SOAR Packet 1

Clark County, WA

Packet 1:Submit Online

These forms may all be sent in the mail,but only if necessary

SSA-16 The SSDI application

Secure your client’s protective filing date

Can also be electronically signed if your client is present. If client is not present, still complete online and have client sign paper application. Send to SSA with packet 2 contents

SSA-8000The SSI Application (Only if applicant meets the following criteria. If not, then proceed onto Packet 2 as usual).

a. Are between the ages of 18 and 65;

b. Have never been married;

c. Aren’t blind;

d. Are a U.S. citizen residing in one of the fifty states, District of Columbia, or the Northern Mariana Islands; and

e. Haven’t applied for or received disability or SSI benefits in the past

SSA-827 Authorization to Disclose Information to the Social Security Administration

  1. Allows SSA and DDS to obtain medical records for your client
  2. This form can be signed electronically if your client is present
  • If your client is not present, the originalcopy needs to be sent to SSA in

Packet 2

  1. Keep a copy for yourself

SSA-i3368 or SSA3368 The Disability Report

  1. Always completed online
  2. A list of commonly used medical facilities is posted on the Clark Co. SOAR website to assist you with this form

Timeline:

These four steps in Packet 1 should be completed in one day

Note: It is always a good idea to print copies of each form once they’ve been submitted electronically. Don’t forget to write down the application number for both the SSA-16 and the SSA i3368. You will not be able to get back into the application without this numbe

SOAR Packet 2

Clark County, WA

Packet 2: Send in the mail to the Social Security Administration

Best practice is to send packet contents in this order

SOAR Cover Sheet

SSA-827only if not electronically signed online (See Packet 1)

SSA-1696send copy that says “File Copy”

  • Claimant copy-To client
  • Representative copy- Put in Client File
  • ODAR copy -Keep in client file in case a hearing is needed

SSA-8000 The Application for Supplemental Security Income

a)Fill out completely and signed

b)Keep a copy for your client’s file

SSA-3373 The Function Report-Adult

a)Filled out by your client with your support

b)Keep a copy for your client’s file

Note:AFunction Report-“Third Party” may be sent to you after Packet 2 is submitted. You should complete it and fax it back using the barcode enclosed

SSA-3369 The Work History Report

a)A good way to fill this out is to have your client bring in an old resume

b)Keep a copy for your client’s file

c)If no work history then complete it and indicate “no work history”

Timeline:

Packet 2 should be mailed or hand-delivered to SSA no later than one week after Packet 1 has been submitted online

SOAR Packet 3

Clark County, WA

Packet 3: Send to Disability Determination Services (DDS)through Electronic Records Express (ERE) or FAX

Note: If you do not receive a barcode document within 3-4 weeks of submitting Packet 2, call DDS and request one

ERE: Upload documents in this order:

*You will need the Barcode document to enter the ERE system

Medical Records Cover Sheet

a)Completed with the medical sources, dates of service and dates of visit

b)This document can be found on the Clark County SOAR webpage

Personal History Report- Don’t forget to sign it

ALL medical records you received

FAX: Fax documents in this order to the adjudicator:

The BarcodeDocument

a)This document must be on top of all faxed items

Medical Records Cover Sheet

a)Completed with the medical sources, dates of service, and dates of visit

b)This document can be found on the Clark County SOAR website

SOAR fax cover sheet

Personal History Report-Don’t forget to sign it

ALL medical records you received

Timeline:

After Packet 2 has been sent to SSA, begin requesting medical records within one week

After records request(s) have been faxed, schedule time to meet with client to begin working on Personal History Report (should be within one week of when medical records requests were sent)

Begin writing Personal History Report (should be started within three weeks of submitting Packet 1)

If you have not heard from the DDS adjudicator within one month of your client’s protective filing date, you will need to call DDS and ask if your client has been assigned. The number to call is 800-562-6074

Once you’ve made contact with the adjudicator, request the barcode. You may have to leave a voicemail for the adjudicator asking them to send it to you

Medical records and Personal History Reports should be uploaded via ERE within a month and a half from your client’s protective filing date. No later than two months from protective filing date if you haven’t received all the requested records

Note: If you do not receive the barcode from the disability adjudicator, the best option is to call DDS at: 1-800-562-6074. You will speak to a receptionist who can look up your client’s adjudicator, but you must have the answers to the security questions (place of birth, mother’s maiden name, and father’s name). Once you have the name of the adjudicator and their phone number, ask to be transferred. If the adjudicator doesn’t answer, leave a message indicating you have medical records to submit and would like a copy of the barcode either mailed or faxed to you (your preference).

If you call and leave a message or speak to the adjudicator and don’t receive the barcode, please let Suzanne know and she will go through the proper channels to assist with this. If you experience that you are leaving messages for the adjudicator (to update he/she on your client’s information) and they aren’t calling you back, please contact Suzanne.

SOAR Packet 4

Clark County, WA

Packet 4: For your use as needed

Note: All letters should be printed on your own agency letter head and signed with your credentials

Medical Records Request Letter

Authorization for Release of Information (ROI)

  1. This ROI is used along with your agency ROI to request medical records

Letter to SSA to request electronic file (e-file)

Personal History Report Worksheets

  1. To help assist in writing the Personal History Report only
  2. Do not turn into SSA

Applicant Tracking Worksheet

  1. Helpful for client’s file to have all their vital information on hand when calling SSA
  2. You will also need to know client’s place of birth, mother’s maiden name, and father’s name when calling SSA for information about current SOAR applicant status

SSA-3288

  1. Used only if you are requesting information from the Social Security Administration about your client’s current or past application status before SOAR involvement
  2. Must include a return address for the agency requesting information (no information can be released without it)

Updated: May 2017