Trying to be an advocate for a friend, but it's so complicated!!!

[happyslug]

6. First he is 54 years of age

Which is a factor is any consideration that he is NOT disabled. As a person ages, it gets easier to win SSI benefits. Now given this person's main problems are psychological those regulations are not a big factor in this case (the regulations, unless they are jobs the claimant has done in the last 15 years, eliminate Sedentary jobs at age 50, light jobs at age 55 and Medium Jobs at age 60, thus geared more to people with Physical problems not Psychological problems).

Second, SSA to find him NOT disabled MUST produce new evidence AND that the evidence shows Medical improvement. SSA can not just say they reviewed the old evidence and now finds the claimant disabled, some new evidence must be produced.

Please remember, the burden is on the claimant that he is still disabled and thus MUST go to any exam SSI schedule him to go to, if possible.

Given the requirement for new evidence, SSA makes it their practice to request people ruled to be disabled to be re-evaluated every so often (Congress says every five years, if SSA has the money, tends to be every five years for people under age 50, but almost never above that age, thus you comment that the Claimant made a request to be removed probably is what kicked in this reevaluation). The fact he has NOT seen a doctor since 2010 only shows that his mental condition is severe, so severe he can NOT even go see a doctor for treatment let alone work.

I tell my client to go to the re-evaluations, see what happens and if they decide to terminate his SSI, AND file an appeal if benefits are terminated (If one appeals within 10 days, the SSI benefits continue during the appeal process, if done within the 60 day appeal period but outside that 10 day period, no benefits till the hearing).

This being a SSI case, you have the re-evaluation and if ruled no longer disabled, file a request for reconsideration (just go to the SSA and get a copy of that form and have him sign it unless you are on records as his Representative, then you can sign it for him). When the Reconsideration is denied (and it almost always is if the original determination denies benefits), file for a Request for a Hearing and call the local Legal Aid agency for representation. File the appeal FIRST, then contact Legal Aid, Legal Aid may NOT get him in within the 10 day appeal period, thus file the appeal then call Legal Aid.

This NOT being a initial request for SSI, most private attorneys will NOT take the case for there is no way for them to get paid. In an initial SSI Case, Attorneys can request up to 1/4 of any arrears as their fee. In a re-evaluation case there are NO arrears to collect that 25% out of.

AS to his mother claiming him as a dependent, that has NO AFFECT ON HIS SSI. That is for Income Tax purposes only. Now SSI, is reduced by any "In kind" assistance he is receiving, but it has to be actual assistance, such as paying his rent, as opposed to giving things that he would want. It is a fine line, but I do NOT see his mother stepping over that line.

Remember as long as he is on SSI, even during the appeal process (which is one of the reasons you file the appeal within the 10 day appeal period), he remains on Medicaid, for his Medicaid is 100% federally funded and the states have no reason to cut it (unlike Welfare Medicaid which is a 50-50 Federal State share, the Federal Government will pay equal to the amount the State says it will pay, but not more but that is ONLY if he is no longer getting SSI).

That SSA is still sending him checks implies to me that SSA has not ruled him ineligible for SSI. I suspect SSA may have ruled him NOT competent to manage his own affairs and if that is the case SSA will NOT take his word that he is no longer disabled. Thuis he continues to get checks.

Please also note, there is a two months delay in SSI checks and eligibility. Thus what you tell SSA about as to income in January affects one's March's SSI. Just a comment about the reevaluation, get him to go to the consultative exam (if and when one is scheduled) and if benefits are denied, file the appeal immediately, so you can get the appeal in within the 10 day period to appeal AND CONTINUE TO GET BENEFITS.