Child’s Social Security Disabilty or SSI Benefits

Disability in Children

Under title XVI, a child under age 18 will be considered disabled if he or she has a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months.

What is a “Medically Determinable Impairment”?

A medically determinable physical or mental impairment is an impairment that results from anatomical, physiological, or psychological abnormalities which can be shown by medically acceptable clinical and laboratory diagnostic techniques.

A physical or mental impairment must be established by medical evidence consisting of signs, symptoms, and laboratory findings-not only by the individual’s statement of symptoms.

There are three ways a child might be eligible for benefits from Social Security Disability or SSI.

The three kinds of benefits are:

  • SSI Benefits For Children are payable to disabled children under age 18 who have limited income and resources, or who come from homes with limited income and resources.
  • Social Security Dependents Benefits are payable to children under the age of 18 on the record of a parent who is collecting retirement or disability benefits from Social Security, or survivors benefits payable to children under the age of 18 on the record of a parent who has died.
  • Social Security Benefits For Adults Disabled Since Childhood Benefits can continue to be paid into adulthood if the child is disabled. To qualify for these benefits, an individual must be eligible as the child of someone who is getting Social Security retirement or disability benefits, or of someone who has died, and that child must have a disability that began prior to age 22.

Although most of the people getting these benefits are in their 20s and 30s (and some even older), the benefit is considered a “child’s” benefit because it is paid on the basis of a parent’s Social Security earnings record.

Child’s Disability Conditions: http://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm

SSI Benefits – Children with Disabilities

Non-Medical Rules

SSI is a program that pays monthly benefits to people with low incomes and limited assets who are 65 or older, or blind, or disabled. Children can qualify if they meet Social Security’s definition of disability for SSI children and if their income and assets fall within the eligibility limits.

Supplemental Security Income works to supplement an income to a specified level determined by individual states.

Children Under 18

The income of a parent and their assets are considered in a determination of qualification for a when deciding if a child under 18 for SSI.

Rules for Children 18 And Older

The parental income and assets are no longer considered once a child turns 18. A child ineligible for SSI before his or her 18th birthday may become eligible at age 18.

If a disabled child getting SSI turns 18 and continues to live with his or her parents, but does not pay for food or shelter, a lower SSI payment rate may apply.

SSI Disability Determination for a Child

Income and assets for SSI are determined by the local Social Security Office. Documents and evidence pertaining to the disability are forwarded to a state office of a disability evaluation specialists and a medical or psychological consultant who review the disability claim.

A special examination may be requested. The expense will be paid by Social Security. Failure to attend the examination, or invalid results due to poor effort, could result in an unfavorable decision.

Deciding SSI Disability For Children Under 18

The law states that a child will be considered disabled if he or she has a physical or mental condition (or a combination of conditions) that results in “marked and severe functional limitations.” The condition must last or be expected to last at least 12 months or be expected to result in the child’s death. And, the child must not be working at a job that we consider to be substantial work.

Social Security Listing of Impairment

See: http://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm

To make this decision, the disability evaluation specialist first checks to see if the child’s disability can be found in a special listing of impairments that is contained in Social Security’s regulations.

These listings are descriptions of symptoms, signs or laboratory findings of more than 100 physical and mental problems, such as cerebral palsy, mental retardation or muscular dystrophy, that are severe enough to disable a child.

The child’s condition does not have to be one of the conditions on the list. But, if the symptoms, signs or laboratory findings of the child’s condition are the same as, or medically equal in severity to the listing, your child is considered disabled for SSI purposes.

If your child’s impairment(s) does not meet or medically equal a listing, the DDS then decides whether it “functionally equals” the listings. They assess the effects of the condition or combination of conditions on your child’s ability to perform daily activities by comparing your child’s functioning to that of children the same age who do not have impairments. To do this, they consider questions such as:

  • What activities is your child able or not able to perform?
  • Which activities are limited in comparison with those of same-age peers?
  • What type and amount of help does your child need to complete age-appropriate activities?

To determine whether your child’s impairment causes “marked and severe functional limitations,” the disability evaluation team obtains evidence from a wide variety of sources who have knowledge of your child’s condition and how it affects his or her ability to function on a day-to-day basis and over time.

These sources include, but are not limited to, the doctors and other health professionals who treat your child, teachers counselors, therapists and social workers. A finding of disability will not be based solely on your statements or in the fact that your child is, or is not, enrolled in special education classes.

A Special Message To Parents Of Children With Severe Disabilities

The disability evaluation process generally takes several months. However, the law includes special provisions for people signing up for SSI disability whose condition is so severe that they are presumed to be disabled. In these cases, SSI benefits are paid for up to six months while the formal disability decision is being made. (These payments can be made only if the child meets the other eligibility factors.)

Following are some of the disability categories in which we can presume your child is disabled and make immediate SSI payments:

  • HIV infection
  • Total Blindness
  • Total Deafness (in some cases)
  • Cerebral palsy ( in some cases)
  • Down syndrome
  • Muscular dystrophy (in some cases)
  • Mental retardation
  • Diabetes (with amputation of one foot)
  • Amputation of two limbs
  • Amputation of leg at the hip

If we make these special payments, and we later decide that the child’s disability is not severe enough to qualify for SSI, the benefits do not have to be paid back.

