The U.S. Social Security Administration (SSA) offers social security benefits for eligible children. Disabled children who have limited income and resources, or who come from homes with limited income and resources, may be eligible to receive social security, or specifically, Supplemental Security Income (SSI). Children can qualify if they meet SSA's definition of disability and if their income and assets fall within eligibility limits.

As a result of legislative changes in 1996, the definition of disability for children under the SSI program is as follows:

• a child must have a physical or mental condition or conditions that can be medically proven and which result in marked and severe functional limitations;
• the medically proven physical or mental condition or conditions must last or be expected to last at least 12 months or be expected to result in death;
• a child may not be considered disabled if he or she is working at a job that is considered to be substantial work.

Children Under 18 Years of Age

To determine whether a child is considered disabled, SSA evaluation specialists check to see if the child's disability can be found in a listing of impairments that is contained in SSA's regulations or if the condition is medically or functionally equal to an impairment that is on the list. To determine whether a child's impairment causes "marked and severe functional limitations," the evaluation specialist obtains evidence from a wide variety of sources who have knowledge of the child's condition and how it affects his/her ability to function on a day-to-day basis and over time.

The functional areas used to consider severity are as follows:

• cognitive/communicative function
• social function
• personal function
• deficiencies of concentration, persistence or pace resulting in frequent failure to complete tasks in a timely manner

A child's impairment, or combination of impairments, is disabling if it causes severe and marked functional limitations in two broad areas of functioning, such as social functioning and personal functioning or extreme limitations in one area of functioning, such as inability to walk.

When considering whether a child's impairment(s) is disabling, all relevant factors are considered, including those listed below.

• If the symptoms are reduced by medications, consideration will be given to whether any functional limitations which may persist are marked and severe, even if there is apparent improvement from the medications. Also, side effects of medications on functional limitations will also be considered.
• If the child has a chronic impairment that is characterized by episodes of exacerbation (worsening) or remission (improvement), the frequency and severity of episodes will be considered.
• In considering the fact that a child may spend much of his/her time in a structured or highly supportive setting, the child's functioning will be considered outside of this setting.
• If the child uses assistive devices, the degree to which the adaptation enables the child to function and any functional limitations that persist will be considered.
• Consideration will be given to the frequency of therapy the child must have, how long the child has needed therapy and will continue to need it, and whether it interferes with the child's functioning.
• The child's functioning in school will also be considered.

The law requires a continuing disability review (CDR) to determine whether or not the child is still disabled. The CDR must be done at least every three years for recipients under age 18 whose conditions are likely to improve and not later than 12 months after birth for babies whose disability is based on their low birth weight. At the time of the CDR, the recipient payee must present evidence that the child is and has been receiving treatment considered medically necessary and available for his/her disabling condition.

Additional Benefits

In most states, children who get SSI benefits qualify for Medicaid (a health program for people with low incomes and limited assets). In many states, Medicaid comes automatically with SSI eligibility whereas in other states you must sign up for it. Also, children eligible for SSI are referred by the SSA 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. Most CSHCN programs help provide specialized services through arrangements with various treatment providers.

Young Adults over 18 Years of Age

Once an individual with a disability turns 18, he/she might be eligible to receive SSI benefits without counting the parents' income, even if the individual resides at home. As with children, the SSI program for young adults qualifies the individual both on the severity of the disability and the level of his/her income. Determination of eligibility is based on the following areas:

• The young adult must meet the qualifications of being disabled. This means that the disability will keep the individual from working for at least a year, or result in death.
• The young adult's assets must be within SSI guidelines. These guidelines depend partly on state in which the person applying for benefits lives. If the young adult owns bonds, a college fund, stock, etc., these items will be counted as income. If such assets have been sold within three years from the date of application, the applicant must supply all applicable documentation regarding the sale of these assets.

If the individual meets the criteria for eligibility, then the individual will receive a monthly check and a Medicaid card. If the individual is able to return to work, the monthly check will be reduced by a specific formula, but the individual may continue to receive the benefits of Medicaid throughout his lifetime if he/she is still considered disabled.

SSA redetermines eligibility for SSI benefits on a random and a continuous basis. The disabled young adult must submit documentation substantiating continued disability. This process is not as lengthy as the initial application for SSI benefits.

For More Information

A booklet SSI Help for Children with Disabilities is available (in English and Spanish) from the Bazelon Center for Mental Health Law. The booklet contains a list of state children's SSI hotlines.

To receive more information on social security benefits and SSI eligibility, Click Here

To request SSA's Publication No. 05-10026 (March 1997) entitled "Benefits for Children with Disabilities" call the Social Security Administration at1-800-772-1213.

For more information on Medicaid benefits, Click Here