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 of our initial determination that you were disabled.

That last sentence from 20 CFR 416.990 is a bit unclear. While not legally binding on Social Security, the publication Benefits For Children With Disabilities provides a better explanation.

By age 1 for babies who are getting SSI payments because of their low birth weight, unless we determine their medical condition is not expected to improve by their first birthday and we schedule the review for a later date.

In other words, unless Social does not expect improvement, a low birth weight baby approved for Social Security SSI benefits will usually have his or her case reviewed by age 1.

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:

1. The individual (adult or child) has to be medically disabled (this includes psychological disabilities).
2. 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 about financial eligibility in adult SSI cases.

Children’s SSI cases can be even tougher.  In adult SSI cases, Social Security considers the individual’s and their spouse’s income. In children’s SSI cases, Social Security considers then entire household income in deciding financial eligibility. The household finances test continues until the child turn 18. On the child’s 18th birthday, Social Security only considers the child’s income (which in many cases is zero).  However, once the child turns 18, he or she is considered an adult and evaluated under the adult standard of disability.

What often happens is the parents’ income makes the child financially ineligible for children’s SSI benefits. If this happens to you, there are a couple of limited options.

• Look into the possibility of DAC benefits.
• Reapply once the child turns 18 or if the household income decreases.

Has your child been financially denied children’s SSI benefits? How did you handle it? Tell me in the comments.

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 largely remain a private matter. It is possible for a child to be on Social Security disability benefits and not have other students, their parents, or even the school know. Of course, this depends on the nature of the disability and medical practicalities. In many cases, the school should be aware of disabling medical conditions to allow the child to have access to medications at school and to let the school take appropriate action in case of a medical emergency. Also, you may want the school to know so an appropriate Individualized Educational Plan (IEP) or 504 Plan can be put into place.

Parents should consider what receiving Social Security benefits might provide and weigh that against the potential negatives. Children’s Social Security benefits usually consist of a monthly benefit amount plus Medicaid benefits. Medical benefits provided by Medicaid are often the main reasons parents apply for their children. Medicaid helps many parents getting out of the local clinic, and opens new treatment possibilities such as seeing a specialist, and obtaining speech, occupational, physical, and cognitive therapies.

Ultimately, I believe it comes down to this, if you feel that the treatment options possible under Medicaid can help your child, it may be time to consider applying for Social Security 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.

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:

• If you have never worked.
• You worked so long ago that you are past your date last insured.  
• Instead of paying into Social Security, you paid into a state program (such as PERA). 

In each of these cases, you might not be eligible for Disability Insurance (DIB).
Please note that this is just an overview.  There are several circumstances in which you may still be eligible for Social Security Disability Insurance (DIB) even if you do not have not have enough credits under your own earnings, including:  

• Social Security Disability Insurance (DIB) based on a spouse’s, or former spouse’s, earnings.
• Widow/er’s benefits and Children’s benefits when a spouse/parent dies.
• DAC (Disabled Adult Child) benefits.

It is often a good idea to speak with Social Security if you think you may qualify for one of these other types of Social Security Disability Insurance Benefits (DIB).

What is Supplemental Security Income (SSI)?

Even if you are not eligible for DIB, you may still be able to apply for SSI.  

Supplemental Security Income is a Social Security program which provides disability benefits to the following groups:

• Children, 
• Adults who have never worked; and 
• Adults who do not have enough quarters of coverage, or are past their date last insured.

Between a Rock and Hard Place:

Is it possible to not be eligible for either Disability Insurance Benefits (DIB) or Supplemental Security Income (SSI)?

Sadly, yes.

If you cannot prove your disability prior to your date last insured, and your spouse makes too much money (or you have another problematic source of income), it is possible that you may not qualify for either DIB or SSI.  This is the proverbial between a rock and a hard place.

Which Program Should I Apply For?

In my opinion, apply for both.  Do not rule out your eligibility for a particular Social Security program. When you apply, Social Security will determine which benefit program(s) you are eligible for and will help you file the application. However, if you want to know if you will qualify for either program, Social Security has a website where you can see what benefits you may be eligible for.

But, Wait!  There’s More.

Once again, this is just a quick overview of DIB and SSI.  There are differences between Social Security Disability Insurance (DIB) and Supplemental Security Income (SSI) which I will address in other articles.

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 in Colorado, a lot of schools do not keep these write-ups in the student’s permanent file.

So, if you do not hold on to these documents, they may not be available when you are trying to prove your child’s disability claim.

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:

1. The child is the insured person’s child. See §§404.355 through 404.359;
2. The child is dependent on the insured. See §§404.360 through 404.365;
3. The child applies for benefits;
4. The child is unmarried; and
5. The child is under age 18; – OR – 18 years old or older and has a disability that began before the child became 22 years old; – OR – the child is 18 years or older and qualifies for benefits as a full-time student in a primary or secondary school as described in §404.367.

See 20 CFR 404.350 for more information.

Updated 04/30/09.

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 Blogging.

If you have a child on Supplemental Security Income, Social Security looks at the entire household income to determine if the child is financially elligible to receive SSI benefits.

In some cases, this means even if the child is disabled, the family cannot receive any SSI benefits because the household income is too high. I have had cases where the parents wait until the child is 18 to apply, because at 18, Social Security only looks at the child’s income (often zero), not the household income.

But even if your household income is not too high at the beginning, you have to regularly prove to Social Security that your income is below the allowed amount. This results in audits.

 photo credit: Phillip