Is a 504 plan or IEP enough to win Social Security children’s benefits
My Colorado law office handled a number of Social Security disability benefits for children. Often parents have a 504 plan or an IEP (Individualized Education Program) from the school. Parents often ask me if this is enough to have their child approved for children’s disability benefits.
Unfortunately, typically not. While a 504 plan or an IEP is good evidence and often contains useful information about the child’s disability, it is often not enough by itself.
There is no single formula for winning a disability case. There is a wide range of possible …
Children’s Social Security Disability Cases and Early Impairments
Many people ask me about whether their children will qualify for Social Security benefits based on medical conditions early in their lives:
We have two adopted children that we have had since birth. One is now 14, but was born at 26 weeks weighing 1lb 14 ou. The other is now 12 but was born at 32 weeks at 3lbs 5oz.
Are they eligible for Social Security benefits now?
It is important to remember that Social Security benefits for disabled children fall under the Supplemental Security Income (SSI) program. Just as in adult SSI cases, children can only receive benefits as of their protected filing date (PFD); there are no benefits before the PFD.
That means Social Security will focus its attention on whether the child is disabled at present. There is actually a bit of wiggle room here as there can be an issue of disability starting before the PFD. However, the period of disability has to continue through the protected filing date. If you cannot show the child is disabled as of the date of filing a claim for Social Security child SSI benefits, while the child may have been disabled in the past, there are no benefits available to the child and there is no case.
Child SSI cases after 18th birthday
Disabled children can apply for Social Security benefits under the Title 16 children’s Supplemental Security Income (child SSI) program. Children’s cases are considered differently than adult disability claims. However, after a child turns 18, Social Security applies the adult standard to decide disability. Note: children between 18 and 22 may be eligible for Disabled Adult Child benefits based on their parents’ contribution to Social Security.
What happens if a child turns 18 before Social Security decides if the child is disabled?
Here is what Social Security says on this (20 CFR 406.924):
If you attain age 18 after you file your disability application but before we make a determination or decision. For the period during which you are under age 18, we will use the rules in this section. For the period starting with the day you attain age 18, we will use the disability rules we use for adults who file new claims, in §416.920.
Put another way, Social Security will consider disability under the child standard for the portion of time the individual was under 18, and use the adult standard for the portion of time the individual was 18 or over. That means you, in effect, have to prove the case twice: once under the child standard and again under the adult standard.
Social Security Disability Benefits for Children
Disabled children under age 18 can receive Social Security disability benefits under the Supplemental Security Income (SSI) program, or “Child’s SSI.” In order to qualify for children’s disability benefits, Social Security requires that the child:
Is not working at a job that Social Security considers to be substantial work; and
Has a physical or mental condition (or a combination of conditions) that results in “marked and severe functional limitations.” This means that the condition(s) very seriously limits his or her activities; and
The condition(s) has lasted, or is expected to last, at least 1 year or is expected to result in death.
Note: some conditions result in presumptive disability decision. If your child has one of these condition, he or she may be able to be instantly approved.
However, the majority of children’s disability cases focuses on the second part, the requirement of that a condition produces “marked and severe functional limitation.” There are several ways of doing this:
Can a 18 year old full time student still get Social Security child’s benefits?
I was recently asked if Social Security child’s benefits continue for a full-time student who is 18 or over.
Here is the answer in a directly from Social Security:
No. At one time, SSA did pay benefits to eligible college students, but the law changed in 1981. Benefits stop when a child reaches age 18 unless he or she:
Is disabled; or
Attends a secondary (grade 12 or below) or elementary school full-time.
In general, benefits end when:
The student graduates ; or
The student turns age 19 and two months, whichever is first.
Normally, benefits stop when a child reaches age 18 unless he or she is disabled. However, if the child is still a full-time student at a secondary (or elementary) school at age 18, benefits generally can continue until he or she graduates or until two months after he or she reaches age 19, whichever is first.
Here are the applicable regulations:
When does Social Security review cases for premature babies?
Social Security may approve Supplemental Security Income (SSI) benefits to children with a low birth weight (regardless or whether the child is premature).
According to the Social Security regulations, these cases are often reviewed by the child’s first birthday.
