II. Background

  1. Entitlements
    1. Social Security Disability Insurance
      1. Average monthly payment (2013): $1177
      2. Typically qualify for Medicare after 2 years on SSI
    2. Supplemental Security Income
      1. Adults and children without significant work history and with limited resources
      2. Typically also qualify for Medicaid
  2. Application Process
    1. Denial rate for applicants for Disability: One third of initial applicants
    2. Full Appeals process

III. Indications: Adults

  1. Inability to engage in significant gainful activity (SGA)
    1. Must earn less than a specific amount
  2. Medical physical or psychological severe Impairment (based on Blue Book listings)
    1. http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm
  3. Must exceed 12 months, or expected to result in death
  4. Under age 65 years old
  5. Contributed to social security to a specific degree in the last 10 years

IV. Indications: Children

  1. Financially eligible
  2. Medical physical or psychological severe Impairment (based on Blue Book listings)
    1. http://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm
  3. Must exceed 12 months, or expected to result in death

V. Indications: Substance Abuse criteria

  1. Must have significant history from family and doctor
  2. Must have severe Disability
  3. Benefits up to 3 years
  4. Must pursue Chemical Dependency rehabilitation
  5. Someone they know must administer money and observe

VI. Protocol: Types of Medical Evidence

  1. Medical evidence of record
    1. Disability Evaluation Under Social Security
    2. Documents evaluation required for Disability
    3. Clinic progress notes
  2. Agency purchases
    1. Consultation exams
    2. Imaging Studies and Lab Tests

VIII. Reference

  1. Austin (1995) Lecture, University Minnesota
  2. Maness (2015) Am Fam Physician 91(2): 102-9 [PubMed]

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