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About Expedited Disability Benefits: Presumptive Disability (PD) Or Presumptive Blindness (PB) Payments

By Kenton Koszdin on June 12, 2018 | In Disability Insurance

About Expedited Disability Benefits: Presumptive Disability (PD) Or Presumptive Blindness (PB) Payments

In certain circumstances, the Social Security Administration (SSA) may commence the payment of benefits more quickly than usual. It is important to note that these payments may be made while a decision regarding benefit eligibility is pending. Payments may be expedited when an applicant is deemed to be presumptively blind or have a presumptive disability, i.e., amputation of a leg. In this case, the decision to make expedited payments is not based on the financial need of an applicant but the severity of the condition and ultimate success of the claim.

For Supplemental Security Income (SSI) benefit claims for disability or blindness, the SSA may make presumptive disability (PD) or presumptive blindness (PB) payments for up to 6 months while an applicant awaits Disability Determination Services (DDS) to render a final decision. Any expedited payments are based on the amount of an applicant’s “countable income.”

Applicants for disability benefits may be eligible to receive expedited SSI benefit payments on the basis of a PD or PB determination if they have one or more of the following medical conditions:

  • amputation of a leg at the hip;
  • an allegation of total deafness; that is, no sound perception in either ear;
  • an allegation of total blindness; that is, no light perception in either eye;
  • an allegation of bed confinement and immobility without a wheelchair, walker, or crutches, due to a longstanding condition excluding recent accident and recent surgery;
  • an allegation of stroke (cerebral vascular accident) more than three months in the past and continued marked difficulty in walking or using a hand or arm;
  • an allegation of cerebral palsy, muscular dystrophy, or muscular atrophy and marked difficulty in walking (for example the use of braces), speaking, or coordination of the hands or arms;
  • an allegation of Down syndrome;
  • an allegation of severe mental deficiency made by another individual filing on behalf of a claimant who is at least 7 years of age;
  • a child has not reached his or her first birthday and the birth certificate or other medical evidence shows a weight below 1,200 grams (2 pounds, 10 ounces) at birth:
  • a child has not attained his or her first birthday and available medical evidence shows a gestational age (GA) at birth with certain corresponding birth-weights;
  • symptomatic human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS); Form SSA-4814 or SSA-4815 is needed;
  • a physician confirms by telephone or in a signed statement that an individual has a terminal illness with a life expectancy of six months or less; or a physician or knowledgeable hospice official (for example, hospice coordinator, staff nurse, social worker or medical records custodian) confirms that an individual is receiving hospice services because of a terminal illness;
  • an allegation of a spinal cord injury producing an inability to ambulate without the use of a walker or bilateral hand-held assistive devices for more than two weeks with confirmation of such status from an appropriate medical professional;
  • an allegation of end-stage renal disease (ESRD) requiring chronic dialysis, and the file contains a completed CMS–2728-U3 End Stage Renal Disease Medical Evidence Report–Medicare Entitlement and/or Patient Registration;
  • an allegation of amyotrophic lateral sclerosis (ALS) known as Lou Gehrig’s disease.

The SSA will not request that an applicant repay payments based on PD or PB, even if he or she is later found not to be disabled or blind. The SSA will request an applicant to refund any overpayment of benefits based on PD or PB payments.

The Kenton Koszdin Law Office treats all cases equally but also treats each as distinct and unique. My personal experience with disability and workers’ compensation cases has given me the precise knowledge and insight necessary to successfully obtain benefits for my clients. I’ve lived through and experienced many different circumstances with my clients from the beginning of the application process all the way to the end. Contact the Kenton Koszdin Law Office today for a free consultation. We even offer free in-home consultations! Call 800-438-7734 or visit us online. It will be a pleasure to hear from you. Se habla espańol!

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