Social Security Benefits for Children
What do I need to know to apply for Social Security benefits for my disabled child?
Children from birth up to age 18 may get Supplemental Security Income (SSI) benefits. They must be disabled and they must have little or no income and resources.
Answers to some questions people ask about applying for SSI for children.
Social Security has a strict definition of disability for children.
The child must have a physical or mental condition(s) that very seriously limits his or her activities; and
The condition(s) must have lasted, or be expected to last, at least 1 year or result in death.
Who and what steps are taken when making decision for SSI
- A state agency makes the disability decision.
- They review the information you give us.
- They will also ask for information from medical and school sources and other people who know about the child.
- If the state agency needs more information, they will arrange an examination or test for the child, which we will pay for.
SSI rules about income and resources
- When the decision is made if your child can get SSI, your child’s income and resources are considered
- The income and resources of family members living in the child’s household are also considered
- These rules apply if your child lives at home.
- They also apply if he or she is away at school but returns home from time to time and is subject to your control.
NOTE: If your child’s income and resources, or the income and resources of family members living in the child’s household, are more than the amount allowed, the child’s application for SSI payments will be denied. There is a limit to the monthly SSI payment of $30 when a child is in a medical facility where health insurance pays for his or her care.
SSI rules about disability
Your child must meet all of the following requirements to be considered disabled and therefore eligible for SSI:
- The child must not be working and earning more than $1,070 a month in 2014.
- (This earnings amount usually changes every year.) If he or she is working and earning that much money, we will find that your child is not disabled.
- The child must have a physical or mental condition, or a combination of conditions, that result in “marked and severe functional limitations.”
- This means that the condition(s) must very seriously limit your child’s activities.
- The child’s condition(s) must have been disabling, or be expected to be disabling, for at least 12 months; or must be expected to result in death.
- If your child’s condition(s) results in “marked and severe functional limitations” for at least 12 continuous months, your child will be found disabled.
- But if it does not result in those limitations, or does not result in those limitations for at least 12 months, we will find that your child is not disabled.
What information will I need to provide about my child’s condition?
- When you apply for benefits for your child, you will be asked for detailed information about the child’s medical condition and how it affects his or her ability to function on a daily basis.
- You will ask be asked to give permission for the doctors, teachers, therapists and other professionals who have information about your child’s condition to send the information to Social Security Disability Determination Services
NOTE: If you have any of your child’s medical or school records, please bring them with you. This will help speed up the decision on your application.
What happens next?
- All of the information you give will be sent to the Disability Determination Services in your state.
- Doctors and other trained staff in that state agency will review the information, and will request your child’s medical and school records, and any other information needed to make the decision if your child is disabled.
Note: If the state agency cannot make a disability decision using only the medical information, school records and other facts they have, they may ask you to take your child for a medical examination or test. Social Security Disability Determination Services will pay for the exam or test.
- Immediate SSI payments will be sent to your child
- It can take three to five months for the state agency to decide if your child is disabled.
- However, for some medical conditions, we make SSI payments right away and for up to six months while the state agency decides if your child is disabled.
Following are some conditions that may qualify SSI:
• HIV infection;
• Total blindness;
• Total deafness;
• Cerebral palsy;
• Down syndrome;
• Muscular dystrophy;
• Severe intellectual disorder (child age 7 or older); and
• Birth weight below 2 pounds, 10 ounces.
Note: If your child has one of the qualifying conditions, he or she will get SSI payments right away. However, the state agency may finally decide that your child’s disability is not severe enough for SSI. If that happens, you will not have to pay back the SSI payments that your child got.
What is a SSI disability review?
Once your child starts receiving SSI, the law requires that we review your child’s medical condition from time to time to verify that he or she is still disabled.
This review must be done:
- At least every three years for children younger than age 18 whose conditions are expected to improve
- Age one for babies who are getting SSI payments because of their low birth weight, unless determined their medical condition is not expected to improve by their first birthday and review will be scheduled for a later date
Note: We may perform a disability review even if your child’s condition is not expected to improve. When the review is done, you must present evidence that your child is and has been receiving treatment that is considered medically necessary for your child’s medical condition.
