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.

This can get tricky as an individual can be disabled under the one standard but not the other.

Also, when a child was under 18 for only a short part of the total claim, there is an issue of whether it is worth doubling the analysis for the amount of amount of benefits potentially due.

Keep in mind that SSI back benefits can only be paid back to the protected filing date. Also, unless the claim was protectedly filed on the first day of the month, the benefits are rounded up to the next full month.

If a claim was filed on anything other than the first day of the month the child turns 18, there are no additional benefits available. However, the case will still be considered under both the child and adult standards of disability.

If the case was filed on the first day of the month in which the child turns 18, there is only one additional month of benefits. However, the case will be evaluated under both the adult and child standards. The same applies if the child was only under 18 for only a short period of time.

As a result, it is sometimes worthwhile to move the onset date to the date of the child’s 18th birthday. Of course I cannot give you a hard and fast rule describing when to amend the onset date. However, you should be aware of the costs and benefits so you can make an informed decision. In my Colorado disability practice, there have been times where the onset date was amended to age 18, and other times not.

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:

1. Is not working at a job that Social Security considers to be substantial work; and
2. 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
3. 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:

1. Just as in adult cases, a child may meet one of the Listing of Impairments. A listing of medical conditions, acceptable medical evidence, and the severity necessary for an impairment to be considered disabling. The children’s listings are available here.
2. An impairment may also “medically equal” a listing level impairment. Medically equaling an impairment means that the child’s impairment is not provided in the listings, however, the conditions produces the same or very similar symptoms and limitation as a listed impairment. Note: while you can certainly consider medically equaling a listing, as a practical tip, it is often better to consider meeting or “functionally equaling” a listing.
3. An impairment may also “functionally equal” a listing level impairment. This is another way of saying that the child’s condition is as bad as a listing level impairment. However, there are very specific rules for functional equivalence which are best discussed in their own article.

INCOME AND ASSET LIMITS APPLY:

Additionally, just like the adult SSI program, income and asset limits apply. One wrinkle in children’s SSI case is that Social Security looks at household income and assets (instead of just those of the child). Social Security has pages discussing how it decides whether parents’ and child’s income and resources are within allowed limits.

The household financial limits sometimes make children financially ineligible for children’s SSI benefits even though they might meet the medical requirements for disability.

If denied on financial grounds, parents sometimes wait to re-apply for Social Security benefits for their children until the child is 18. At 18, only the child’s income and resources are counted. However, the child is then evaluated under the adult standard for Social Security disability.

Another option parents are often not aware of when re-applying at age 18, is also apply for Social Security Disabled Adult Child (DAC) benefits.

• DAC provides benefits under the parent’s contribution to Social Security (which may allow for higher monthly benefits).
• As a Title II benefit program, DAC does not count non-compensation sources of income. Gifts, support, inheritance, settlements would not affect DAC eligibility.
• DAC benefits provide Medicare health insurance instead of Medicaid coverage provided with SSI.

Disabled Adult Child benefits have additional requirements. For example: one parent needs to have worked long enough paying into Social Security to qualify.

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 [high school]; 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:

20 CFR 404.350 “Who is entitled to child’s benefits” states

(a) General. You are entitled to child’s benefits on the earnings record of an insured person who is entitled to old-age or disability benefits or who has died if

(1) You are the insured person’s child, based upon a relationship described in §§404.355 through 404.359;
(2) You are dependent on the insured, as defined in §§404.360 through 404.365;
(3) You apply;
(4) You are unmarried; and
(5) You are under age 18; you are 18 years old or older and have a disability that began before you became 22 years old; or you are 18 years or older and qualify for benefits as a full-time student as described in §404.367.

Subsection 5 concerns continuing benefits for those 18 or over, who are still full-time students. This section requires an individual to be either:

1. Under 18; or
2. A Disabled Adult Child (DAC); or
3. 18 or older and a full-time student under §404.367.

However, §404.367 only deals with primary and secondary school students. Part “e” specifically requires that “You are in grade 12 or below.

Keep in mind we are talking about auxiliary benefits for children due to the death or disability of a parent. How going to school affects a disabled child’s entitlement to disability benefits is discussed here.

Updated 04/07/11.

I enjoy reading attorney Paul Nidich’s blog Nidich on Anything. Paul’s knowledge nicely dovetails with my own. When there is an area I am uncertain about, I check to see what Paul has written.

A while ago, Paul wrote a nice article about Disabled Adult Child (DAC) benefits.

I did a search for “Disabled Adult Child” last night. On one of the web sites, the “expert” writing about the DAC benefit had the “disabled before age ___” incorrect. In speaking about special needs trusts and attending other’s presentations on special needs trusts, I find that few lawyers are aware of the DAC benefit, and, of course, fewer people in the disability community are aware of the benefit.

Disabled Adult Child is a Social Security program for adults who became disabled before the age of 22. The main benefit of this benefit program is that is allows the adult child to receive benefits based on the parent’s earnings record, which may mean more benefits than the child would otherwise be entitled to.

DAC benefits may also be a better option than Supplemental Security Income (SSI) benefits.

Under SSI, a spouse’s income, an inheritance, or a law suit settlement may make the individual ineligible for benefits and force Social Security to suspend or terminate benefits.

However, under DAC, these sources of (non-employment) income are not considered.

How do you qualify for DAC?

Here is what Social Security says:

An adult disabled before age 22 may be eligible for child’s benefits if a parent is deceased or starts receiving retirement or disability benefits. We consider this a “child’s” benefit because it is paid on a parent’s Social Security earnings record.

We make the disability decision using the disability rules for adults.

The “adult child”-including an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild-must be

• unmarried,
• age 18 or older, and
• have a disability that started before age 22.

Click here for more information Social Security about DAC benefits. Read the rest of Paul’s article here.

Update: unfortunately Paul has taken down his site, so I have removed the links.