Is My Disabled Child Eligible for Disability Benefits?

Little girl on a wheelchair

As disability attorneys in Atlanta, we’ve seen first-hand how Social Security can truly benefit children with disabilities and ease the financial and emotional burdens of their families. One of the things we’re most proud of at Affleck and Gordon is our ability to help families navigate the complex Social Security infrastructure to get the help they need.

Just like adult disabilities, the Social Security Administration (SSA) has a listing of disabilities for children. Children’s disability comes through Supplemental Security Income (SSI) and Medicaid programs. The SSA defines a child as a person under the age of 18, though that limit is raised to age 22 if the child is still attending junior high or high school.

Disability is defined by how much a child’s condition inhibits his or her activities and ability to care for themselves. The disability must be present for at least 12 months before applying for disability benefits. To qualify as disabled, children may meet a listing or meet various domains of functioning, as defined by the SSA. 

Meeting a Listing

The SSA’s disability listing is quite expansive and runs the gamut from physical disorders to emotional and mental health issues. 

To name a few:
  • Musculoskeletal system problems like spina bifida or restricted movement from severe burns.
  • Skin disorders like ichthyosis and dermatitis.
  • Mental disorders like anxiety, depression, and eating disorders. 
  • Immune system disorders like lupus or HIV/AIDS.

To meet a listing, a child must meet every single element within the listing, and the family must provide medical proof to back up your claim. If a child doesn’t meet each element, the family must prove that the impairment is just as severe as the listing describes. 

Domains of Functioning 

For adults, the SSA gauges functionality based on the applicant’s ability to work. It’s not so simple when it comes to children. The SSA’s six domains of functioning prove how a child’s disability is affecting his or her ability to function in the following areas:

  • Acquiring and using information--A child’s ability to learn
  • Attending to and completing tasks--A child’s ability to pay attention and complete tasks
  • Interacting and relating to others--A child’s ability to socially and practically communicate with others
  • Moving around and manipulating objects--A child’s physical ability to move, use tools, and exhibit fine motor skills
  • Self-care--A child’s ability to take care of themselves and understand what behavior is and isn’t acceptable
  • Health and physical well-being--A child’s physical fortitude

A child’s limitation within these fields can be noted as “marked” or “extreme.” For a child to satisfy the definitions of disability, the child must show marked impairment in at least two of the functional domains or one extreme impairment in one domain. 

Applying for Disability

SSI benefits for disabled children also depend on a household’s income level. The higher a household’s income, the less its benefit will be. However, not all types of income count toward the benefits. Earned and unearned income, in-kind income, and deemed income are counted as income when determining a household’s benefit amount. Discounted income includes income tax refunds, home energy assistance, SNAP benefits, loans, or resources provided by nonprofit agencies. 

To determine the amount of a child’s benefit, the SSA adds up all the countable income and subtracts it from the SSI federal benefit rate, i.e., the maximum benefit amount possible.

To begin the process of obtaining these benefits, the SSA asks adult family members to apply for SSI and submit a Child Disability Report. After that, the SSA works with applicants to obtain the medical and school information they need to make a decision. This may include school records, teachers’ notes, absenteeism reports, doctor notes, and questionnaires from counselors and therapists.

If the child needs further testing or examination to help the SSA make its decision, the SSA will pay for these measures.

The SSA has a specialized agency purposed toward evaluating childhood disability. The Disability Determination Services (DDS) makes disability determinations based on input from DDS examiners and medical or psychological consultants. DDS is run and coordinated at the state level.

Once the child begins receiving SSI benefits, the SSA will review the child’s condition at least every three years, even if the child’s disability isn’t likely to improve. 

Qualifying for Medicaid

Usually, Medicaid coverage comes with approval for SSI benefits. When a disabled child’s primary health insurance stops paying, Medicaid may provide coverage as a secondary payer. To receive Medicaid coverage, the child’s family must pay a premium based on household income. 

If a disabled child is not approved for SSI benefit, he or she may still receive Medicaid. Medicaid rules vary by state, so be sure to contact your local Social Security office and Georgia Medicaid to get the most accurate information. 

The State Children’s Health Insurance Program (SCHIP) offers health insurance to children and families whose household income is too high to qualify for Medicaid, but too low to afford private health insurance. SCHIP insurance covers prescription drugs, routine medical checkups, mental health services, and more. 

Getting Care

As a parent, nothing is more important than getting your child a high quality and quantity of care. Finding your way through the complicated Social Security system can be draining both financially and emotionally. At Affleck and Gordon, we can help your family get the assistance you need so you can focus on what’s important.

We’ve been helping people throughout Georgia obtain the social security benefits they deserve for the past 45 years. With six offices located throughout the state, we’re ready to serve you. We don’t charge our clients to tell us about their case. That’s right—we’ll evaluate your claim for free. As you pursue your claim, we’ll be with you every step of the way.

If your Social Security Disability Insurance or Supplemental Security Income claim has been denied, or you’re thinking about filing and don’t know where to start, Affleck and Gordon can help. We’ve been helping people in Georgia just like you for over 45 years. Sign up for a free case evaluation here, or call us (404) 990-3945.

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