Assisting Disabled TANF
Participants to Apply for Social
Security Benefits
Mary Hanley
Ramsey County, Minnesota
July 11, 2007

Overview of Social Security
Disability Programs
SSI
SSDI/RSDI
Similarity and difference between the 2 programs.

Criteria for Disability
Diagnosis meeting or equal to “Blue Book” listings
Unable to work at Substantial Gainful Activity
(SGA) -- $900 per month gross income in 2007
Duration of one year or expected to last one year or result in death
Functional Impairment in 2 of 4 areas

How Eligibility is Decided
Non-medical information
Role of Disability Determination Services (DDS)
Consultative Exams (CE)
Work History
Function Reports
Third Party Reports

Important Information Sources
The applicant and significant others
Service providers
Vocational programs
Longitudinal evidence
Work attempts
One time psychological and cognitive assessments
Medical tests such as Xrays, MRIs, EKGs etc.
Functional assessment

Benefits of SSI Advocacy
Once approved, participants receive increased income and medical benefits
Lengthy appeals are avoided
Participants gain access to disability programs that can be a path to employment, training, reasonable accommodations, job coaching, etc. that limited TANF funds don’t cover, including work incentives programs exclusive to SSI/RSDI
TANF agencies can focus on providing services to parents that are more job ready and caseloads decrease
Housing agencies are able to collect additional rent and can provide more subsidies
States recover interim reimbursement and can pass some of the funds on to SSI advocacy programs to offset the cost of advocate salaries

Why Do TANF Participants get
Denied??
NOT

So…Why are TANF Participants
Denied so Often?
Complete the applications themselves
Overestimate their abilities and underestimate their impairment
Reporting discrepancies
Denial of disability by TANF recipient
Family and community members reinforce the denial
Have diagnosis or low IQ score, but don’t meet severity criteria for functional impairment

Why …..Denied? (2)
Go to medical appointments alone and aren’t able to communicate needs effectively
Don’t show up for scheduled appointments with us or their treatment providers
Co-occurring disorders
No treatment history or insufficient treatment history
Evidence Disability Determination Services
(DDS) needs is not obtained in a timely manner

How Can SSI Advocates Help?
Conduct home visits
Become the applicant’s authorized representative
Discover and explain context of co-occurring chemical dependency disorders
Communicate the severity of functional impairment to the often too busy medical providers and to DDS
Persuade applicant to follow through with treatment for their illness(es)
Attend the Consultative Exam (CE) and talk with the examiner directly to provide collateral functional information

How can SSI Advocacy Help? (2)
Fill out all Adult Function Reports and Third Party forms with the applicant and family members
If history of Special Education in school, attempt to obtain school records
Have all information at time of application and hand it off to the SSA staff member taking the application
Accompany to all appointments from the application to the award appointment and all medical appointments
Do the legwork of obtaining medical records

Necessary Components for SSI
Advocacy Programs
Agency and supervisory support
Thorough knowledge of the process
Comprehensive training
Communication with SSA and DDS
Adequate time and resources

History/Overview of the Ramsey
County’s SSI Advocacy Program (1)
Intensive Integrated Intervention (III) program for
TANF recipients nearing the time limit
Intensive case managers with caseloads of 25 assisted clients who were disabled with obtaining SSI benefits.
43% of III closed TANF cases closed due to approval for SSI benefits
Funding ended in 2003, unable to continue this intensive advocacy due to increased caseloads

History/Overview of the Ramsey
County’s SSI Advocacy Program (2)
Temporary SSI advocacy program started in 2004
4 social workers/advocates
Goals:
• increase the number of successful first time applications for
TANF participants who we thought were disabled
• develop a process that decreased waiting time for benefits
Unexpected Success
• In just 6 months, 39 referred participants were approved for benefits on first time applications
• Estimated there were 1600 possible additional disabled participants

History/Overview of the Ramsey
County’s SSI Advocacy Program (3)
Response to RFP from MN DHS for SSI
Advocacy for TANF Recipients
County contracted with Goodwill Easter Seals to hire
8 full time, permanent advocates to provide the services
State reimburses the county $2500 for each successful first time application (SSI only)
If the application is denied, but is later approved on appeal, the county gets $500 and the legal services attorneys collect $2000
Ramsey County is the most successful county in the state for obtaining reimbursement for advocacy services

How the Current Ramsey County
Project Works
The Referral process
All employment counselors are able to refer any participants or their household members who they suspect are disabled through a centralized intake coordinator
Certain participants are mandatory referrals: IQ below 70, Severe and
Persistent Mental Illness (SPMI), children with Severe Emotional
Disturbance (SED), and individuals ill and incapacitated for one year or more
The Advocacy Process
Initial home visits to begin the process
Advocate sees the participant through every step of the application process
• accompanies them to the initial application
• assists with gathering all necessary documentation to prove disability
• obtain necessary evaluation and treatment for the participant’s disabling conditions, usually including functional assessment.