months to render a decision. The principle exists based on the SSA’s view that some health conditions are so severe that they almost always meet the criteria for disability. 

Presumptive disability rules aim to allow the SSA to provide quick financial assistance to those in dire need while they wait for the formal decision on their disability application. To qualify for PD, a claimant’s condition must be one that is likely to meet the SSA’s definition of disability. To be clear, the decision to grant PD benefits does not guarantee an ultimate approval for SSI. Still, it is a very strong sign that a person will qualify for Social Security disability benefits through SSI. 

Presumptive Disability is Only for SSI Claims, Not SSDI Claims

Social Security disability benefits are paid out across separate federal programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). These programs have distinct financial/legal eligibility criteria. One key difference lies in the use of presumptive disability benefits. Presumptive disability applies strictly to the SSI program. It is not a provision within SSDI. If you are applying solely for SSDI benefits, presumptive disability will not be a factor in your case. 

SSI is a federal program intended to assist low-income individuals who are elderly, blind, or disabled. To qualify for disability benefits through SSI, a person must have limited financial resources. Conversely, SSDI provides benefits to disabled or blind individuals who are “insured” by workers’ contributions to the Social Security trust fund. The SSA’s presumptive disability provision is tied to the SSI due to its focus on providing immediate assistance to those in financial need. 

A List of Conditions that Could Qualify as Presumptive Disabilities for SSI Claims

Are you or is your loved one applying for Social Security disability benefits through SSI in Arizona? You may be qualified to obtain expedited financial support through a presumptive disability. The SSA manages a list of conditions that are likely to qualify for SSD benefits on the grounds of a presumptive disability.

These generally include severe disabilities that are easily identifiable and likely to meet the disability criteria. Some of these conditions include, but are not limited to:

  • Total blindness; 
  • Complete deafness; 
  • Down Syndrome; 
  • Severe Intellectual disorder; 
  • Cerebral Palsy; 
  • Muscular Dystrophy; 
  • Severe Muscular Atrophy;  
  • ALS (Lou Gehrig’s disease)
  • End-stage renal disease; 
  • Amputation of two limits; 
  • Amputation of one leg at the hip; 
  • Spinal cord damage that prevents walking; and
  • A terminal illness (six months or less to live). 

Presumptive disability provisions can make it easier for a person to qualify for SSI benefits. Further, they allow the SSA to process the claim on a preliminary basis, thereby awarding benefits before a full and complete review occurs. Still, an SSI disability claim can be extremely complicated.

You do not have to take on the process alone. An Arizona Social Security disability lawyer with experience taking on SSI claims can protect your rights and your interests every step of the way. 

Set Up a Free Case Review With a Top Phoenix Social Security Disability Attorney Today

At Snow, Carpio and Weekley, PLC, our Arizona Social Security disability lawyer has the legal knowledge and professional expertise you can count on. If you have any questions about presumptive disabilities and SSI claims, we are here to help. Reach out to us (877) 370-5788 or contact us online for your free, no obligation consultation. We handle Social Security disability claims and disability appeals in Phoenix, Maricopa County, and throughout all of Arizona. 

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