Strengthening Applications: Diving In: A SOAR Application Walk Through

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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
  

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Welcome

• Pam Fischer
• SAMHSA

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Webinar Instructions

• Question instructions
• Muting
• Recording availability
• Downloading documents
• Evaluation

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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

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

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Getting Started Completing an Initial SOAR
SSI/SSDI Application
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Getting Started Day 1

• SOAR Consent for Release of Information

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Getting Started Day 1

• Complete the top-half of the Applicant Tracking
  Worksheet and use as a cover-page in your client
  file

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Getting Started Day 2-3

• Complete and have applicant sign the SSA-1696
  Appointment of Representative form

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Getting Started Day 2-3

• Request Letter

SSA-827
Agency Release
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Getting Started Day 2-3

• Medical Records Department Spreadsheet

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Getting Started Day 2-3
Applicant Assessment Worksheet
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Getting Started Week 1-2
http//www.ssa.gov/disabilityreport
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Getting Started Week 3-4
SSA-8000 Application for SSI
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Getting Started Week 3-4
http//www.ssa.gov/applyfordisability/
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Getting Started Week 5-8
Medical Summary Report (First and last pages)
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SOAR Application Checklist
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Reminder! A Complete SOAR Packet Includes

1. SOAR Checklist as a cover sheet for the completed
   application package
2. SSA-1696 Appointment of Representative form
3. SSA-827 Authorization to Disclose Information to
   SSA
4. SSA-8000 signed and dated by applicant
5. MSR signed by the SOAR provider as well as the
   applicants physician or psychologist
6. Copies of all medical records in chronological
   order
7. SSA-3368 and SSA-16 submitted on-line 24-48 hours
   before turning in completed application package
   (Items 1-6)

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

• Knowledge of individual
• Where they present
• Symptom awareness
• Dont choose your most challenging client
• Consider availability of co-signer
• Current partners and engagement

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SOAR Applicant Checklist
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Writing Your First Report Strategies

• Reviewing Medical Records
• Questions to Ask
• Documenting Observations

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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

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Questions to Ask the Client

• What does the clients diagnosis mean to them?
• Find out how THEY experience the symptoms
• Dont assume!

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Documenting Observations

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

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

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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
• Dont wait to submit all records together
• If inheriting a claim, read others notes and
  verify the work noted was completed with DDS

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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

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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

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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

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Functional Summary Outline
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Information to Include in Summary

• Review health records on hand for any info
• Use the SSA Blue Book
• http//www.ssa.gov/disability/professionals/bluebo
  ok/
• 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. Smiths mental health
  report, January 25, 2011 
• Utilize functional questionnaire completed by
  claimant

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Wrapping Up

• Know what records say and dont contradict
  yourself
• Ensure what you note in Functional Summary is
  consistent with medical records and Function/Work
  History Reports
• Doctors 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
• Dont tell DDS the claimant is disabled, but let
  them draw that conclusion because you provided
  the evidence and information

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Functional Provider Signature Request
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Incorporating SOAR into a Diversion Treatment
CourtSusan Berberian, LCSW, CPRPDiversion Treat
ment Court, Magistrate Court of DeKalb CountyDeca
tur, GA
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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

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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

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Biopsychosocial Assessment

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

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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

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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

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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

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Questions and AnswersFacilitatorsNational
SOAR Technical Assistance Center TeamPolicy
Research Associates, Inc.
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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_at_prainc.com