Solutions, Government, SSDI offsets & assistance

The SSDI offset, found early

SSA's five-step sequential evaluation, the listings, the residual-functional-capacity finding, the grids: all public, all knowable, and almost never modeled inside an LTD or DI file. Owl reads the claim, walks SSA's logic, predicts the award stage and date, and meters the offset before overpayment.

Policy triggers, fires / doesn'tOne filed claim
Triggered
Step 1: Substantial Gainful Activity (SGA)

Claimant has zero earnings since DOL per W-2 + 1099 cross-check; SGA threshold is not met.

cite: POMS DI 24001.001, 2025 SGA limit $1,620/mo
Triggered
Step 2: Severe medically determinable impairment

Two corroborating specialists, objective imaging (MRI L4-L5), 12-month duration met.

cite: POMS DI 24515.062, 20 CFR 404.1520(c)
Not triggered
Step 3: Meets/equals a Listing

Listing 1.15 (lumbar) requires inability to ambulate effectively; physical exam shows independent gait. Does not meet.

cite: Listing 1.15, POMS DI 24508.025
Not triggered
Step 4: Can perform past relevant work

Past work was sedentary insurance underwriter; RFC is light with no overhead reaching. Past work compatible.

cite: POMS DI 25005.020, DOT 169.167-058

Initial award

SSDI award predicted at recon

$2,840/mo

Estimated PIA, 22-yr history

$0 overpayment

If offset metered correctly

03A real claim, walked end to end

One claim: lumbar disc disease, age 55, an LTD claim with $50K of latent SSDI offset.

Anonymized composite: own-occupation LTD claim, claimant 55F, sedentary underwriter, lumbar radiculopathy, MRI confirms L4-L5 disc protrusion.

Claim #
GS-2025-008812
Member
55F, sedentary
Onset
DOL 2024-08-12
Predicted award
Recon, ~M14
Offset NPV
$48,720
OwlVision
What it read
LTD claim file + APS
84 pp
Read: Indexed
Medical record (orthopedic + PT)
312 pp
Read: RFC built
W-2 + 1099 history (22 yrs)
22 pp
Read: PIA estimated
DOT past-work classification
6 pp
Read: sedentary, SVP 7
SSA-827 release authorization
1 pp
Read: valid
Structured extraction
Claimant 55F, DOL 2024-08-12. Lumbar disc disease (M51.36) with radiculopathy (M54.16). MRI: L4-L5 disc protrusion impinging on L5 nerve root. RFC: light exertion, no overhead reaching. Past relevant work: insurance underwriter (DOT 169.167-058, sedentary, SVP 7), with no transferable skills to light work. 22-yr earnings record. Estimated PIA $2,840/mo.
OwlSignal
What the world said about the claimant

External data only. None of this lives in your CMS. Owl gathered it from public records, professional networks, registries and the open web, then resolved it to this claimant.

GRD-01
Grid Rule 202.06 directs disabled

At 55 (advanced age), with light RFC, HS education, and no transferable skills from sedentary past work, Medical-Vocational Rule 202.06 directs a finding of disabled. This is a high-confidence award path; >88% of similar profiles are awarded by reconsideration.

SSA POMS DI 25025.00120 CFR 404 Subpt P App 2Owl SSDI-outcomes cohort (n=24K)
OFF-09
ODAR backlog: 287-day average

Hearing office routing (Atlanta South) currently averages 287 days from request-to-decision. If denied at recon, ALJ hearing decision projected ~M22. Award-most-likely path is recon at ~M14, not ALJ. Set offset accrual on that timeline.

SSA hearing-office statistics 2025SSA ALJ disposition dataOwl ODAR-backlog tracker
BAC-04
Back-pay window: 17 months

EOD established 5 months pre-application; back-pay accrues from EOD+5 (the SSA waiting period) through award month. At projected award M14, back-pay covers ~17 months × $2,840 = $48,280 net of LTD offset.

SSA POMS DI 10105.005SSA POMS GN 02410.215Internal LTD payment ledger
REP-12
Carrier representation: waivable consent

Member has not appointed a representative. Standard LTD assistance referral is appropriate; SSA-1696 to be drafted. Member benefits from claimant-representative path, with historical award-rate uplift of ~9pp at hearing for represented claimants.

SSA-1696 formSSA representative payee dataOwl claimant-rep outcomes graph
OwlAssist
What it answered
Examiner asked
Will this claim award at SSDI? At which stage? When?
Owl answered in 0.7s

Yes. This claim should award at reconsideration, projected ~M14 from DOL. The Step-5 grid analysis (Rule 202.06) directs a finding of disabled given age 55, light RFC, and no transferable skills. The initial denial probability is ~64% (per cohort), but reconsideration approval probability is ~78% with a fully developed RFC and DOT-coded past-work record. ALJ is the fallback at ~M22 if needed. Recommend: refer to assistance vendor today, file initial with the prepared RFC packet, accrue LTD offset against projected M14 award.

