Age and Financial Requirements for Child SSI A child must be younger than age 18 to be eligible for child SSI payments.
Because SSI is a needs-based program, the Social Security Administration (SSA) will consider income and resources when determining if the child is eligible for SSI.
Income includes earnings, Social Security checks, pensions, and non-cash items such as food, clothing, or shelter. SSA considers the child’s income (if any). Also, the income from a parent available to the child is considered to be deemed income when the child lives at home or is dependent on parents while at school. The amount of income affects a person’s eligibility for SSI, as well as the amount of the SSI payment he or she can receive.
Resources include things like bank accounts, stocks, bonds, and property. Certain things do not count as resources, such as personal belongings, the family home, and family car. Also, funds provided for the child in an Achieving a Better Life Experience (ABLE) account are not counted. An individual’s resources must be worth not more than $2,000 and a couple’s resources can be no more than $3,000. If the parent’s resources exceed $3,000, SSA considers the excess resource belonging to the dependent child.
In addition, SSA may consider the resources of a stepparent or adoptive parent if he or she lives with the child. Living arrangements can make a difference with regard to SSI eligibility. The Three-Step Process for Determining Disability for Child SSI A child is considered to be “disabled” for SSI if he or she has medically determinable impairment(s) that result in marked and severe functional limitations. A child must be disabled for the past 12 months, or is expected to be disabled for 12 months or more, or has a disability that is expected to result in death.
To determine whether a child is disabled, SSA uses a three-step process. The steps are:
Step 1. Is the child working or engaging in substantial gainful work activity (SGA)? SGA (non-blind) is presumed to be at or more than $1,260 a month in 2020. If the child is working at an SGA level, the child’s SSI claim will be denied. If the child is not working or earning SGA, SSA moves to step 2.
Step 2. Does the child have a medically determinable impairment (MDI), or combination of impairments, that is “severe”? An MDI must be established by objective medical evidence from an acceptable medical source. A “severe” impairment is considered to be one that results in more than minimal limitations. If there is no severe, impairment the claim will be denied. If the child has a severe impairment, SSA moves to step 3.
Step 3. Does the child’s impairment meet, medically equal, or functionally equal one of the listed impairments? Proof at this step requires significant evidence and is critical to whether the child’s impairment(s) are determined to be disabling. Severe Medically Determinable Impairment (MDI) An MDI is established by objective medical evidence of signs, laboratory findings, or both. Examples of signs are fever, swelling, and clubbing of the fingers. Examples of laboratory findings are blood tests and medical imagining, such as x-rays, MRI and CT scans. The objective medical evidence must be from at least one acceptable medical source. A diagnosis must be supported by signs, laboratory findings or both.
A MDI is “severe” when it causes more than minimal functional limitations. Severe impairment(s) must meet the durational retirement to last or be expected to last for at least 12 months or result in death. Other Important Evidence in a Child SSI Case Once an MDI is established, information from others in addition to acceptable medical sources can be used to document the degree of limitations caused by impairment(s) and describe the child’s ability to function independently, appropriately, and effectively in an age-appropriate manner. Additional information can be from a “medical source”, such as a healthcare worker, a speech-language pathologist, or a school psychologist licensed.
Also, information from “nonmedical sources” are important to proving your child’s case. Nonmedical sources include:
Educational personnel, such as school teachers, counselors, early intervention team members, Developmental center workers, and daycare center workers;
Social welfare agency personnel; and
Your child, your child’s family members, caregivers, friends, neighbors, employers, and clergy.
SSA will consider school records, such as an Individualized Education Plan (IEP), and reports, such as progress reports or report cards, in evaluating the child’s limitations. Impairments that Meet or Medically Equal a Listing in the Listing of Impairments at Step 3 The listings sets out for each major body system the criteria resulting in “marked and severe functional limitations” that are disabling. Part A of the listings is generally for adults, but can be used by children under certain circumstances. Part B of the listings is for children and gives appropriate consideration to the child’s growth and development, as well as the effects of the disease process in childhood. A listing is met when an impairment meets every criteria in the listing.
An impairment or combination of impairments is medically equivalent to a listing if the medical evidence is at least equal in severity and duration to listing criteria. Impairments Functionally Equal a Listing at Step 3 If a child’s impairment(s) do not meet or medically equal any listing, SSA moves to the last part of step three to decide whether the child’s impairment(s) results in limitations that functionally equal the listings. There are six broad areas of functioning called domains that SSA looks at when determining whether or not a child’s impairment(s) is functionally equivalent to the listings. These six domains are intended to cover everything that your child can and cannot do. The child’s impairment(s) must cause “marked and severe functional limitations” in order to be found disabling. The six domains of functioning in SSA regulations are:
Acquiring and using information
Attending and completing tasks
Interacting and relating to others
Moving about and manipulating items
Health and physical well-being
SSA considers how appropriately, effectively, and independently a child performs activities compared to other children children the same age who do not have impairments perform those activities.
Therefore, you can strengthen your child’s SSI application by providing additional information and detail about your child’s functional limitations. Tips on Proving Your Child Functionally Equals a Listing and Qualifies for SSI Encourage your child to describe to you his or her impairment(s), symptoms, and limitations. Being able to express abilities and limitations will be helpful at a hearing before an Administrative Law Judge. The child is expected to attend the hearing and will likely be asked questions about impairment(s) and the effect on his or her daily activities.
As a parent or caregiver, focus on when and where the child needs extra help. Make sure to describe all additional help provided to the child to cope with his impairments such as additional supervision, help getting dressed or eating, help with grooming, additional help with doing homework or after-school activities.
Ask other caregivers to describe the child’s functional limitations they have seen. The term “caregiver,” as used by SSA, means a person who has a close, familial-type relationship with a child. A child’s parent is usually a caregiver, but other individuals may also be caregivers. For example, grandparents, siblings, or others with whom the child lives or spends a lot of time. Some caregivers may present testimony if you have a hearing before an Administrative Law Judge.
Ask medical providers to compare the child’s functional abilities to others of the same age that do not have impairments in a medical report or letter to SSA. You may want to give each medical provider a copy of Childhood Disability: Supplemental Security Income Program A Guide for Physicians and Other Health Care Professionals for information.
Ask professionals who conducted the child’s testing to provide interpreted test results that are easily understood and compared to SSA requirements.
If the child requires a nurse, home health aide, or other professional assistance, make sure that SSA knows details about this additional help.
If the child needs an assistive device or assistive technology, get medical documentation of this need.
Seek support from the child’s teacher by having a meeting and discussing the child’s functioning at school. If the child’s teacher says the child is doing well, clarify whether the teacher is comparing the child to others with similar accommodations or children of the child’s age who do not have limitations. You may want to provide the teacher with Childhood Disability: Supplemental Security Income Program A Guide for School Professionals for information. Offer to provide any necessary information about your child’s functioning to assist the child’s teacher when answering the Teacher Questionnaire Form SSA-5665.
Obtain copies of school evaluations, testing, education plans, and other important documents to help create a complete profile of the child and the extent to which, his or her impairment(s) affects day-to-day functioning.