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Analytic Rehabilitation

Social Security Benefits For Older Children With Disabilities And For Adults Disabled Since Childhood

Non-Medical Rules

As indicated earlier, although children under 18 who are eligible for benefits might be disabled, we don't need to consider their disability when deciding if they qualify for Social Security dependent's or survivor's benefits. When a child who is getting a dependent's or survivor's benefit form Social Security reaches 18, however, those benefits generally stop unless one of the following conditions is met:

Many times, a person doesn't become eligible for a disabled child's benefit from Social Security until later in life. Here's an example: John Jones starts collecting Social Security retirement benefits at the age of 62. He has a 38-year-old son, Ben, who has had cerebral palsy since birth. Ben will start collecting a disabled "child's" benefit on his father's Social Security record.

How We Decide If An "Adult Child" Is Disabled

We will evaluate the disability of an adult child (age 18 or older) who is applying for Social Security for the first time, or who is being converted from a Social Security dependent child's benefit, by using adult disability criteria. To qualify for disability, an adult must have a physical or mental impairment, or combination of impairments, that is expected to keep him or her from doing any "substantial" work for at least a year or is expected to result in death. (Generally, a job that pays $740 or more per month is considered substantial.)

The person's condition is compared to a listing of impairments that are considered to be severe enough to prevent someone from working for a year or more. If the person is not working and has an impairment that meets or equals a condition on the list, then he or she is considered disabled for Social Security purposes.

If we cannot match the person's impairment with one of the listings, then we assess his or her ability to perform the same type of work he or she did in the past (if any). If the person cannot do that work, or does not have any past work history, then we consider his or her ability to do any kind of work he or she is suited for (based on age, education and experience). If, considering all these factors, we find that a person is unable to do any substantial work, then he or she would qualify for disability benefits from Social Security.

Continuing Disability Reviews

Once benefits start, the law requires that we periodically review all disability cases to verify that people continue to be disabled. The frequency of the review depends on whether the person's disability is expected to improve, might improve, or is not expected to improve. The award notice you receive will explain when the review will take place.

Applying For Social Security Or SSI Benefits... 
And How To Expedite The Process

You can apply for Social Security or SSI benefits for your child by calling or visiting your local Social Security office. You should have your child's Social Security number and birth certificate available when you apply. If you're signing up your child for SSI, you also will need to provide records that show your income and your assets, as well as those of your child.

The medical evaluation specialists at the DDS need thorough and detailed medical records to help them decide if your child is disabled. You can speed up the claims process by providing the child's medical records or helping us get them. When you file, we will ask you to provide names, addresses and telephone numbers of all doctors, hospitals, clinics and others specialists your child has visited.

In addition, if your child is under age 18 and applying for SSI, we will ask you to describe how your child's disability affects his or her ability to function on a day-to-day basis. Therefore, we may ask you to provide the names of teachers, day care providers and family members who can give us information about how your child functions. If you have any school records, you should bring them with you to the interview.

Please be as specific and thorough as possible when you answer these questions. This means that you should give us the dates of visits to doctors or hospitals, the account numbers and any other information that will help us to get your child's medical records as soon as possible. If you do not have all of this information, tell the interviewer as much as you know.

In many communities, special arrangements have been made with medical providers, social service agencies and schools to help us get the evidence we need to process your child's claim. Most DDSs have Professional Relations Officers who work directly with these organizations to facilitate this process. However, your additional cooperation in obtaining records and evidence will help us decide your child's claim faster.

Employment Support Programs For Young People With Disabilities

There are many Social Security And SSI rules that can help young people receiving disability benefits who want to go to work. These rules are called work incentives.

Some rules apply to both programs, and some apply only to one program.

Social Security and SSI
Social Security Only
SSI Only

Your local Social Security office can provide more information about the work incentive provisions. Many answers to your questions can also be found here on Social Security's website.

Medicaid And Medicare

Medicaid is a health care program for people with low incomes and limited assets. In most states, children who get SSI benefits qualify for Medicaid. In many states, Medicaid comes automatically with SSI eligibility. In other states, you must sign up for it. And some children can get Medicaid coverage even if they don't qualify for SSI. Check with your local Social Security office or your state or county social services office for more information.

Medicare is a federal health insurance program for people 65 or older, and for people who have been getting Social Security disability benefits for two years. Because children, even those with disabilities, do not get Social Security disability benefits until they turn 18, no child can get Medicare coverage until he or she is 20 years old.

The only exception to this rule is for children with chronic renal disease who need a kidney transplant or maintenance dialysis. Children with chronic renal disease can get Medicare if a parent is getting Social Security or has worked enough to be covered by Social Security.

State Children's Health Insurance Program (CHIP)

Legislation passed in 1997 created a new Title XXI of the Social Security Act, known as the State Children's health Insurance Program (CHIP). This new program enables states to insure children from working families with incomes too high to qualify for Medicaid, but too low to afford private health insurance. The program provides protection for prescription drugs, vision, hearing and mental health services and is available in all 50 states, and the District o Columbia, Your state Medicaid agency can provide more information about CHIP. Or, you can go to cms.hhs.gov/schip/.

Other Health Care Services

If we decide a child is disabled and eligible for SSI, we refer him or her for health care services under the Children with Special Health Care Needs (CSHCN) provisions of the Social Security Act . These programs are generally administered through state health agencies.

Although there are differences, most CSHCN programs help provide specialized services through arrangements with clinics, private offices, hospital-based out- and in-patient treatment centers or community agencies.

CSHCN programs are known in the states by a variety of names, including Children's Special Health Services, Children's Medical Services and Handicapped Children's Program. Even if your child is not eligible for SSI, a CSHCN program may be able to help you. Local health departments, social services offices or hospitals should be able to help you contact your CSHCN program.

To Learn More About Social Security And SSI

Social Security produces a variety of publications that explain the various Social Security programs, including benefits available to children. For general information, we suggest you ask for a free copy of one of these:

(Many of these publications are available in Spanish.)

For More Information

Check out the rest of Social Security Online for a variety of information and services, including:

If you don't have a personal computer, many libraries, churches and other nonprofit organizations provide Internet access services to the public. Call your local library for more information.

You can get recorded information 24 hours a day, including weekends and holidays, by calling a toll-free number, 1-800-772-1213. You can speak to a service representative between the hours of 7 a.m. and 7 p.m. on business days. The lines are busiest early in the week and early in the month, so, if your business can wait, it's best to call at other times. Have your Social Security number handy when you call.

People who are deaf or hard of hearing may call a toll-free TTY number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days.

Calls are treated confidentially.

Click here for Part One

This information is from Publication No. 05-10026