Special thanks to the “Health Forward/Salud Adelante” team for sharing their reflections and learnings on their BUILD Opportunity Fund Award in this blog. BUILD awardees were eligible for ad hoc funding awards to catalyze efforts in policy, data, system change, and/or health equity that complemented their ongoing efforts to support community health.
Legal Aid Chicago resolves critical civil-legal problems that trap people in poverty. Staff prevent unfair evictions from the only decent housing our clients can afford; protect survivors of sexual assault, human trafficking and domestic violence; secure or preserve desperately needed benefits such as veterans’ benefits, social security, or health benefits; assist senior citizens who have been swindled by consumer scams or robbed of their livelihoods through fraudulent consumer scams; and help children receive the education they need to succeed.
Cook County Health is a public hospital and health system that has been meeting the health care needs of Cook County’s underserved populations since 1857. Legal Aid Chicago, Cook County Health, and the Chicago Department of Public Health entered into a Medical-Legal Partnership in 2017, with the support of the BUILD Health Challenge, to address the health-harming legal needs of Cook County Health patients who receive care coordination services.
Through the BUILD Health Challenge Opportunity Fund award program, Legal Aid Chicago received $50,000 in 2018 to begin a SOAR Disability Application assistance program through our Medical-Legal Partnership with Cook County Health.
Supplemental Security Income/Social Security Disability (SSI/SSDI) Outreach, Access, and Recovery (SOAR) is a methodology created by the Substance Abuse and Mental Health Services Administration designed to increase access to Social Security Administration disability benefits for eligible individuals who are experiencing or at risk of homelessness and have a mental illness, medical impairment, and/or a co-occurring substance use disorder.
The SOAR advocate interviews clients to gather information about their potential eligibility for disability benefits from the Social Security Administration; works with the client to complete the Social Security application forms and supporting documents; collects medical, vocational and educational records; analyzes those records to determine if they support a finding of disability; works with medical providers to create new evidence that explains how client medical conditions limit client functioning, rendering the client disabled as defined by Social Security; submits all of this information to Social Security; and follows-along with the client and Social Security until a decision is made.
Below are a few examples of patients who participated in the SOAR Disability Application assistance program:
- Mohammed A. is two years old and diagnosed with Tay Sachs, a progressive neurological condition that is not treatable. We were able to help him qualify for SSI in just 43 days. The family, which speaks Urdu, had tried to work with other attorneys to apply for disability benefits but kept getting turned away because of language barriers.
- Steven R. is a 60-year-old recent widow experiencing homelessness. He suffered from heart disease, which prevented him from continuing his past work as a plumber. We successfully helped him apply for Social Security widow’s benefits. He began receiving $1,001 in monthly benefits just 81 days after his application was submitted.
- Mary M is a 60-year-old legal permanent resident from Poland who has been living in a nursing home for many years and uses a wheelchair because of a leg amputation. She did not require nursing home care, but did not have any income to support herself living independently. She had previously been denied SSI because she could not prove residency. All of her identification was stolen and lost 5 years ago. For months, we gathered existing documentation, contacted the consulate in Poland, conducted research, and circumvented repeated dead ends. Finally, we were able to complete the application for green card renewal, and she got her replacement green card. Her SSI application is now pending and we expect it to be approved. Mary’s case demonstrates the importance of being able to provide SOAR services in a law firm where the applicant can be easily connected to other legal services that increase the likelihood of a successful disability application.
- Michael L is a 42-year-old man whose feet were amputated after he experienced frostbite living on the streets. He had been receiving SSI disability benefits prior to 2012 because of cognitive impairments, but was not sure why they stopped. We assisted with a new application. Once it was received by the Disability Determination Service (DDS), it was fast tracked and approved.
Cook County Health referred 61 patients for assessment and assistance related to Social Security Disability benefits. Legal Aid Chicago’s SOAR advocate submitted applications for 31 of those patients. So far, SSA has issued decisions on 17 of those applications. 11 have been approved and 6 have been denied. The 65% approval rate is much higher than the national 29% approval rate on all initial disability applications processed by Social Security.
Social Security has initiated benefits for 8 out of the 11 clients who have been medically approved. The Project obtained back awards totaling $22,861.97 and a total increase in annual income of $70,056.00, or an average of $8,757.00 per approved client.
Among the lessons learned:
- Communication is so important. The Medical-Legal Partnership facilitates staying connected with patient and clients, particularly with a population that can be very difficult to keep engaged. People experiencing homelessness, with a history of substance use disorders or mental health diagnoses, have additional barriers and challenges when engaging with the administrative process. Working with care coordination and having additional opportunities and spaces to connect was very valuable. Having a medical provider as a partner made access to medical records and development of provider opinions easier.
- Having SOAR coordinators at the Social Security Administration and at other community partners made a difference for our clients. There were many times when we would hit a stumbling block at the local SSA office or DDS. When we reached out to the SOAR liaison or tapped into the broader knowledge base of the community, we were able to overcome that barrier.
About BUILD’s Opportunity Fund:
In 2018, BUILD’s funder collaborative allocated $250,000 (total) to be made available for past BUILD awardees in an effort to support BUILD projects and improve community health. The goal of this fund is to provide monetary support to awardees when a unique opportunity to catalyze efforts in a targeted manner presented itself. From these projects, BUILD sought to gain insights into the BUILD model, systems change, and better understand the role of targeted interventions that have the potential to be replicated or scaled.