Applying for Supplemental
Security Income (SSI)

Children Under the Age of 18
To qualify for SSI, a child must meet Social Security’s 1) disability qualifications and 2) his/her family must meet income and resource requirements. 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 2005 is $579 per month (the FBR or Federal Benefit Rate), and in most states a child who qualifies for SSI will automatically qualify for Medicaid coverage (see pg. 3 for a list). 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 SSI by calling 1-800-772-1213 or visiting your local Social Security office. The application forms (SSA-3881-BK and others) are available on the Social Security website, www.socialsecurity.gov (or more specifically https://s044a90.ssa.gov/apps6a/i3820/main.html).

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 or not 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 and 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
In general, resource limits are $2,000 for a single person and $3,000 for a couple. For a family with a disabled child who is applying for SSI, there is an additional $2,000 asset limit for the child.

When Social Security looks at the assets of the parents of a minor child, the following things will be examined:

• Cash on hand, in a bank, or other financial institution;
• Stocks and bonds, CDs, IRAs;
• Contents of a safe deposit box;
• Valuable coins/stamps, other collections, or antiques;
• Property and homes, including a home you may own, but don’t live in;
• Funeral/burial agreements, etc.; and
• Insurance policies and their “cash surrender value.”

After examining the parental resources, SSI will also explore any resources owned by the minor child.

Resources SSA won’t count for an individual:

• Up to $2,000 total of any assets combined.;
• A home, as long as you live in it;
• An irrevocable funeral agreement of up to $2,000, or up to $1,500 in a separate account that is designated “for future burial expenses.”;
• An insurance policy with a face value of under $1,500;
• An insurance policy owned by someone other than the child’s parents;
• “Term” insurance policies (having no cash surrender value);
• Personal possessions and household goods;
• Property essential to self-support (for instance, land that you farm for income, tools needed to work, rental property that brings in net income, a business bank account);
• Assets excluded as part of a Social Security Plan to Achieve Self Support (PASS); and
• Trusts that are not under the family’s control, or where the trust principal or interest cannot be used to provide cash to you or your child, or used for food, clothing, or shelter.

See Weighing the Risks Fact Sheet in Appendix B for complete list of resourcs.

Income and Deeming
Along with having 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 many 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.

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Example: How Social Security Counts Unearned Income
Family receives $350 in Railroad Retirement

$350
- $20 unearned income exclusion
$330 Social Security “counts” this amount as income

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Countable Income
Some examples of unearned income are: SSDI, Veterans Benefits, Railroad Retirement, Unemployment Insurance, and Child Support. Generally, unearned income is counted dollar for dollar, 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.”

Child support counts as a child’s income, not the parent’s income. One-third of child support income is excluded, so 2/3 of the monthly child support is counted. “In-kind support and maintenance” is free food/shelter the family may be receiving from someone else. If the family is receiving free food and/or shelter, the SSI FBR will be reduced by 1/3 (to $386 in 2005). If the value of the free food and shelter is less than $193 per month in 2005, the SSI check will be reduced by that amount but will never be reduced more than 1/3 of the FBR for free food and shelter. (See the Sharing Worksheet for information on in-kind.)

Generally, earned income is wages, tips, salary, or the net income from self-employment. SSI does not count the first $65/month of earned income (earned income exclusion), and the first $ 20 of unearned income (general income exclusion). If there is no unearned income, SSI will not count $85 ($65 + $20) of earnings. After the first $65 (or $85) of earnings, SSI will only count half of what remains.

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Example:
How Social Security Counts Earned Income when
there is no Unearned Income
Family total wages are $2300/month

$2300
-$  85  general & unearned income exclusions ($65 + 20)
$2215
÷     2
$1107.50 Social Security “counts” this amount as income

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Student Earned Income Exclusion (SEIE)
Once your child qualifies for SSI, if he/she is a student and begins to work, SSI won’t count the first $1,410/month he/she earns, up to a total of $5,670/year (in 2005). If your child earns more than $5,670 in a year, SSI will count the earnings over $5,670 in the same way it counts other earnings; the first $65/$85 each month won’t count, nor will half the remainder. This is called the Student Earned Income Exclusion (SEIE). A more complete description of this work incentive can be found on page 22. See Appendix A for a sample letter to SSA informing them that the beneficiary is a student and is going to work.