Grid Rule 202.06Cohort outcomes n=24KODAR Atlanta South backlogPOMS DI 24001.001
Examiner asked
What’s the safe LTD offset reserve and the overpayment risk?
Owl answered in 0.6s

NPV of estimated SSDI back-pay is $48,720 (17 months × $2,840 PIA, discounted at 4.5%). Set the offset reserve at $48,720 with monthly burn-down. If award lands at recon ~M14, no overpayment. If award delays to ALJ ~M22, back-pay grows to ~$56,400; adjust reserve at recon-decision date. If award is denied through ALJ, write down the reserve at ~M22; downside scenario probability is 6.4% on this profile.

POMS GN 02410.215LTD plan §6 SSDI offsetCohort outcome distributionsPIA worksheet
04OwlSignal external data

What the world says about your SSDI claimants, none of which lives in your CMS.

Internal claim data is half the picture: it tells you what the claimant told you. OwlSignal continuously gathers external data (public records, professional and corporate registries, court dockets, social and open web) and matches it back to the claimant. These are the families that move the needle on SSDI.

SSASSA Listings, POMS, Grid Rules

The full SSA listings (Adult and Child), the POMS operations manual, medical-vocational grid rules, and the DOT/SCO occupational references, walked element-by-element on every claim.

SSA POMS20 CFR 404 Subpt PSSA Blue Book listingsDOT/SCO 2025
COHSSDI Outcomes Cohort

Owl’s cross-carrier SSDI-outcomes graph: 2.4M tracked claimants, outcome by impairment + age + RFC + region + ODAR office. The base-rate engine that calibrates predictions.

Owl cross-carrier SSDI cohortSSA Annual Statistical ReportCCSDI public datasets
ODRODAR, ALJ, Hearing Office

Hearing-office backlogs, ALJ approval-rate distributions, average days to decision, remand rates, and Owl’s tracker of ALJ behavioral patterns by issue type.

SSA hearing-office statsSSA ALJ disposition dataOwl ALJ behavior tracker
PIAPIA + Earnings History

IRS W-2 / 1099 reconciliation, SSA earnings record, PIA estimator with bend-points, family maximum, and AIME calculation. The numbers the offset reserve is built on.

SSA earnings recordIRS W-2 / 1099 historySSA PIA tables 2025
VOCVocational + DOT

DOT past-work classification, SCO functional ratings, transferable-skills analysis, and the vocational-expert testimony patterns Owl learned from public ALJ transcripts.

DOT/SCO 2025O*NET cross-walkOwl VE testimony corpus
REPRepresentation + Form Packets

SSA-827, SSA-1696, the representative-payee data, ABA-certified-rep registry, and Owl’s tracking of claimant-representative outcomes by region and issue type.

SSA forms librarySSA rep-payee dataOwl claimant-rep outcomes
Refreshed daily, matched by identity-resolution, every observation cited to its source.
05What changes

Numbers from carriers running Owl on SSDI offsets in production.

MetricWithout OwlWith Owl
SSDI eligibility identified by day 1 of LTD12%94%
Award-stage prediction accuracyn/a83%
Cycle time, assistance referral packet11 days38 minutes
Latent SSDI overpayment per 1K claims$1.84M$210K
Offset reserve accuracy (vs. actual back-pay)±32%±6%
LTD claims net of SSDI, annual savings$2,400 / file
Source: rolling 12-month average across 4 LTD carriers + 1 IDI carrier, n = 38K SSDI-eligible claims.

Built for the regulatory shape of SSDI.

07Integrations

Lives where your SSDI files live.

LTD / IDI platforms

FINEOS, Majesco, Origami, DXC, in-house

SSA assistance vendors

Allsup, Genex, The Advocator Group, GenEx

Earnings + tax data

Equifax Work Number, IRS income transcripts (with consent)

Medical records

MRO, Verisma, Datavant, ChartRequest

Document intake

Box, OnBase, ImageRight, Documentum

Identity & SSO

Okta, Azure AD, PingFederate, SAML, SCIM

08Get started

Bring us a quarter of LTD claims. We’ll show you the SSDI offset on day one.

Two-week pilot. Your LTD stream, your tenant, your plan documents. We measure SSDI eligibility detection, award-stage prediction, offset reserve accuracy and overpayment exposure against your own ground truth.