1619(a) and (b)— Programs that allow SSI recipients to retain Medicaid eligibility even though earnings may exceed the SGA level.
Activities of daily living— Behaviors that a claimant engages in on a regular basis.
Administrative Law Judge (ALJ)— A judge responsible for holding hearings and making SSA appellate decisions, after a Request for Reconsideration has been denied.
Alien— A person who is not a citizen or national of the United States.
Appeals Council— The final level of appeal for a SSDI or SSI claim before filing in Federal court.
Consultative examination— A medical examination ordered by and paid for by the DDS that provides evidence regarding an applicant’s impairment.
Contact person— Person listed on a disability application who can provide information to SSA about an applicant’s functioning.
Countable income— The amount of monthly income that SSA attributes to an applicant for SSI benefits. Calculated by taking total net income and subtracting any income exclusions.
Deeming— When income from another person is applied to the income calculation for a SSI applicant or recipient.
Dictionary of Occupational Titles (DOT)— Department of Labor publication that describes how occupations are performed in the national economy. The DOT is used by SSA to help determine whether or not a SSDI or SSI applicant can perform their former work or any other type of work.
Disability Determination Services (DDS)— State agency under contract with SSA to determine medical eligibility for disability benefits.
Disabled— According to SSA, one is disabled if he or she cannot engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment (or combination thereof) which can be expected to result in death or can be expected to last for a continuous period of not less that 12 months.
Diagnostic and Statistical Manual of Mental Disorders–IV–Text Revisions (DSM–IV–TR)— A manual that lists psychiatric and psychological conditions and their characteristics.
Earned income exclusion— Portion of the work income received by an applicant for disability benefits, that is not considered in determining “countable income.”
Expedited reinstatement— Process whereby a recipient of disability benefits who is terminated for earning too much income can quickly begin to receive benefits again if his or her income dips below SSA’s income limits. Expedited reinstatement must be requested within 60 months of the date that benefits are terminated for excess income.
Failure to cooperate— Term SSA uses when they ask an applicant to take an action and the applicant does not respond.
Federal Benefit Rate— Monthly maximum amount of SSI that the Federal government pays either an individual or a couple. Many states supplement this amount.
Fully favorable determination— SSA decision that is completely in favor of an applicant for, or recipient of, disability benefits.
Good cause— Valid reason for not complying with a SSA rule or regulation.
Grids— Medical–Vocational guidelines used by SSA at Step 5 of the sequential evaluation process to determine if a person can engage in SGA.
International Classification of Diseases (ICD)— A diagnostic manual.
Impairment–related work expenses— Costs associated with helping a person with disabilities to work.
In–kind income— In–kind income is not cash, but is actually food or shelter, or something you can use to get one of these.
Legal incompetence— A decision issued by a court, after reviewing evidence, that a person is not able to make decisions on his or her own behalf.
Listings, the— Compilation of physical and mental impairments used by SSA to determine whether a SSDI or SSI applicant is disabled at Step 3 of the sequential evaluation process.
Medicaid— A Federal health insurance program for low-income and disabled people.
Medical evidence— In this context, evidence used to indicate the existence of specific impairments and to demonstrate the severity of those impairments. Medical evidence can include objective information such as medical or laboratory tests; treatment records from a hospital or doctor’s office; medical or psychiatric conclusions reached by a physician or psychologist; and medical histories.
Medicare— A Federal health insurance program for aged and disabled people.
Notice— Official communication from SSA.
Partially favorable determination— When an applicant is determined disabled, but not for the entire time during which disability was alleged.
Period of ineligibility— A number of months during which a SSI recipient is not eligible to receive benefits.
Presumed value rule— A reduction in SSI benefits, of up to 1/3 + $20, that SSA makes when a person receives in kind assistance and the one third reduction rule does not apply.
Presumptive disability determination— A procedure, authorized by Social Security rules, under which applicants for SSI who have a high probability of being found disabled once all evidence is received can receive up to six months of payments before a full medical evaluation is completed.
Protective filing date— The date SSA recognizes as the official date when an application was filed, even if the application was physically received on a later date.
Release of information— Legal document signed by an applicant allowing a health care or other service provider to release confidential treatment information to the DDS or to SSA.
Representative— Person who has been formally identified to SSA by an applicant as someone who can act on the applicant’s behalf.
Representative payee— Person who is responsible for receiving and managing a recipient’s SSI/SSDI benefit.
Request for Reconsideration (SSA–561)— Form used to request an initial appeal in a SSDI or SSI case.
Retroactive benefit— Benefits paid from the date as of which a person is determined to be disabled through the date when the determination of disability is issued.
Sequential evaluation process— Five-step process SSA uses to determine if a person is disabled.
Transfer— When an applicant for or recipient of disability benefits gives cash or other resources to another person.
Trial work period— SSDI work incentive program that allows SSDI recipients to continue receiving benefits for a trial period once they are employed.
Unearned income— Any income that is not earned through paid employment (e.g., alimony, child support, retirement benefits)
Unfavorable determination— SSA decision that finds a person ineligible for disability or other benefits.
Unstated income— The difference between documented monthly living expenses and reported monthly income.
One–third reduction rule— A one–third reduction in SSI benefits that SSA makes when a person lives in the household of another person for a full month and receives both food and shelter from that person.
Waiver of overpayment— Formal agreement with SSA that a person who has been overpaid by SSA does not have to pay back some or all of the money.
Whereabouts unknown— Classification for cases that are closed by SSA when an applicant cannot be reached.