Deeming Chart
On the next page is a chart you can use to determine 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 four 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 higher than the bottom number, your child is not financially eligible for SSI. If your income is less than the top number, your child is eligible for a full SSI benefit ($579/month in 2005). If your income falls between the two numbers, your child is financially eligible for a partial SSI benefit.

Parents might be able to reduce their countable income, thereby making their child eligible for SSI and Medicaid, through an SSI work incentive called a PASS. Click here to go to the PASS plan section in the article on working and SSI.

*These rates assume that all children have no countable income and that there is only one eligible child in the household. For each additional ineligible child in the household, add $287 to the rate shown. If there is more than one eligible child, or if there is both earned and unearned income, contact Social Security to find out about eligibility and amount of SSI.

Disability Qualification
Children have different disability standards to meet than adults in order to be determined eligible for SSI. The 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.

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 be descriptive and detailed. 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 but no documentation is available, DDS will seek a “consultative exam (CE).” DDS will ask the treating and/or consultative physicians to complete forms on which 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.

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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.

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Disability Evaluation Under Social Security - A guide for physicians and health professionals which explains the Social Security Disability definitions, eligibility criteria, and kinds of information that are helpful to make disability determinations. Also known as the Social Security Blue Book. (Available at: www.ssa.gov/disability/professionals/bluebook.)

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SSI and Children Turning 18
When your child with a disability turns 18, several things happen in relation to his/her Supplemental Security Income (SSI) benefits. First, the young adult must reapply with Social Security for SSI benefits as an adult. For this application, Social Security will use somewhat different disability criteria than were used to evaluate his/her disability as a child.

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If your child has been receiving Social Security Child’s benefits, when he/she turns 18, he/she will have to apply to begin receiving benefits as a “Disabled Adult Child.”

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You can prepare for this inevitable re-application by:

• Keeping your child’s medical and school records updated and complete.
• If your child is working, asking that any support staff who assist your child document what your child actually does in relation to what a person without a disability might accomplish.
• Documenting all supports your child receives. Emphasize support needs and performance on worst days.
• Alerting school staff, your child’s employer, and medical personnel that your child is applying for SSI.
• Sharing with them that they need to emphasize your child’s disability on their worst day of performance since this is a program based on what someone can NOT do, not what they can do. If they provide glowing reports of your child’s performance their reports will be of little help to no help in establishing your child’s eligibility for SSI.

Secondly, the family’s income and resources will no longer be considered when determining your child’s financial SSI eligibility. Only your child’s resources and income will count. This frees the rest of the family from the SSI resource limits, so the family can begin to accumulate cash, stocks, bonds, and all the other financial assets prohibited when your minor child was receiving SSI. The family’s combined income can also increase without risking your child’s SSI benefits and Medicaid.

Once your child turns 18, the amount of his/her SSI check will be based on his/her monthly countable income, and also on his/her living arrangement. Social Security will count your child’s income (earned and unearned income) just like it counted your family’s income when your child was a minor, and will adjust his/her monthly SSI check based on that countable income. The same formula for calculating countable earnings applies: half of wages after disregarding $65 (or $85 if only income is earned).

The countable earned income is subtracted from the Federal Benefit Rate ($579 in 2005) to determine the amount of the SSI check due. For example, your child has a part time job and earns $240 gross each month.

$240 (child’s wages)
- $85 (general and earned income exclusions)
$155
÷    2
$77.50 (countable earned income)

$579.00 (FBR)
- $77.50
$501.50 (amount of SSI your child will be due two months later).

