Strengthening Applications: Diving In: A SOAR Application Walk Through

1. Strengthening Applications: Diving In: A SOAR Application Walk Through Presented by: National SOAR Technical Assistance Center Policy Research Associates, Inc. Under contract to: Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services

2. Welcome • Pam Fischer • SAMHSA

3. Webinar Instructions • Question instructions • Muting • Recording availability • Downloading documents • Evaluation

4. Agenda Organizing the Application and Getting Started Kristin Lupfer, SOAR Technical Assistance Center Identifying Applicants and Writing Successful Reports Katie League, Baltimore, MD Being Proactive and Functional Summary Reports Sara Stoffers and Lorelei Church, Salt Lake City, UT Incorporating SOAR into a Diversion Treatment Court Susan Berberian, Decatur, GA Questions and Answers Facilitators: National SOAR Technical Assistance Team

5. Organizing the Application and Getting StartedKristin LupferNational SOAR Technical Assistance CenterPolicy Research Associates, Inc.

6. SOAR Critical Components • Serving as the appointed representative • Collecting and submitting medical records • Electronically submitting applications and medical evidence whenever possible • Collaborating with physicians for assessments and medical information • Collaborating with SSA and DDS • Submitting a Medical Summary Report

7. Getting Started: Completing an Initial SOAR SSI/SSDI Application

8. Getting Started: Day 1 SOAR Consent for Release of Information

9. Getting Started: Day 1 • Complete the top-half of the Applicant Tracking Worksheet and use as a cover-page in your client file

10. Getting Started: Day 2-3 • Complete and have applicant sign the SSA-1696 Appointment of Representative form

11. Getting Started: Day 2-3 Agency Release SSA-827 Request Letter

12. Getting Started: Day 2-3 Medical Records Department Spreadsheet

13. Getting Started: Day 2-3 Applicant Assessment Worksheet

14. Getting Started: Week 1-2 http://www.ssa.gov/disabilityreport

15. Getting Started: Week 3-4 SSA-8000: Application for SSI

16. Getting Started: Week 3-4 http://www.ssa.gov/applyfordisability/

17. Getting Started: Week 5-8 Medical Summary Report (First and last pages)

18. SOAR Application Checklist

19. Reminder! A Complete SOAR Packet Includes: • SOAR Checklist as a cover sheet for the completed application package • SSA-1696 Appointment of Representative form • SSA-827 Authorization to Disclose Information to SSA • SSA-8000 signed and dated by applicant • MSR signed by the SOAR provider as well as the applicant’s physician or psychologist • Copies of all medical records in chronological order • SSA-3368 and SSA-16 submitted on-line 24-48 hours before turning in completed application package (Items 1-6)

20. Identifying Applicants and Writing Successful ReportsKatie League, LCSW-CHealth Care for the HomelessBaltimore, MD

21. Identifying Applicants • Knowledge of individual • Where they present • Symptom awareness • Don’t choose your most challenging client • Consider availability of co-signer • Current partners and engagement

22. SOAR Applicant Checklist

23. Writing Your First Report: Strategies • Reviewing Medical Records • Questions to Ask • Documenting Observations

24. Reviewing Medical Records • Flag important information in medical records: • Diagnoses • Quotes • Descriptions of symptom • Use quotes to create paragraphs • When you find something useful put it in a document right away

25. Questions to Ask the Client • What does the client’s diagnosis mean to them? • Find out how THEY experience the symptoms • Don’t assume!

26. Documenting Observations • Observations: - How they say things - Speech: Pace, flow, words used - Appearance, movement - Eye contact, eye movement

27. Being Proactive and Functional Summary ReportsSara Stoffers and Lorelei ChurchState of Utah General AssistanceSalt Lake City, UT

28. Being Proactive: Starting an Application • Secure protective filing date ASAP • Customers may get more money the sooner you file • Get Releases of Information signed ASAP • Include necessary medical providers and collateral contacts • Ask claimants to prepare for your next contact • Create a list of all medical providers and facilities

29. Being Proactive: DDS Coordination • Contact DDS for needed information: How can I help? • Confirm alleged conditions • Medical records requested, missing and received • If denied, what symptoms are not present in the records to meet the listing? • Request the records used to make the decision • Know and use your local DDS terms when appropriate • Send records as soon as you can • Don’t wait to submit all records together • If inheriting a claim, read others’ notes and verify the work noted was completed with DDS

