The Social Security Administration, or SSA, administers a disability benefits program for children who are younger than 18 years of age. Known as Supplemental Security Income (SSI) or Title 16, the program distributes regular cash payments to support the care and well-being of a disabled child. A parent or legal guardian handles the funds under strict rules, but the payments are made to and for the child.
To qualify for SSI benefits, a child’s household must demonstrate financial need by documenting that it has a low monthly income and few financial resources. The SSA revises its standard for determining financial need each year.
Additionally, a child can only qualify to receive SSI benefits after being found to be disabled according to criteria established by the Social Security program. Here, “disability” is a legal definition rather than a diagnosis. Neither a child’s doctor nor psychologist can determine that the child is disabled for the purposes of qualifying for SSI benefits. Only the SSA can make that determination.
The SSA asks three questions in order to determine whether a child is disabled and eligible to receive SSI payments. The questions are posed and answered in the order that they are presented below.
Substantial gainful activity (SGA) is the threshold for gross (pretax) monthly income. The SGA amount changes each year. For 2020, it was $1,260 for non-blind children and $2,110 for blind children.
When a child is not working or working and earning below SGA, the child’s application proceeds to step 2. Otherwise, the application is rejected.
The SSA reviews medical and/or mental health records submitted with the SSI application to determine whether a child has a “medical impairment” (i.e., a diagnosis) that is “medically determinable.” The terms in quotes are the ones used by Social Security.
If it is determined that a child has a medically determinable medical impairment, their application proceeds to step 3. A claim can also be denied at this step, and the child’s parent or guardian may need to work with an SSI attorney to appeal the denial. Incomplete medical documentation is a common reason for rejecting claims for federal disability benefits.
The SSA maintains a Listings of Impairment for children, which is a compendium of symptoms for a wide array of disabling physical and mental conditions. You will find it here.
The SSA refers to the Listings to determine whether the symptoms described in a child’s medical and/or mental health records “meet” all the criteria for any listed condition. When it is determined that a child does not have an impairment that meets every criteria but does suffer from an impairment that “equals” a listed condition, the SSA considers whether the child’s impairment produces “marked” limitations in two domains of functioning or an “extreme” limitation in one domain. The domains considered include acquiring and using information, attending to and completing tasks, interacting and relating with others, moving about and manipulating objects, caring for oneself, and maintaining health and physical well-being.
If the child’s impairment is found to be functionally equal to that of a listed condition, their claim will be approved. Otherwise, the claim will be denied.
Duration of Symptoms Also Considered
Generally, a child will only be approved to receive SSI benefits if the symptoms of their medical impairment have or will persist for more than 12 months or will result in the child’s death.
If you believe your child has a physical or mental health impairment that causes them marked and severe functional limitations, you may file an application for SSI benefits on their behalf at your local Social Security office, which you can locate by visiting this link. You can also complete an SSI application online and start the process over the phone.
As Social Security disability lawyers based in Columbus, Ohio, attorneys with Agee Clymer Mitchell & Portman are available to answer your questions. We encourage claimants to prepare and submit applications on their own, but we invite anyone whose claim for SSI benefits for their child has been denied to contact us to discuss their options for appealing the rejection. You can schedule a free consultation by calling (614) 221-3318 or schedule an appointment online.