Print & Go

Appealing an SSI denial or termination

  • An appeal is available if the medical CDR or Age 18 Redetermination results in a termination of benefits. 

  • The SSI applicant or beneficiary will get a notice of termination. 

  • The notice will explain how to appeal and the time limits for appealing (generally 60 days after getting the notice). 

  • The notice will explain how to request that SSI continues during the appeal and the time limits for doing so (generally 10 days after getting the notice). 

  • When the appeal goes to an administrative law judge (ALJ), SSI can continue until the ALJ issues a written decision.

Knowing your state’s SSI program

Establishing financial eligibility

  • Part of two-part SSI eligibility test. 

  • Countable income and resources must be within SSI program limits. 

  • Other income, after subtracting income exclusions, gets subtracted from SSI base rate (i.e., federal benefit rate plus optional state supplement). 

  • SSI requires countable resource of no more than $2,000. 

  • For children under age 18, a part of the parent(s)’ income and resource may be counted to determine SSI eligibility and payment amount. 

  • At age 18, the SSI program no longer counts any part of the parent(s)’ income and resources. 

The Medical Continuing Disability Review (CDR)

  • One of two medical reviews all SSI youth may face. 

  • Most recipients will face a medical CDR every 3 to 5 years. 

  • Reviewer will look at medical records and other relevant records (including educational records for a child under 18) to determine if there is medical improvement. 

  • Even if there is medical improvement, SSI will continue unless the improvement means the individual no longer meets the disability criteria. 

  • If the review results in a termination of benefits, a written notice goes to the recipient explaining appeal rights. 

The Age 18 Redetermination

  • One of two medical reviews all SSI youth may face. 

  • At age 18 the SSI beneficiary will have a redetermination to determine if he or she meets the adult standard of disability. 

  • Unlike the medical CDR which looks for medical improvement, the Age 18 Redetermination is considered a new, initial determination. 

  • If the review results in a termination of benefits, a written notice goes to the beneficiary explaining appeals right. 

Establishing disability

  • Part of two-part SSI eligibility test. 

  • Adults must establish they cannot work at substantial level. 

  • Children under 18 must establish severe deficits in functional activities at school and at home.