SOCIAL SECURITY BENEFITS FOR CHILDREN WITH DISABILITIES
There are three ways a child might be eligible for benefits from Social
Security or SSI. The three kinds of benefits are:
- SSI Benefits For Children-
These are benefits payable to children with disabilities under age 18
who have limited income and resources, or who come from homes with
limited income and resources.
- Social Security Dependents Benefits –
These are benefits 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 survivor benefits payable to children under the
age of 18 on the record of a parent who has died.
Although children eligible for these benefits might be disabled,
their disability does not qualify them for benefits. In other words, a
child under age 18 is eligible for Social Security merely because he or
she is the dependent child of someone getting retirement or disability
benefits, or of a parent who has died. Note: A child can continue
receiving dependents or survivors benefits until age 19 if he or she is
a full-time student in elementary or high school.
- Social Security Benefits For Adults Disabled Since Childhood-
The benefits explained in the previous section normally stop when a
child reaches age 18 (or 19 if the child is a full-time student).
However, those benefits can continue to be paid into adulthood if the
child is disabled. To qualify for these benefits, an individual must
be the son or daughter 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 20’s
and 30’s (and some even older), the benefit is considered a
"child’s" benefit because of the eligibility rules.
SSI Benefits For 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, blind, or have a disability.
Children can qualify if they meet Social Security’s definition of
disability (see pages 2 & 3) and if their income and assets fall
within the eligibility limits.
As its name implies, Supplemental Security Income supplements a
person’s income up to a certain level. The level varies from one State
to another and can go up every year based on cost-of living increases.
Check with your local Social Security office to find out more about the
SSI benefit levels in your state.
Rules For Children Under 18
Most children do not have their own income and do not have
many assets. However, when children under age 18 live at home (or are away
at school but return home occasionally and are subject to parental
control), we consider the parent’s income and assets when we decide if
the child qualifies. We refer to this process as "deeming" of
income and assets.
Check with you Social Security office for information about your
child’s specific situation and for a full explanation of the
"deeming" process.
Rules For Children 18 And Older
When a child turns 18, Social Security no longer consider a parent’s
income and assets when they decide if he or she can get SSI. A
child who was not eligible for SSI before his or her 18th
birthday because a parent’s income or assets were too high may become
eligible at 18.
On the other hand, if a child with a disability who is getting SSI
turns 18, continues to live with his or her parent(s), but does not pay
for food or shelter, a lower payment rate may apply.
How We Decide If A Child Is Disabled For SSI
While your local Social Security office decides if your child’s
income and assets are within the SSI limits, all documents and evidence
pertaining to the disability are sent to a State office, usually called
the Disability Determination Service (DDS). There, a team comprised of a
disability evaluation specialists and a doctor reviews your child’s case
to decide if he or she meets our definition of disability.
If the available records are not thorough enough for the DDS team to
make a decision, you may be asked to take your child to a special
examination that Social Security will pay for. It is very important that
you do this.
Defining "Disability"
To understand how Social Security evaluates disabilities in children,
you must first understand how Social Security defines disability in
general.
To qualify for a Social Security or SSI disability benefit, a person
must have a physical or mental impairment that is expected to keep him or
her from doing any "substantial" work for at least a year.
(Generally, a job that pays $500 or more a month is considered
"substantial" work.) Or a person must have a condition that is
expected to result in his or her death.
Deciding SSI Disability For Children Under 18
Of course, a child’s disability cannot be evaluated using these
work-related adult criteria. The law states that a child will be
considered disabled if he or she is not working and has an impairment that
is as severe as on that would disable an adult. This means the condition
must limit the child’s ability to function like other children of the
same age to such a degree that the impairment is comparable to one which
would make an adult disabled.
To make this decision, the disability evaluation specialist first
checks to see if the child’s disability can be found in a specific
listing of impairments that is contained in Social Security’s
regulations, or if the condition is equal to an impairment that is on the
list. These listings are descriptions of symptoms, signs, or laboratory
findings of physical mental problems, such cerebral palsy, mental
retardation, or muscular dystrophy, that are severe enough to disable a
child. If the symptoms, signs or laboratory findings of the child’s
condition are the same as, or equal to, the listing, he or she is
considered disable for SSI purposes.
If a disability cannot be established using the "listing"
criteria, then the disability evaluation team will assess the child’s
ability to function in everyday life. Children are considered
"disabled" for SSI purposes if their impairment substantially
reduces their ability to do the things and behave in the ways that
children of a similar age normally do.
A Special Message To Parents Of Children With Severe Disabilities
The disability evaluation process generally takes several months. But
the law includes special provisions for people (including children)
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 6
months while the formal disability decision is being made. (Of course,
these payments can only be made if the child meets the other eligibility
factors explained on pages 2 and 3.)
Following are some of the disability categories in which we can presume
the child is disabled and make immediate SSI payments:
 | HIV infection |
| Blindness |
| Deafness (in some cases) |
| Cerebral Palsy (in some cases) |
| Down Syndrome |
| Muscular Dystrophy (in some cases) |
| Significant mental deficiency |
| 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 affects their ability to engage
in activities expected of children of the same age. As indicated earlier,
this kind of evidence may help show that your child is disabled for SSI
purposes.
Social Security Benefits For Older Children With Disabilities And For
Adults Disabled Since Childhood
Non-Medical Rules
As indicated earlier, a child under the age of 18, including a child
with a disability, qualifies for Social Security benefits simply because
he or she is a minor child of a retired, disabled, or deceased worker. In
other words, Social Security doesn’t consider a child’s disability
when deciding if he or she can get Social Security dependent’s or
survivor’s benefits.