What happens when my child turns age 18?
For disability purposes in the SSI program, a child becomes an adult at age 18, and different medical and nonmedical rules are used when deciding if an adult can get SSI disability payments.
- For example, we do not count the income and resources of family members when deciding whether an adult meets the financial limits for SSI. We count only the adult’s income and resources.
- We also use the disability rules for adults when deciding whether an adult is disabled.
- If your child is already receiving SSI payments, there must be a review of the child’s medical condition when he or she turns age 18.
Note: Usually this review is done during the one-year period that begins on your child’s 18th birthday. We will use the adult disability rules to decide whether your 18-year-old is disabled.
If your child was not eligible for SSI before his or her 18th birthday because you and your spouse had too much income or resources, he or she may become eligible for SSI at age 18.
For more information, ask for Supplemental Security Income (SSI) (Publication No. 05-11000).
What are the regulations/rules for Social Security Disability Insurance (SSDI) for adults disabled since childhood?
The SSDI program pays benefits to adults who have a disability that began before they became 22 years old. We consider this SSDI benefit as a “child’s” benefit because it is paid on a parent’s Social Security earnings record.
For a disabled adult to become entitled to this “child” benefit, one of his or her parents:
- Must be receiving Social Security retirement or disability benefits; or
- Must have died and have worked long enough under Social Security.
- These benefits also are payable to an adult who received dependents benefits on a parent’s Social Security earnings record prior to age 18, if he or she is disabled at age 18.
Note: The disability decision is made using the disability rules for adults.
SSDI disabled adult “child” benefits continue as long as the individual remains disabled. Your child does not need to have worked to get these benefits.
How do they decide if my “child” is disabled for SSDI benefits?
If your child is age 18 or older, there will be an evaluation of his or her disability the same way an evaluation would be done for the disability for any adult.
- The application is sent to the Disability Determination Services in your state that makes the disability decision for us.
Note: For detailed information about how we evaluate disability for adults, ask for Disability Benefits (Publication No. 05-10029).
Where do I apply for my child?
You can apply for SSI payments or SSDI benefits for your child by calling Social Security toll-free at 1-800-772-1213 or by visiting your local Social Security office. If you are applying for SSI payments for your child, you should have his or her Social Security number and birth certificate with you when you apply.
Note: If you are applying for SSDI benefits for your child, please have your own Social Security number with you in addition to the child’s Social Security number and birth certificate.
You can help us make a decision by:
- Telling as much as you can about your child’s medical condition(s);
- Giving the dates of visits to doctors or hospitals, the patient account numbers for any doctors or hospitals, and any other information that will help us get your child’s medical records; and
- Providing us copies of any medical reports or information that you already have in your possession.
NOTE: You do not need to request information from your child’s doctors. Contact will be made directly to them for any reports or information that may be needed to make a decision about your child’s disability.
If your child is younger than age 18 and applying for SSI, you will need to provide records that show your income and resources, as well as those of your child. Also it will be asked to you to describe how your child’s disability affects his or her ability to function on a day-to-day basis. In addition, they will ask for the names of teachers, day care providers and family members who can provide information about how your child functions. If you have any school records, you should bring them to the interview.
In many communities, special arrangements have been made with medical providers, social service agencies and schools to help get the evidence needed to process your child’s claim. However, your cooperation in getting records and other information will help finish the job more quickly.
What are employment support programs for young people with disabilities?
There may be many ways to encourage young people who are receiving SSI payments or SSDI benefits and who want to go to work.
- When your child’s monthly SSI payment are figured out, they do not count most of your child’s income.
- If your child is younger than age 22 and a student who regularly attends school, they exclude even more of his or her earnings each month.