If your child’s income fluctuates, the monthly benefit amount will fluctuate. If your 18-year-old is still in school the Student Earned Income Exclusion still applies, which allows a student to earn $1410/month (up to $5670/year) without this income being counted against their SSI. (See pg. 22 for SEIE information.)

Living Arrangement and Sharing
The example above assumes the 18-year-old child is living alone in his/her own home. If the 18-year-old lives with his/her family or others, his/her living arrangement can impact the amount of the monthly SSI check.

If your 18-year-old lives with you, or others, and doesn’t pay any portion of the household’s food and shelter expenses, he/she will be considered to be “living in the household of another” and receiving “in-kind support and maintenance” from someone else. When Social Security views your child as “living in the household of another” he/she is only eligible to receive the one-third-reduced rate ($386/month in 2005) and not the full Federal Benefit Rate ($579/month in 2005). Regardless of the value of the food and shelter your child is receiving, SSI will never reduce your child’s SSI check by more than one third.

In-kind support is calculated as unearned income. For example, if your child pays for shelter but someone else is paying $120 per month for his/her food, SSI will reduce the $579 by $100 ($120 - $20 general income exclusion = $100 countable unearned income), and he/she will be eligible for a $479 SSI check. The same would be true if your child paid for food but someone else was providing shelter worth $120 per month.

NOTE: Your child is eligible for more than the one-third-reduced payment for “living in the household of another” ($386/month in 2005), if he/she can establish that he/she has paid his/her “fair share” of household expenses for at least one month, and is able to continue that contribution. When this is the case, your child’s classification changes to Sharing/Independent ($579/month in 2005).

Determining “Fair Share”
If your household has income other than public assistance, SSI, etc., the expenses listed in the Sharing Worksheet are used to determine your child’s fair share contribution. Every household does not have expenses in every category. Only the expenses listed that apply to your household can be included in figuring your child’s fair share. No other additional expenses can be considered (e.g., cable TV, phone).

Determine the average monthly expense for each item listed. Add those average monthly expenses and divide the total by the number of persons in your household, regardless of their age or relationship to you. Babies, grandparents, and unrelated persons living in the home should all be counted, as should any adult children away at college during the school year. After the total is divided by the number of people in your household, the resulting number will be the “pro rata” or “fair share” for each household member.

While Social Security doesn’t usually require documentation for these expenses, the fair share should always be figured based on real expenses. When establishing an amount for food, use an estimate that reflects food only, not laundry soap, paper goods, personal hygiene articles, etc.

The fair share will generally remain unchanged for a year, and your household expenses should be re-evaluated every year to determine whether or not a change in the amount is warranted. The amount of money your child contributes toward household expenses must be within $5 of this “pro rata” share to establish the existence of a “sharing” arrangement.

Sharing and Income Taxes
If your child lives with you, you can legally claim your child as a dependent on your income tax return if your child is receiving SSI at the “living in the household of another” rate ($386 in 2005). You will have to be able to show that you spent at least 1¢ more on your child than the total of all your child’s SSI payments for the year. Once a child establishes “sharing” and receives an increased SSI check ($579 per month in 2005), parents can no longer claim the child as a dependent. Your tax accountant may say it is okay to claim your son or daughter because you can show how you spent more on the child than the yearly total of SSI payments. The accountant may be correct as far as the Internal Revenue Service (IRS) rules are concerned, but if you tell SSA that your child is paying a “fair share,” it is not appropriate to tell the IRS your child is not really paying his/her own way. When most families do the math, they find they gain more by having a son or daughter receive the increased SSI check than they do by claiming them as dependents and getting a small credit on their taxes.

The only exception to this general rule is when parents can continue to carry a child on their health insurance only if the child is a dependent for tax purposes. If your child is covered by Medicaid and has good healthcare providers who accept Medicaid, your insurance may be of little additional benefit. However, if it is better for your child to remain covered by your insurance, it may be beneficial to forego the sharing rate and to stay at the “household of another” rate.

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