30. Being Proactive: Collaboration • Create and maintain creditability and reliability • If you state the application is SOAR, then follow the SOAR model • If you mark a time for an appointment, be available at that time • Build relationships (community partners, collateral contacts, DDS, etc) • Learn their names, roles and acknowledge their expertise • Set specific deadlines. Communicate these to others (including DDS) • When will you provide information? • When do you need information? • What will happen if the deadline is not met? • Coordinate with other SOAR providers and co-workers • Ask others to give you feedback • Explain your roll to the claimant • Use Google to research unknown information

31. Being Proactive: Organization • Make copies of all information submitted to DDS • Document your progress in your own records and with DDS whenever possible (Date, time, what was discussed) • Use fax coversheets, ERE notes, etc… to document DDS info and requests needed • Spreadsheets/tracking of previous information are great • Track examiner and claim # in case notes • Medical records requested, missing and received • Local medical providers with medical records request procedures and contact information

32. Functional Summary Report: Educating the Client • Begin laying out groundwork of summary report at first appointment • Explain to the claimant the purpose of the summary report • How it will be used: “Paint a picture” • How long will it take? • Tell them how many appointments it will take to complete summary questions • Make sure they are comfortable with sharing personal history and if they are not that is okay

33. Functional Summary Outline

34. Information to Include in Summary • Review health records on hand for any info • Use the SSA Blue Book • http://www.ssa.gov/disability/professionals/bluebook/ • What is the listing? • Show link between function and diagnosis • Always keep in mind or substantiate why claimant cannot work • Use footnotes • Provide contact information of any individual or organization referenced in your Functional Summary: Full name & title, address, phone, fax, email • If summarizing information in other records, cite it and attach it. (reports, photos, collateral letters etc…) • Label attachments • Ex: See Attachment 1: Dr. Smith’s mental health report, January 25, 2011  • Utilize functional questionnaire completed by claimant

35. Wrapping Up • Know what records say and don’t contradict yourself • Ensure what you note in Functional Summary is consistent with medical records and Function/Work History Reports • Doctor’s co-signature = Medical evidence • Be careful when asking a physician to sign off on information they may not have discussed with the claimant • Ask the claimant if they have shared the information with the physician • Don’t tell DDS the claimant is disabled, but let them draw that conclusion because you provided the evidence and information

36. Functional Provider Signature Request

37. Incorporating SOAR into a Diversion Treatment CourtSusan Berberian, LCSW, CPRPDiversion Treatment Court, Magistrate Court of DeKalb CountyDecatur, GA

38. Diversion Treatment Court • Mental Health Court • Voluntary pre-plea program • Mental illness and co-occurring disorders • Felony or misdemeanor • Comprehensive Services • Judicial supervision, treatment connections, community training, counseling, housing support, SSI assistance

39. Brief Screen • Court observation for informed decision • Description of program and expectations • Two-page brief screen form • Needs assessment for SSI/SSDI • Medical records requested, appointment made for Biopsychosocial assessment • SSI Applications in Process Tracking Form

40. Biopsychosocial Assessment • Thorough assessment, include quotes • Symptom checklist • Team case review • SSI may be added as a bond condition

41. SSI Paperwork Appointment • Complete prepared packets of forms • SSA-8000 (SSI App) • SSA-16 (SSDI App) • SSA-3368 (Disability Report) • SSA-827, Agency Release • SSA-1696 • Explain the process, give handouts, etc. • Online applications completed within a couple days of the appointment • Signed forms are delivered to document drop box at SSA field office

42. Family Collateral Contact • With permission, contact family • Schedule one-on-one appointment • Use Medical Summary Report-Family Collateral form • History, symptoms, functioning • Last 12 months (incidents or episodes) • Mobile crisis to house, police to house, hospital, jail, citation

43. SOAR Case Follow-Up • Medical records reviewed as received • Medical Summary Report (MSR) completed • DTC and family signatures obtained • Mental Impairment Questionnaire (MIQ) completed • MD given MSR, MIQ, letter of explanation • Follow through while in DTC, referral as necessary

44. Questions and AnswersFacilitators:National SOAR Technical Assistance Center TeamPolicy Research Associates, Inc.

45. For More Information on SOAR Visit the SOAR website at www.prainc.com/soar Or contact: SOAR TA Center Policy Research Associates, Inc.Delmar, NY518-439-7415soar@prainc.com