When we will conduct a continuing disability review. … we will start a continuing disability review …
By your first birthday, if you are a child whose low birth weight was a contributing factor material to our determination that you were disabled; i.e., whether we would have found you disabled if we had not considered your low birth weight. However, we will conduct your continuing disability review later if at the time …
How parent’s income effects children’s Supplemental Security Income (SSI) disability benefits
If you have a child or grandchild with a disability, you may be thinking about applying for Social Security disability benefits for the child. The most common type of children’s disability benefits is Supplemental Security Income (SSI).
However, proving disability in only half of a SSI case. All SSI cases have two parts:
The individual (adult or child) has to be medically disabled (this includes psychological disabilities).
The individual has to be financially eligible to receive SSI benefits.
It is quite possible for Social Security to decide that a person is disabled, but then deny that individual on financial grounds. See my article …
Will it hurt my child if I apply for children’s SSI Social Security disability benefits
I was asked to address some of the issues parents should consider when deciding whether to start an application for Social Security disability benefits (typically children’s Supplemental Security Income – SSI – benefits) for their disabled child.
Many parents worry that if their child receives Social Security disability benefits, they will be labeled as “disabled,” and carry that for the rest of their lives. Even beyond being on disability, the child may be diagnosed with a socially stigmatizing condition such as mental retardation.
I want my child to have a normal life. I want my child to overcome this. Will being “disabled” make my child stop trying?
I believe that disability can …
What you should know before you apply for children’s SSI disability benefits
Social Security has a fact sheet answering common questions about Supplemental Security Income (SSI) benefits for disabled children:
How does Social Security decide if a child is disabled?
How can I get ready for the disability interview?
How does Social Security decide if a child can get SSI?
How will I know what Social Security has decided?
Will my personal information be kept safe?
What if I am more comfortable speaking in a language other than English?
The fact sheet also has information about:
Medicaid.
State Children’s Health Insurance Program (SCHIP).
Other Health Care Services.
Work Opportunities for Young People Who Are Getting SSI.
You can get the factsheet as a pdf here.
Supplemental Security Income (SSI) or Social Security Disability Insurance Benefits (DIB)?
Social Security has two different benefit programs for individuals who are disabled.
Disability Insurance Benefits (DIB, also known as SSDI, or Title 2 benefits); and
Supplemental Security Income (SSI or Title 16 benefits).
Because of its name, it is a common misconception that must apply for “Disability Insurance” if you are disabled. Actually, both programs provide disability benefits.
What is Disability Insurance Benefits (DIB)?
Generally, Disability Insurance Benefits are based on your payroll contribution to Social Security. To qualify for DIB, you have to have earned enough Social Security credits, in the right time frame, by paying into Social Security through payroll taxes.
There are several circumstances in which you may not have enough credits for Social Security Disability Insurance:
Social Security children’s SSI tip: keep those school write-ups!
One of the best tips I can give about building a child’s Social Security (Supplemental Security Income) case is to hold on to any disciplinary report, office notes, write ups, teachers notes, detention or suspension notices, etc.
This includes notes for:
Talking out of turn
Not following instructions
Not sitting down
Fighting
Yelling
Being disruptive
Cursing
Throwing things
These documents are an important source of independent evidence about the child’s problems at school.
“Independent evidence” is key. Social Security looks for corroboration of the problems the family will tell them about. Reports from teachers, counselors, administrators, coaches, can be extremely valuable in proving the type and severity of the child’s problems.
Unfortunately, based on my experience …
Can a child get Social Security benefits if a parent dies?
Children can be entitled to receive Social Security child’s benefits if the deceased parent was fully insured by Social Security and if they meet 5 tests:
The child is the insured person’s child. See §§404.355 through 404.359;
The child is dependent on the insured. See §§404.360 through 404.365;
The child applies for benefits;
The child is unmarried; and
The child is under age 18; – OR – 18 years old or older and has a disability that began before the child became …
Surviving a Social Security Audit for Children’s SSI Benefits
California Blogging has a story about surviving a four year Social Security Audit(!)
During the audit they inspect every account, every dime I make and spend. I am allowed some money from some sources. Services from other government or social programs are not counted against Zachary. Even though it’s immaterial it’s still audited. Child support is counted against Zachary and people wonder why I don’t really go after his dad? During the audit if you are missing a receipt for anything, your worker will make up an amount higher than the average number you have shown.
You can read the entire story on story on California …
