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Details about initial determinations for SSI benefits?

There are many terms that will be heard and read by a New Jersey resident who is seeking Supplemental Security Income (SSI). Some of them are relatively easy to understand. Others can be more complex and confusing.

When trying to meet the requirements to be approved for SSI benefits, however, some of these seemingly arcane and unimportant terms could be the difference between an approval or a denial. It is not necessary for an applicant to be able to teach a course on SSI, but it is wise to know what to expect when terms like "initial determination" are referenced.

When a person is applying for SSI benefits, there was an event post-eligibility or during an intermittent redetermination, the initial determination is the first decision made by the Social Security Administration (SSA). In general, this will center around how much SSI a person should get or if he or she is or should remain eligible to get SSI. People who receive an initial determination they are dissatisfied with have options.

The SSA grants alternatives for independent reviews. This is based on an administrative appeal, and there are several levels available. For a person requesting a review, it is imperative to do so in the necessary time-frame. Failure to adhere to the required time constraints will result in the SSA's decision being finalized and binding except in the case of administrative finality. That will be discussed in a separate post. The applicant can appeal based on the initial determination. There is no right to appeal a matter that is not linked to an initial determination, therefore knowing what falls into the category of an initial determination is critical.

The following are examples of initial determinations: a person's eligibility based on the fundamental SSI criteria of age, blindness or disability; the amount of SSI payment; residency, citizenship or alien status; how much income the person gets and what is counted as income; living arrangements, and much more. When a person believes he or she meets the requirements to get SSI benefits, there are various factors that could impact the SSA's decision. Initial determinations fall into that category. A legal professional who has experience with helping clients with their Supplemental Security Income cases should be consulted with when considering seeking benefits to ensure all parts of the process are handled correctly.

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