What Is Presumptive Disability and How It Affects Benefits

What is presumptive disability? Discover how presumptive disability impacts your benefits eligibility, the qualifying conditions, and how to apply.

If you or a loved one have a severe illness such as a stroke, total blindness, or similar, then you may qualify for presumptive disability. Continue reading to find out if you qualify and understand the impact of presumptive disability.

What Is Presumptive Disability?

Presumptive Disability is a condition that is so severe that it renders you permanently unable to perform your previous work duties. Social Security sets forth a “Presumption of Disability,” meaning that before the Disability Determination Services has a chance to review your case, the Social Security Administration will issue up to six months of disability pay before an official decision is made on your disability case. It is important to note that presumptive disability is for Supplemental Security Income (SSI) cases.

How Presumptive Disability Affects Your Benefits

If you are deemed presumptively disabled, the Social Security Administration begins sending your Supplemental Security Income benefits immediately, before a full review of your claim. Payments can continue for up to six months and do not have to be repaid even if you are ultimately not found to have a qualifying disability. This is one of the rare instances where there is no overpayment.

What Conditions Qualify for Presumptive Disability?

  • Total blindness: Complete lack of light perception, documented as no light perception (NLP).
  • Total deafness: Usually the result of inner ear or nerve damage.
  • Leg amputation at the hip: The entire leg is removed at the hip or pelvic level, leaving no residual limb.
  • Down syndrome: A genetic condition where a person is born with an extra copy of chromosome 21, resulting in 47 chromosomes instead of 46.
  • HIV or AIDS: HIV stands for human immunodeficiency virus, the virus that causes HIV infection. AIDS is the most advanced stage of HIV infection.
  • Spinal cord injuries: Damage to any part of the spinal cord or nerves at the end of the spinal canal.
  • Amyotrophic Lateral Sclerosis (ALS): Also known as Lou Gehrig’s Disease, a rare neurological disease affecting the motor neurons that control voluntary muscle movement.
  • Low birth weight for children under age one: Babies born at a significantly low birth weight are eligible for presumptive disability, regardless of whether the baby was born premature.
  • Cerebral palsy, muscular dystrophy, or muscular atrophy: Cerebral palsy affects muscle tone, coordination, and mental function, while muscular dystrophy mainly affects muscle tone.
  • Intellectual disability or neurological impairments: Intellectual disability is considered a neurodevelopmental disorder.
  • Bed confinement or immobility due to a longstanding condition: If you are confined to your bed or rendered immobile due to a previous condition.
  • End-stage renal disease (ESRD) requiring chronic dialysis: ESRD occurs when the kidneys are no longer able to work at a level needed for day-to-day life.
  • Terminal illness with a life expectancy of six months or less: This could be cancer or another disease.
  • Stroke that occurred more than three months ago and still causes difficulty: A stroke, or brain attack, occurs when something blocks the blood supply to part of the brain or when a blood vessel in the brain bursts.

Presumptive Disability vs. Total Disability

The Social Security Administration’s decision to grant presumptive disability payments is based on the severity of your condition, the available evidence, and the high likelihood that your claim will be ultimately approved. It is not based on your financial need.

How to Apply for Presumptive Disability

Our office can help you apply, and you can call (855)503-0101, you can apply online, over the phone at 800-772-1213, or in person at your local Social Security Office. Our social security disability attorneys are looking forward to hearing about your case.

Presumptive Disability FAQ

How Long Does It Take To Get Presumptive Disability?

The response time for Presumptive Disability is much quicker than for a regular disabling condition because your presumptive disability is likely to last until death and is very severe. However, what ultimately qualifies as a presumptive disability is determined by your condition and medical history.

How Long Do Presumptive Disability Benefits Last?

Presumptive Disability benefits last for six months and can convert to full Social Security benefits if approved.

Can I Still Receive Presumptive Disability Benefits If My Claim Is Denied?

You can receive presumptive disability benefits for up to six months if your claim is denied, and you do not have to pay these benefits back. Presumptive benefits are not considered an overpayment that needs to be repaid.