SOAR Guidance for Referring Partners

1. Determine if your client is SOAR-appropriate.
   1. Do they have a diagnosed mental illness?
   2. Have you observed them have difficulties functioning?
2. If the answer is yes and yes, completely fill out this SOAR Referral, and send to us either by fax at 215-523-9599 or email to Michele Levy at [email protected].

We have a wait list that’s a few months long. In that time, there are a few steps you can take to improve you clients’ chances of a successful SOAR claim.

1. Make sure your client is in active outpatient treatment! If they aren’t already, you should try and set them up with an intake ASAP after making the SOAR referral.
   1. Important! Not all records are equally helpful. It is critical to a claim that the outpatient records actively and consistently reflect the challenges and symptomatic behavior we are building our case around. If the records indicate the client is doing fine, we are not going to have much to stand on.
2. Build up some sober time.
3. Call CBH and request their treatment history. You will want to have this in hand by the time we call you, so that we can have a full and accurate idea of the client’s treatment history.
4. BONUS: request those records from the service providers. This is usually something we do after intake, but it takes a month or so, and if we have them in hand at time of intake, we can hit the ground running and significantly reduce the time the case will take.

Whether or not you are present during intake is up to you and your client. If your presence there would help make sure we get the most accurate information, then we’d encourage you to be present. We will certainly lean on you to help set up the intake, preferably either over zoom or in person, here at HAP. Intakes are typically 30-60 minutes. All billable!

This is your best opportunity to directly and significantly support your client’s case. Here’s a more in-depth guide for writing a function letter, and here’s an example of a strong one.

In short, a strong letter will do three things:

1. Establish your relationship with your client:
   1. how long you have been working with the client
   2. how often you meet with them
   3. a list of any other supports they might have
   4. all the ways in which you support them.
2. Provide a brief history of the client.
   1. Where do they live? If in a program, explain how it’s supportive.
   2. How long have they been diagnosed?
   3. If they have a trauma-related mental illness, explain any traumatic experiences.
3. Detail the client’s symptoms, behaviors, and specific functional limitations.

HUGE: if you are able to get their prescribing doctor or psychiatrist to contribute to the letter or co-sign it, it will carry that much more weight.

These don’t have to come from just case managers either. A willing therapist would be a great source for a letter.

Generally just be in touch, with the client and with us. Sometimes there are additional appointments we have to set up for clients, and in those instances your support is extremely valuable.

If and when we do get a favorable decision, you can help make sure your client completes their PERC appointment with SSA to actually get into pay. Just have them call 1-866-613-3969 and say they have won their case and need to complete their PERC appointment.

If necessary, support them getting a payee, too.

Treatment providers (typically doctors, CRNPs, and therapists) have enormous impact on the outcome of a disability claim. Whether you want that impact or not, it’s your treatment record that directly informs a decision from SSA.  Here is some general guidance on how to best support your patient in their disability claim:

• Detailed treatment documentation. SSA will review all treatment notes leading up to a decision, and those patients whose notes accurately reflect their symptoms and limitations will have a much better chance at success than those whose notes are cursory.
  • “Doing well on current meds” mean something very different to a prescribing doctor than it does to SSA!
• For any changes in medication, make sure to note the reason. If a change in medication or dosage indicates persistent or worsening symptoms, then we want to make sure that is brought to the attention of SSA. Likewise, if it’s your opinion that a patient should be taking a medication, even if they are refusing it, making mention of your opinion will matter.
• Pay attention to Mental Status Exams! SSA looks very carefully at any section of a medication note where the patient’s mental status is addressed. These sections are very often a check list, and we have seen many cases denied because the check list reflect that everything with a patient is more or less stable.
• Weigh in directly on your patient’s functional capacity.
  • Feel free to utilize this Medical Source Statement.
  • Another option is to write a function letter detailing the ways in which a patient’s symptoms and behaviors limit their ability to function in four general areas. Scroll up two sections to see our general guidance on those.
• Take care to differentiate between mental health issues and addiction issues. SSA does not recognize any addiction issues as disabling.

It can never hurt to familiarize oneself with exactly what Social Security is using to medically determine disability. See their listings for mental disorders here, and click here for all impairments.