SSI Benefits &
Children with disabilities
The Basics
Social Security administers two programs that children with disabilities
under 18 may qualify for: Social Security Child’s/Survivor’s
Benefits and Supplemental Security Income (SSI). This factsheet focuses
only on the application process for SSI for children.
To qualify for SSI, a child must meet Social Security’s 1)
income and resource requirements and 2) disability qualification.
SSI is a needs-based program, so you and your family must have income
and resources below a certain level to qualify. The maximum monthly
benefit for SSI in 2009 is $674 per month (the Federal Benefit Rate),
and in most states a child who qualifies for SSI will automatically
qualify for Medicaid coverage. For some families, whose children
may have expensive medical needs, the Medicaid coverage may prove
to be an even more valuable benefit than the monthly benefit check.
You can apply for Social Security benefits by calling 1-800-772-1213
or visiting your local Social Security office. The application forms
(SSA-3881-BK and others) are also available at the Social Security
website, www.socialsecurity.gov.
It may take up to 100 days to process your application. The time
it takes depends on:
1) the state where you live;
2) the nature of your child’s disability;
3) how quickly SSA receives your child’s medical and school records;
and
4) whether your child will need an additional medical examination.
Financial Eligibility for SSI
Because SSI is a needs-based program, Social Security will investigate
whether your family’s income and resources are below their
allowable limits. Social Security will “count” some resources
and income, but exclude others. For children under 18, Social Security
will count both your child’s and your family’s resources
and income. Once your child turns 18, only his/her resources and
income are counted.
Resources
Income and Deeming
Along with countable resources below the SSI limit, a family
must also have countable income below a certain level in order
to qualify financially for SSI benefits. “Deeming” is
the practice of counting the parents’ income when determining
whether a minor child is financially eligible for SSI. First
Social Security totals all the “countable income” and
then factors in how may other children are in the family who
aren’t applying for SSI.
SSI counts both unearned and earned income, but counts them
differently. In addition, some income is excluded from being
counted. For minor children, Social Security will count the income
of the parents, and the income of all children, including the
child with a disability.
Countable Income
Example:
How Social Security Counts Unearned Income
Family receives $350 in Rail Road Retirement
$350
- $20 unearned income exclusion
$330 Social Security "counts" this amount as income |
Some examples of unearned income are: SSDI, Veterans Benefits,
Rail Road Retirement, Unemployment Insurance, and Child
Support. Generally, unearned income is all counted except
for a $20 general income exclusion. Two exceptions are:
1) when the unearned income is child support, and 2) when the unearned income
is in the form of “in-kind support and maintenance.”
Example:
How Social Security Counts Earned Income when there is no Unearned Income
Family total wages are $2300/month
$2300
- $85 general and unearned income exclusions($65 + $20)
$2215
÷ 2
$1107.50 Social Security "counts" this amount as income |
Child support counts as a child’s income, not the parent’s
income. “In-kind support and maintenance” is
free food/shelter the family may be receiving from someone
else.
Generally, earned income is wages, salary, or the net income
from self-employment. SSI does not count the first $65/month
of earned income (earned income exclusion), and if there
is no unearned income, SSI will not count an additional $20/month
of earnings (general income exclusion). After the first $65
(or $85) of earnings, SSI will only count half of what remains.
Once your child qualifies for SSI, if he/she is a student
and begins to work, SSI won’t count the first $1,640/month
he/she earns, up to a total of $6,600/year (in 2009). If
your child earns more than $6,600 in a year, SSI will count
the earnings over $6,600 in the same way it counts other
earnings; the first $65/$85 each month won’t count,
nor will half the remainder. This is call the Student Earned
Income Exclusion (SEIE).
Deeming Chart
On the next page is a chart you can use to see if your income
is low enough for your child to qualify financially for SSI.
This chart works if you have only earned income or only unearned
income. If you have both, call Social Security to ask if
you qualify financially. To use the chart, find the column
heading across the top that reflects your family’s
situation (e.g. Parent to Child-Earned Income-2 Parents).
Follow that column down until it meets the row that shows
how many children you have in addition to the disabled child
for whom you are applying. (e.g. if you have 4 children and
one is disabled, you will go to
row 3). Where your row and column intersect, there are two
numbers. If your income is more than the bottom number, your
child is not financially eligiblefor SSI. If your income
is less than the top number, your child is eligible for a
full SSI benefit ($674/month in 2009). If your income falls
between the two numbers, your child is financially eligible
for a partial SSI benefit.
