What Is Presumptive Disability?

Presumptive Disability Form in Troy Michigan

Anyone who has ever applied for Social Security Disability (SSD), Supplemental Security Income (SSI) or other disability benefits knows that the approval process can take a long time. Fortunately, the Social Security Administration offers presumptive disability and presumptive blindness payments. These benefits can provide much-needed assistance while the claimant is waiting for a medical determination. If you have questions about presumptive disability or blindness payments, the disability attorneys at Disability Law Group can help.

What Are Presumptive Disability Or Blindness Payments?

An applicant for SSI benefits for disability or blindness can receive temporary payments while the Social Security Administration (SSA) reviews his or her claim. These payments can be made for up to 6 months for eligible claimants. The decision to grant presumptive disability (PD) or presumptive blindness (PB) benefits depends on factors such as severity of the condition, the evidence available at the time of determination, and the likelihood that SSI benefits will later be approved. These payments do not depend on the applicant’s financial need.

What Are The Eligibility Requirements For Presumptive Disability

PD and PB benefits are available to individuals who are disabled or blind and who meet the SSA’s eligibility requirements for disability benefits. Note that presumptive benefits are not available to applicants for Social Security Disability Insurance (SSDI).

You may receive SSI benefits immediately on the basis of a presumptive disability or presumptive blindness determination if you have one or more of the following medical conditions:

  • Amputation of a leg at the hip
  • Total deafness (no sound perception in either ear)
  • Total blindness (no light perception in either eye)
  • Bed confinement or immobility without a wheelchair, walker, or crutches, due to a long-standing condition (excludes recent accident and recent surgery)
  • Stroke (cerebral vascular accident) that happened more than three months in the past with continued difficulty in walking or using a hand or arm
  • Cerebral palsy, muscular dystrophy, or muscular atrophy with difficulty in walking, speaking, or coordination of the hands or arms
  • Down syndrome
  • Intellectual disability or another neurodevelopmental impairment (for example, autism) with complete inability to independently perform basic self-care activities (such as toileting, eating, or bathing) made by someone filing on behalf of a claimant who is at least 4 years old
  • A child that has not yet reached one year of age with a birth weight below 2 pounds, 10 ounces
  • A child with the following gestational ages and corresponding birth weights:
    • 37-40 weeks: 4 pounds, 6 ounces or less;
    • 36 weeks: 4 pounds, 2 ounces or less;
    • 35 weeks: 3 pounds, 12 ounces or less;
    • 34 weeks: 3 pounds, 5 ounces or less;
    • 33 weeks: at least 2 pounds, 10 ounces but no more than 2 pounds, 15 ounces;
    • 32 weeks: at least 2 pounds, 10 ounces but less than 2 pounds, 15 ounces
  • Human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS)
  • An individual who has a terminal illness with a life expectancy of six months or less; or an individual who is receiving hospice care because of a terminal illness
  • Spinal cord injury causing inability to walk for more than two weeks
  • End-stage renal disease (ESRD) requiring chronic dialysis
  • Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease

In addition, you must have limited income and resources, according to standards set by the SSA, to be eligible for presumptive disability or presumptive blindness payments.

How Are Payment Amounts Determined?

The amount of PD or PB payments is based on the applicant’s countable income. For purposes of SSI, several types of income – including earned, unearned (e.g., unemployment benefits), in-kind, and deemed – are included. There are certain exemptions, and if the applicant earns too much he or she may not ultimately be eligible for SSI.

How Do Presumptive Payments Terminate?

Although presumptive disability or blindness payments can last up to 6 months, they will terminate once the SSA makes its determination as to your eligibility for SSI. Even if you haven’t received a decision after 6 months, these temporary payments will end.

What Happens To PD Or PB Payments If SSI Is Ultimately Denied?

You are not required to repay presumptive disability or presumptive blindness payments if you are later determined to not be eligible for SSI benefits. You also don’t have to repay them if you are approved for SSI. But you may be required to repay presumptive benefits if you were overpaid for other reasons, such as an error in your countable income.

How Do I Apply For PD Or PB Payments?

You can apply for presumptive disability or presumptive blindness payments at the time you apply for SSI. The SSA field office at which you apply may be able to make a determination on its own. For certain claimed conditions, the field office must get confirmation from a reliable medical source. This includes a doctor, social worker, or school personnel.

The field office may decline your request and forward your application to Disability Determination Services, which is responsible for SSI disability decisions. This office has more leeway in granting presumptive disability. It can also approve benefits for individuals with illnesses and conditions that are not on the above list.

Contact A Michigan Social Security Disability Benefits Attorney

If you have questions about presumptive disability or presumptive blindness payments, contact Disability Law Group. We specialize in helping disabled people get the benefits they need in a timely and efficient manner, and we can assist you with the application process. Give us a call today to schedule a consultation or fill out the contact form on our website.