Representing People With

Social Security Disability, Veterans Benefits

and Injury and Accident Claims

Presumptive Disability Payments Sometimes Available

Published on December 11th, 2015

A claimant, including a child, applying for Supplemental Security Income (SSI) based on disability or blindness may receive up to 6 months of payments before the final determination of disability or blindness if he/she is found to be presumptively disabled or blind and meets all other eligibility requirements.

A presumptive disability (PD) determination requires that evidence reflect a high degree of probability that the claimant’s impairment or combination of impairments meets the Social Security Administration’s (SSA) definition of disability or blindness.

If your claim is for Supplementary Security Income (SSI) benefits for disability or blindness, Social Security may make presumptive payments for up to 6 months while you are waiting for the Disability Determination Services (DDS) to make a final decision. The decision is based on the severity of your condition and the likelihood that your claim will be ultimately approved, and is not based on your financial need.

Social Security will base the amount of these payments on your countable income.

You may be eligible to receive SSI benefits right away on the basis of a PD or PB determination if you have one or more of the following medical conditions:

  • amputation of a leg at the hip;
  • allegation of total deafness; that is, no sound perception in either ear;
  • allegation of total blindness; that is, no light perception in either eye;
  • allegation of bed confinement and immobility without a wheelchair, walker, or crutches, due to a longstanding condition excluding recent accident and recent surgery;
  • 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;
  • 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;
  • allegation of Downs syndrome;
  • 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 these corresponding birth-weights:
    • GA: 37-40 weeks; weight at birth: less than 2000 grams (4 pounds, 6 ounces);
    • GA: 36 weeks; weight at birth; 1875 grams (4 pounds, 2 ounces) or less;
    • GA: 35 weeks; weight at birth: 1700 grams (3 pounds, 12 ounces) or less;
    • GA: 34 weeks; weight at birth: 1500 grams (3 pounds, 5 ounces) or less; or
    • GA: 33 weeks; weight at birth: at least 1200 grams, but no more than 1325 grams (2 pounds, 15 ounces);
  • human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS); Form SSA-4814 or SSA-4815 is needed;
  • 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;
  • 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;
  • 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;
  • allegation of amyotrophic lateral sclerosis (ALS) known as Lou Gehrig’s disease.

A claimant, including a child, applying for Supplemental Security Income (SSI) based on disability or blindness may receive up to 6 months of payments before the final determination of disability or blindness if he/she is found to be presumptively disabled or blind and meets all other eligibility requirements.

A presumptive disability (PD) determination requires that evidence reflect a high degree of probability that the claimant’s impairment or combination of impairments meets the Social Security Administration’s (SSA) definition of disability or blindness.

Back to News

Contact Us

Jackson & MacNichol

Attorneys at Law

238 Western Ave.
South Portland, ME
04106

Call Us Today

800-524-3339

Start Your Disability Claim by Contacting Our Attorneys Get Started Now!

Copyright 2017 Jackson & MacNichol, All Rights Reserved