Note: In 2014, disabled students younger than age 22 may exclude $1,750 of their monthly earnings, with an annual limit of $7,060, when counting their income for SSI purposes. These limits may increase each year.
- With a Plan to Achieve Self-Support (PASS), a child who is age 15 or older can save some income and resources to pay for education and other things needed to be able to work. We do not count the saved income when we figure your child’s income for SSI purposes.
- The saved income and resources are not counted when we figure the amount of your child’s payment.
- Because of a medical condition(s), your child may need certain items and services in order to work, such as a wheelchair or a personal assistant.
- When figuring your child’s SSI payment, some or all of the amount paid for these items and services in your child’s earnings will not be counted.
- Your child older than age 15 may get help with rehabilitation and training.
- Medicaid coverage will continue even if your child’s earnings are high enough to stop the monthly SSI payment as long as the earnings are under a certain amount.
- An adult disabled before age 22 can get the same help with work expenses explained above for an SSI child, and help with rehabilitation and training.
- Cash benefits may continue until the individual can work on a regular basis.
- Medicare may continue for up to 93 months (seven years, nine months).
Note: You can get more information about these programs at our website, www.socialsecurity.gov, or by calling us toll-free at 1-800-772-1213.hat are employment support programs for youth?
Social Security Administration
SSA Publication No. 05-10026 ICN 455360
Unit of Issue - HD (one hundred) January 2014 (Recycle prior editions)
Will my child still be able to get Medical Assistance if he or she does not qualify for SSI?
- Even if your son or daughter does not qualify for SSI because your family income is too high, your child may still be eligible to receive Medicaid.
- If your assets exceed the maximum allowable asset level, the application will be rejected. If the application is rejected due to the asset test make sure to keep a copy of the rejection letter for your files.
- Your child may still be able to receive Medical Assistance but will need a copy of the rejection letter.
Note: As long as your son or daughter meets the SSA requirements for level of disability, they qualify for Medical Assistance.
What are the Monthly SSI Rates for 2014?
- Supplementary Security Payments vary depending upon living arrangements and income.
- In 2014, the maximum monthly benefit amount for an individual living alone is $721, and for an eligible couple, the monthly amount is $ 1,082.
- For an eligible person living in another person’s household, and receiving in-kind support of rent and food, the monthly amount is $481. This is the "Value of One-Third Reduction Rule".
Note: The rule states if you are living in somebody else’s household, and somebody in that household gives you both food and shelter (no matter its value) then the maximum amount of SSI you are eligible for goes down by 1/3.
Is There a State Supplement to SSI?
- Most states offer a supplement to SSI with the exception of Arkansas, Arizona, Mississippi, North Dakota, Tennessee, and West Virginia.
- In a few states you may be eligible for a state payment even if you don't meet the federal standard for SSI.
What happens if my Son or Daughter is Unable to manage his/her Benefits?
If your son or daughter (aka, the SSI benefit recipient) is unable to manage his/her personal finances and does not have a court-appointed legal guardian, the SSI benefit recipient can request that a friend/family member or other agency/person act as his/her Representative Payee.
Note: If the SSI benefit recipient has been found to be incapacitated by a judge, the guardian of the estate/finances will be appointed Representative Payee. (A representative payee is an individual or organization appointed by SSA to receive Social Security and or SSI benefits for someone who cannot manage their monthly benefits).
- The main responsibilities of a payee are to use the benefits to pay for the current and foreseeable needs of the beneficiary and to properly save any benefits that are not currently needed.
- Additionally, a payee must keep records of expenses, and when SSA requests a report the payee must provide an accounting to SSA of how benefits were saved or spent.
Note: As a representative payee, there are certain expenses for which you may be reimbursed. See the SSA site for more information: http://www.socialsecurity.gov. In addition to SSI, your son or daughter may be eligible for other SSA benefits, notable, SSDI (Social Security Disability Insurance). Click here Social Security benefits for a summary description of Social Security programs for which your son or daughter may be eligible.
Where can I find a local Social Security Administration office in Pennsylvania?