However, when a child who is getting a dependent’s or survivor’s
benefit from Social Security reaches 18, those benefits generally stop
unless one of the following conditions is met:
| The child is a full-time student in an elementary or high school. In
this case, benefits continue until age 19; or |
| The child is disabled. In this case benefits can continue as long as
the child remains disabled, even into his or her adult years. |
Many times an individual doesn’t become eligible for a disabled
child’s benefit from Social Security until later in life. Here’s an
example: John Jones starts collecting Social Security retirement benefits
at the age of 62. He has a 38-year-old son, Ben, who has had cerebral
palsy since birth. Ben will start collecting a disabled "child’s
benefit on his father’s Social Security record.
How Social Security Decides If An "Adult Child" Is Disabled
We will evaluate the disability of an adult child (age 18 or older) who
is applying for Social Security for the first time, or who is being
converted from a Social Security dependent child’s benefit, by using
adult disability. An adult must have a physical or mental impairment or
combination of impairments, that is expected to keep him or her from doing
any "substantial" work for at least a year or is expected to
result in death. (Generally, a job that pays $500 or more per month is
considered substantial.)
The individual’s condition is compared to a listing of impairments
that are considered to be severe enough to prevent an individual from
working for a year or more. If the individual is not working and has an
impairment that meets or is equal to a condition on the list, then he or
she is considered disabled for Social Security purposes.
If we cannot match the person’s impairment with one of the listings,
then we assess his or her ability to perform the same type of work he or
she did in the past (if any). If the person cannot do that work or does
not have any past work history, then we consider his or her ability to do
any kind of work he or she is suited for (based on age, education, and
experience). If, considering all these factors, a person is found to be
unable to do any substantial work, then he or she would qualify for
disability benefits from Social Security.
Applying For Social Security Or SSI Benefits…And How To Expedite The
Process
You can apply for Social Security or SSI benefits for your child by
calling or visiting your local Social Security office. You can help
expedite the claims process if you have the child’s Social Security
number and birth certificate available when you apply. If you’re signing
up your child for SSI, you also will need to provide records that show
your income and your assets, as well as those of the child.
The medical evaluation specialists at the DDS need thorough and
detailed medical records to help them decide if your child is disabled.
When you file, you will be asked to provide names, addresses, and
telephone numbers of all doctors, hospitals, clinics, and other
specialists your child has visited.
In addition, if you child is under age 18 and applying for SSI, you
will be asked to describe how your child’s disability affects his or her
ability to function as a child of similar age normally would. Therefore,
we will ask you to provide the names of teachers, day care providers, and
family members who can give us information about how you child functions
in his or her day-to-day activities.
Please be as specific and thorough as possible when you answer these
questions. This means that you should give us the dates of visits to
doctors or hospitals, the account numbers, and any other information that
will help us to get your child’s medical records as soon as possible. If
you do not have this information, tell the interviewer as much as you
know. If you have any school records, bring them with you to the
interview.
In may communities, special arrangements have been made with medical
providers, social service agencies, and schools to help us get the
evidence we need to process your child’s claim. Most DDS’s have
Professional Relations Officers who work directly with these organizations
to facilitate this process. However, your additional cooperation in
obtaining records and evidence would be helpful.
Medicaid And Medicare
Medicaid is a health care program for people with low incomes and
limited assets. In most States, children who get SSI benefits qualify for
Medicaid. In may States, Medicaid comes automatically with SSI
eligibility. In other States, you must sign up for it. And some children
can get Medicaid coverage even if they don’t qualify for SSI. Check with
your local Social Security office or your State or county social services
office for more information.
Medicare is a Federal health insurance program for people 65 or older,
and for people who have been getting Social Security disability benefits
for 2 years. Because children, even those with disabilities, do not get
social Security disability benefits until they turn 18, no child can get
Medicare coverage until he or she is 20 years old.
The only exception to this rule is for children with chronic renal
disease who need a kidney transplant or maintenance dialysis. Children in
such a situation can get Medicare if a parent is getting Social Security
or has worked enough to be covered by Social Security.
Other Health Care Services
If Social Security decides a child is disabled and eligible for SSI, we
refer him or her for health care services under the Children with Special
Health Care Needs (CSHCN) provisions of the Social Security Act. These
programs are generally administered through State health agencies.
Although there are differences, most CSHCN programs help provide
specialized services through arrangements with clinics, private offices,
hospital-based or- and in- patient treatment centers, or community
agencies.
CSHCN programs are known in the States by a variety of names, including
Children’s Special Health Services, Children’s Special Health
Services, Children’s Medical Services, and Handicapped children’s
Program. Even if your child is not eligible for SSI, a CSHCN program may
be able to help you. Local health departments, social services offices, or
hospitals should be able to help you contact your CSHCN program.
To Learn More About Social Security And SSI
Social Security produces a variety of publications that explain the
various Social Security programs, including benefits available to
children. For general information, we suggest you ask for a free copy of
one of these:
| Understanding Social Security (Publication No. 05-10024) |
| Retirement (Publication No. 05-10035) |
| Survivors (Publication No. 05-10084) |
| Disability (Publication No. 05-10029) |
| SSI (Publication No. 05-11000) |
| Medicare (Publication No. 05-10043) |
| A Guide to SSI For Groups And Organizations (Publication No.
05-11015) |
(Most of these publications are available in Spanish.)
To get copies of these and other publications or to learn more about
benefits for children with disabilities, call or visit your local Social
Security office.
Or you can call our toll-free number 1-800-772-1213 any business day
between 7 a.m. and 7 p.m.
The Social Security Administration treats all calls
confidentially-whether they’re made to our toll-free number or to one
of our local offices. But they also want to ensure that you receive
accurate and courteous service. That’s why they have a second Social
Security representative listen to some incoming and outgoing telephone
calls.
