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(must be within 30 days of 18 years of age, or within 180 days if exiting foster care)
(Reverse Chronological Order)
Please list all mental and physical health diagnoses:
Received Treatment for Conditions at the following Facilities:
To assess SSI/SSDI eligibility, we are looking for basic information on:
The presence of medical and/or psychiatric conditions or symptoms which would fit an SSA listing
Current treatment, or a history of treatment for conditions
Inability to work and earn SGA ($1,260/month in 2020) due to medical and/or psychiatric conditions (not because they cannot find work or were laid off)
Impairments in functioning due to medical and/or psychiatric conditions
Thanks for submitting!