Social Security Offices in Pennsylvania
You can now find your local Social Security Office by calling the Social Security Administration toll free number, 1-800-772-1213, or by searching on-line at the Social Security Office Locator. Just enter your zip code to find the address, phone number, directions to the office and even a street map to help you find the office.
What can I do if my claim was denied?
If your claim was denied and you believe you qualify for SSD benefits, don't worry. You can file an appeal.
- There are several levels of determination for Social Security Disability benefits. You have 60 days to appeal a denial to reach the next level of determination.
- If you fail to appeal a denial, you may reapply for Social Security disability or Supplemental Security Income.
Note: Please keep in mind that 'appealing' and 'reapplying', are not the same thing. Reapplying will mean that you have to start the process over again.
What's the process for filing an appeal?
If your initial application was denied, and you believe you qualify, you have 60 days to file an appeal to reach the next level of determination.
- First, you can hire a lawyer and have him or her schedule a hearing.
- Your lawyer should meet with you before the hearing to discuss what will happen and go over questions that are normally asked at the hearing.
- The hearing will be conducted by an Administrative Law Judge and will follow a five-step evaluation.
- The judge will not issue a decision on the day of the hearing; a "Notice of Decision" will be issued to you and your attorney at the same time, which can take anywhere from two to six months.
- Second, you can move on to an Appeals Council.
- The average processing time for the Appeals Council is 18 to 24 months.
- The council can review your claim and render a decision, choose not to review the claim, or remand your claim back to the Administrative Law Judge for reconsideration.
- Finally, you can appeal to the Federal Court if all else fails.
- You can file a civil suit in a Federal District Court and appeal ultimately to the United States Supreme Court.
How long do I have to file an appeal?
Time is critical if your claim was denied. You only have 60 days to appeal. Otherwise you have to start the process all over again.
If your benefits were terminated, you have the right to file an appeal within 60 days. But, you only have ten days to appeal in order to continue receiving your checks while the appeal is pending.
Note: If you appeal but are unsuccessful, and you continued receiving checks while the case was pending, you will have to pay back the money you received while the case was pending.
Do I need a lawyer to represent me in my SSD claim?
You do not have to hire a lawyer to pursue a Social Security Disability or Supplemental Security Income claim. However, because of the various deadlines and other technical requirements for the application and appeals process, a lawyer can be very helpful.
When or why might I need to hire an attorney?
If your claim was denied or your benefits were terminated, you may want to hire an attorney.
Note: Hiring an attorney is not required to file an appeal, but doing so could mean the difference between winning your appeal or not.
Our attorneys at Edgar Snyder & Associates can help with your SSD benefits appeal by:
- Gathering medical records and reports
- Gathering evidence particular to your claim
- Gathering documents from your Social Security file
- Determining the best course of action for your claim based on Social Security regulations
- Talking with your physician about your condition(s)
- Suggesting a "second opinion" on your condition by having the Social Security Administration send you to a doctor
- Reviewing prior actions taken by the Social Security Administration
- Providing helpful advice to you on how to prepare for your Social Security hearing.
- Providing legal counsel at the hearing to ensure a fair and proper procedure
- Reviewing, objecting to, or making changes to the written questions being sent to a doctor by the Administrative Law Judge
- Making sure the Social Security Administration gives you your correct benefit payment, if your claim is approved
- Requesting a review of the hearing decision by the Social Security Administration Appeals Council
- Requesting a review of the Social Security Administration Appeals Council decision by the Federal District Court
Resources and Acknowledgements:
Office of Social Security http://www.ssa.gov/disability/
Checklist for Social Security Benefits Interview for children: http://www.ssa.gov/disability/Documents/Checklist%20-%20Child.pdf
Medical and school worksheet – Child The worksheet can help you to prepare for the disability interview or complete the Child Disability Report on the Internet
Appeals Process Fact Sheet: http://ssa.gov/pubs/EN-05-10041.pdf