Chart of Monthly Deeming Breakeven
points for a Federal SSI Payment
(effective 1/1/2008)
|
| |
Parent to Child |
Spouse to Spouse to Child |
Number of
Ineligible
Children |
| Earned Income |
Unearned Income |
| 1 parent |
2 parents |
1 parent |
2 parents |
|
| All income is earned |
All income is unearned |
|
| 0 |
| reduction begins at: |
| eligibility ceases at: |
|
|
| 1473 |
2147 |
714 |
1051 |
| 2821 |
3495 |
1388 |
1725 |
|
|
| 1 |
| reduction begins at: |
| eligibility ceases at: |
|
|
| 1810 |
2484 |
1051 |
1388 |
| 3158 |
3832 |
1725 |
2062 |
|
|
| 2 |
| reduction begins at: |
| eligibility ceases at: |
|
|
| 2147 |
2821 |
1388 |
1725 |
| 3495 |
4169 |
2062 |
2399 |
|
|
| 3 |
| reduction begins at: |
| eligibility ceases at: |
|
|
| 2484 |
3158 |
1725 |
2062 |
| 3832 |
4506 |
2399 |
2590 |
|
|
| 4 |
| reduction begins at: |
| eligibility ceases at: |
|
|
| 2821 |
3495 |
2062 |
2399 |
| 4169 |
4843 |
2736 |
3073 |
|
|
Disability Qualification
Congress changed the children's eligibility criteria for determining
disability in 1996, so children now have different, higher standards
than adults must meet to qualify for SSI. The new definition of disability
for children in the SSI program is
" ...a child under age 18 will be considered disabled if he
or she has a medically determinable physical or mental impairment
or combination of impairments that causes marked and severe functional
limitations and that can be expected to cause death or that has lasted
or can be expected to last for a continuous period of not less than
12 months."
To apply for SSI for your child, you will complete the "Questionnaire
for Children Claiming SSI Benefits." Provide as much information
as possible on this form, especially names and contact information
for medical or school personnel who can provide information about
your child's disabling conditions.
Tips for a Successful Application
- Include a list of all current medications, dosages,
side effects, and reasons they were prescribed
- Describe the support the child needs from care givers,
school staff, or support staff in detail on the child's
worst day
- Include all doctors' names and contact information
- Compare your child's functioning level (speech, academic,
mobility, ability to assimilate new information or adapt
to change) to other children of the same age
|
The Questionnaire is designed to elicit answers about what your
child can do. However, on this
form, it is important to describe your child's disability by the
limits imposed on the worst
days. When filling out this form, it is important to qualify
items that need qualification. For instance, if your child can walk,
but
only for a few steps at a time, or only if he/she rests five minutes
after each ten minutes of walking, don't write "yes,
he/she can walk" and stop there. Describe all the limits that
apply when your child walks or attempts to walk. If he/she gets very
short of breath, or experiences pain, describe it fully. It may
be helpful to describe how your child is functioning in comparison
to
how a child of that age typically functions. For example, a mom
might say, "my first child was walking by 13 months of age,
but Cindy is now 27 months old and still isn't able to stand
by herself, let alone walk." Don't feel limited by the
space provided with each question. You can always attach additional
sheets if needed to fully answer the questions.
While you apply for SSI through your local office and they review
your financial eligibility, the decisions about your child's
disability are made by each state's Disability Determination
Service (DDS). The Disability Determination Service will screen each
application for a "medically determinable impairment." DDS
will collect all known medical records in order to verify the presence
of a disability. If there are not sufficient medical records or if
a disability is alleged and no documentation is available, DDS will
seek a "consultative exam (CE)." DDS will ask the treating
and/or consultative physicians to complete forms; and the doctors
will have to mark whether the disability exerts "marked" or "severe" functional
limitations. It may be helpful to discuss these standards with your
child's doctors so they can understand the implications of
their check marks and (possibly arbitrary) judgment calls. For instance,
a pediatrician may be reluctant to check "marked" or "severe" so
as not to offend a family, even when there may well be "marked" or "severe" functional
limits. However, if "marked" or "severe" is
not checked, Social Security may deny the claim. Alert your child's
doctor that you are applying for SSI and that they need to emphasize
deficits.
If you are not fully able to list your child's symptoms and
describe his/her functional limits, it can be very helpful for a
friend, advocate, or family member to contact both the DDS Disability
Examiner and the consultative physician. These contacts should provide
both examiners with a real picture of your child and the impact of
his/her disability. Include letters from friends or advocates with
the application.
If DDS finds your child's disability doesn't "meet
the listings" (Social Security's list of approved "medically
determinable impairments"), DDS Disability Examiners are supposed
to evaluate whether your child's disability "equals" the
listings. To determine if your child "equals" the listings,
DDS is also supposed to consider the combined effect of multiple
partial disabilities. SSA calls this a "combination of impairments." This
is often the hardest case to make. If your child has a "combination
of impairments" and DDS denies the application, you should
give serious consideration to appealing.
This Rural Factsheet was written by Marsha Katz and Ellen Condon & Kim Brown.
©
The Rural Institute 2009
The Rural Institute
52 Corbin Hall
The University of Montana
Missoula, MT 59812
(406) 243-5467 Voice/TT
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http://ruralinstitute.umt.edu