SSI Denials

The following chart lists the five different Levels of Denials. Upon discovery or notification that the client’s SSI application is denied, the following actions must taken:

If the Level of Denial was issued during... Then the EW must...
Initial Application,
  • Send a referral to the SSI Advocacy Unit so they can make a determination whether or not the client must apply for a reconsideration.
  • Instruct the client to provide verification of an application for reconsideration within ten (10) days. (Failure to do so will result in ineligibility for GA). 
  • Notify the client (in writing) of the need to apply for reconsideration, allowing at least ten (10) days for the client to comply. If the client does not respond, the GA payment must be held. A ten (10) day NOA is required.
  • Enters SSI/SSP information in CalSAWS.
  • Documents information in a CalSAWS Journal Entry.
Reconsideration, Send a referral to the SSI Advocacy Unit within ten (10) days from the date that the EW is notified of the reconsideration denial.
Federal Administrative Hearing, Appeals Council Review, or Federal District Court, Sends a referral to the SSI Advocacy Unit. The SSI Advocacy Unit must assist at these levels.

 

The following chart lists the various types of denials referred to the SSI Advocacy unit. Upon discovery or notification that the client’s SSI application is denied, the following actions must taken: 

If the Denial was due to... Then the EW must...
Failure to comply or cooperate with SSA and the case is active with the SSI Advocacy Unit,
  • Send the SCD 169 to SSI Advocacy.
  • Document in a CalSAWS Journal Entry the date and reason for the SSI denial and that the SCD 169  was given to the SSI Advocacy Social Worker. 
  • Submit the SSI denial letter to be scanned to Imaging.
  • Follow-up within 30 calendar days for verification that the appeal was filed with SSA. 

  • Note: In extreme situations up to 65 days maybe allowed as the client has 60 days to appeal and allowed 5 days for mailing. 

  • Follow-up with SSI Advocacy prior to discontinuing the case.
Failure to comply or cooperate with SSA and the case is NOT active to the SSI Advocacy Unit,
  • Send an SCD 169 and an SCD 50 to the client.
  • Include information on the SCD 50 that the client must contact the EW if they need assistance with the appeal process.
  • Send a referral to the SSI Advocacy Unit upon the client’s request that assistance is needed for the appeals process. 
  • Follow-up within 10 calendar days for verification that the appeal was filed with SSA.
  • Document in a CalSAWS Journal Entry.

Note: The EW MUST request verification from SSA that the client has cooperated. It is necessary that all requirements to receive GA Interim Assistance are met PRIOR to authorizing aid. Refer to Referral To/From Social Security (SCD 169).
Not meeting Disability Requirements,
  • Send an SCD 169 and an SCD 50 to client. 
  • Include information on the SCD 50 that the client must contact the EW if they need assistance with the appeals process.
  • Complete an email referral to the SSI Advocacy Unit upon the client’s request that assistance is needed for the appeals process.
  • Follow-up within 10 calendar days for verification that the appeal was filed with SSA.

Note: If the client meets or appears to meet the SSI disability requirements at a later date, a NEW SCD 169 and SSP 14 are REQUIRED.
Other reasons, Determine if those reasons affect the client’s eligibility for GA and take the appropriate action accordingly.

Related Topics

 SSI Approvals