Children with HIV Infection

Children with HIV infection may differ from adults in the way the infection is acquired and in the course of the disease. DDS disability examiners and doctors have been provided with extensive guidelines to use when evaluating claims for children involving HIV infection.

Some children may not have the conditions specified in our current guidelines for evaluating HIV infection, but may have other signs and symptoms that indicate an impairment that results in marked and severe functional limitations. As indicated earlier, this kind of evidence may help show that your child is disabled for SSI purposes.

Continuing Disability Reviews

After a child starts receiving SSI, the law requires that the child’s disability be reviewed every six months to verify that he or she is still disabled. The continuing disability review (CDR) must be performed:

  • At least every three years for children under 18 whose conditions are expected to improve; and
  • Not later than 12 months after birth for babies whose disability is based on their low birth weight; unless the condition is not expected to improve by the child’s first birthday, and the SSZ schedules the CDR for a later date.

During the Continuing Disability Review the representative must present evidence that the child is and has been receiving treatment that is considered medically necessary and available for the child’s disabling condition. This requirement applies to all cases unless the SSA decides that such evidence would be inappropriate or unnecessary.

Disability Redeterminations At Age 18

Under the law, children who are eligible for SSI benefits in the month before they turn age 18 must have their eligibility re-determined.

The redetermination will be done during the one-year period beginning on your child’s 18th birthday, or in place of a CDR whenever we determine the individual’s case is subject to a redetermination. The rules for adults filing new claims are used when making the redetermination.

Children in Certain Medical Care Facilities

The monthly SSI payment will be limited to $30 for children under age 18 who live, throughout a calendar month, in certain institutions where private health insurance pays for their care.

You have Disability Rights!…

Note: if you’ve been disabled and are not able to work for at least twelve months, then you should apply immediately as the social security disability and (or) SSI Disability claims process takes a long period of time to complete.

Disability Conditions: Anemia

  • Ankle
  • Anxiety
  • Arthritis
  • Asthma
  • Attention Deficit Hyper Activity or ADHD
  • Autism
  • Back or other
  • Bipolar Disorder or
  • Bradycardia or other arrhythmia
  • Bronchitis
  • Cancer
  • Cancer
  • Cardiomyopathy or tachycardia
  • Carpal Tunnel Syndrome
  • Cerebral palsy
  • CFIDS
  • Chronic fatigue
  • Cirrhosis
  • Clinical Obesity
  • Congestive or Chronic Heart Failure
  • COPD
  • Coronary artery disease
  • Crohn’s disease
  • Cystic fibrosis
  • Degenerative Disc Disease
  • Depression or other Mood Disorders
  • Diabetes
  • Diabetic Neuropathy
  • Disc Herniation
  • Down syndrome
  • Dysthymia
  • Emphysema
  • Epilepsy
  • ESRD or end stage renal disease
  • Head trauma
  • Hearing Loss or Poor Hearing
  • Hepatitis or other liver disease
  • High Blood Pressure (Hypertension)
  • Hip
  • HIV, AIDs
  • Inflammatory Bowel Disease
  • Inner ear problems
  • Irritable Bowel Syndrome
  • Joint Problems
  • Kidney failure requiring dialysis or other renal problems
  • Learning disability
  • Low IQ
  • Lupus
  • Lupus
  • Lyme disease
  • Manic Depression
  • Memory loss
  • Meniere’s
  • Mental retardation
  • Multiple sclerosis
  • Muscular dystrophy
  • Neck
  • Osteoarthritis
  • Osteoporosis
  • Pancreatitis
  • Panic Disorder
  • Peripheral Field Problems or Other Vision Loss
  • Peripheral vascular disease
  • Reflux gerd (gastroesophageal reflux disease)
  • RSD or reflex sympathetic dystrophy
  • RSI or Repetetive Stress Injury
  • Sarcoidosis
  • Schizophrenia
  • Shoulder
  • Sickle cell
  • Spinal Stenosis
  • Statutory Blindness
  • Stroke
  • Thyroid problems including hypothyroidism
  • Type 1 Seizure Disorder
  • Type 2 Diabetes
  • Ulcerative Colitis
  • Vertigo or dizziness
  • Wrist

A disabled child’s claim is based on the parent’s earnings while a disabled widow’s claim is based n the spouse’s earnings.

Approximately forty percent of claims filed are approved at the initial claim level.

During Disability Reconsideration approximately 20% of the claims are successful.

Hearings before an Administrative Law Judge for social security disability or SSI disability are informal with only the judge his secretary. The judge may have a vocational expert present to testify regarding jobs the individual can perform.

Social Security Disability Attorney (is it wise to have one?)

  1. Statistically claimants that are represented by an attorney are much more likely to win their claim.
  2. An experienced attorney knows what proof social security and SSI disability system requires
  3. Using legal help eliminates both the necessity of waiting in long government lines and the chance that a government clerk’s incorrect notation on your condition jeopardizing your claim.