How do I Know if my Child is Eligible for Disability Benefits?
Raising a child with disabilities can be difficult for any family, but even more challenging for those with low incomes. In these situations, families often wonder if their child may be eligible for Social Security Disability benefits.
First off, it’s important to understand children are not eligible for Social Security Disability Insurance (SSDI), which is a program that is meant only for disabled individuals that have a qualifying work history. Children may be eligible for Supplemental Security Income, or SSI. However, only a small percentage of children qualify. The Social Security Administration (SSA) reports that less than 1.5 million children receive SSI—accounting for less than 2% of all children in the United States.
Along with your child’s medical need, the SSA will also evaluable financial need. We’ll take a look at both of these in more depth.
First off, a child in the eyes of the SSA is under the age of 18, unmarried, lives at home, or lives away from home but remains subject to parental control. The one exception to this rule is if they are still enrolled full-time in high school beyond age 18; then they may be able to receive SSI until they graduate or leave school, or until their 22nd birthday, whichever happens first.
To receive SSI for your child, your income and assets must not exceed the federally prescribed limit if your child is living in your household. Most children on SSI typically live in families that have a total income below or near the federal poverty standard (for a family of four, for example, that’s a total household income of $25,750 or less; you can view the full chart here).
If a child lives with a parent or adoptive parent, as well as a step-parent, the income of the step-parent will also be considered. If the child doesn’t live at home, only the income and resources of the parent who is the primary caretaker and who the child visits on weekends and holidays will be considered.
This is all calculated by the SSA through a process called “deeming.” SSI deeming is when the income and resources belonging to parents who don’t personally qualify for SSI are considered available to the child applying for or receiving SSI. You can learn more about deeming and view the SSA’s deeming eligibility chart here.
Along with financial needs, children must also exhibit a medical need to receive SSI. The SSA states that children may be eligible if they have “marked and severe functional limitations that have lasted or are expected to last for 12 months or result in death.” When applying, their condition must be substantiated by medical documentation, physician and therapist notes (where applicable), school notes, and questionnaires from a non-medical standpoint such as a teacher or caregiver who knows the child’s behavior and condition.
When adults apply for disability, the biggest SSA requirement is that their condition prevents them from working. Since this generally won’t apply to children, the SSA will instead look at the child’s level of functionality in comparison with other same-aged children as a benchmark. The “Six Domains of Functioning” that the SSA will look at to determine your child’s abilities include:
- Acquiring and using information
- Attending to and completing tasks
- Interacting and relating to others
- Moving around and manipulating objects
- Ability to care for themselves
- Health and physical well-being
Another Consideration: Medication
Medication also plays a significant role when determining your child’s SSI eligibility, and here’s why: if your child has age-appropriate functioning capabilities while on medication, he/she would not be considered to be disabled. This principle applies to adults who can function on medication, as well—mainly because it means the individual would not meet the SSA’s regulations for a medical condition that is “severe” enough to limit daily activities.
The SSA will determine if your child can function while on medication using the questionnaire and medical records that you submit as part of your application. Once the preliminary criteria are met, the application is examined further by a representative from Disability Determination Services (DDS), which is the state-based agency that makes the final decision for SSI payments.
Get Help With Your Child’s Disability Application
There is no easy “yes” or “no” question concerning your child’s eligibility for benefits, though there are 14 medical conditions that may qualify for approval for SSI under the children’s Blue Book which we’ve linked to for you below:
- 100. Growth Impairment (either by a determinable impairment or not)
- 101. Musculoskeletal System (inability to walk, spina bifida, burns)
- 102. Special Senses and Speech (loss of hearing, limited vision)
- 103. Respiratory System (asthma, cystic fibrosis)
- 104. Cardiovascular System (congenital heart disease, heart transplant)
- 105. Digestive System (inflammatory bowel disease, malnutrition)
- 106. Genitourinary (chronic kidney disease, nephrotic syndrome)
- 107. Hematological Disorders (sickle cell disease, anemia)
- 108. Skin Disorders (ichthyosis, dermatitis)
- 109. Endocrine Disorders (diabetes, thyroid gland disorder)
- 110. Impairments that Affect Multiple Body Systems (Down syndrome)
- 111. Neurological (epilepsy, cerebral palsy)
- 112. Mental Disorders (anxiety, depression, eating disorders)
- 113. Malignant Neoplastic Diseases (cancers, including leukemia)
- 114. Immune System (lupus, HIV/AIDS)
Of course, the Blue Book is not the be-all, end-all of disability eligibility, and the entries can sometimes raise more questions than they answer. In addition, for severe cases, payments can often be expedited to avoid the application review wait time (which averages nearly 20 months in Florida). That’s why it’s often in your best interests—and the interests of your child—to speak with a disability expert who can assist you through the entire process and move things along quickly.
At Disability Experts of Florida, our compassionate advocates work hard to ensure children and their families receive the support they need and deserve. We understand you have a lot on your plate, and handling the application or appeals process on your own shouldn’t be one of them. Let us help you and your child—give us a call today to discuss your situation.