Social Security: Benefits for Children With Disabilities
SSA Publication No. 05-10026
About This Information
This information is written primarily for the parents and caregivers of children with disabilities and adults disabled since childhood. It illustrates the kinds of Social Security and Supplemental Security Income (SSI) benefits a child with a disability might be eligible for and explains how we evaluate disability claims for children. Millions of children already get benefits from Social Security. This information will help you decide if your child, or a child you know, is eligible for Social Security or SSI.
How We Decide If A Child Is Disabled For SSI
A Special Message To Parents Of Children With Severe Disabilities
Children With HIV Infection
Social Security Benefits For Older Children With Disabilities And For Adults Disabled Since ChildhoodNon-Medical Rules
How We Decide If An "Adult Child" Is Disabled
There are three ways a child might be eligible for benefits from Social Security or SSI. The three kinds of benefits are: 1) SSI Benefits For Children These are benefits payable to disabled children under age 18 who have limited income and resources, or who come from homes with limited income and resources.
2) Social Security Dependents Benefits These are benefits payable to children under the age of 18 on the record of a parent who is collecting retirement or disability benefits from Social Security, or survivors benefits payable to children under the age of 18 on the record of a parent who has died.
Although children eligible for these benefits might be disabled, we do not need to consider their disability to qualify them for benefits. In other words, a child under age 18 is eligible for Social Security merely because he or she is the dependent child of someone getting retirement or disability benefits, or of a parent who has died. Note : A child can continue receiving dependents or survivors benefits until age 19 if he or she is a full-time student in elementary or high school.
3) Social Security Benefits For Adults Disabled Since Childhood The benefits explained in the previous section normally stop when a child reaches age 18 (or 19 if the child is a full-time student). However, those benefits can continue to be paid into adulthood if the child is disabled. To qualify for these benefits, an individual must be the son or daughter of someone who is getting Social Security retirement or disability benefits, or of someone who has died, and that child must have a disability that began prior to age 22.
Although most of the people getting these benefits are in their 20's and 30's (and some even older), the benefit is considered a child's benefit because of the eligibility rules.
NonMedical RulesSSI is a program that pays monthly benefits to people with low incomes and limited assets who are 65 or older, blind, or disabled. Children can qualify if they meet Social Security's definition of disability and if their income and assets fall within the eligibility limits.
As its name implies, Supplemental Security Income supplements a person's income up to a certain level. The level varies from one state to another and can go up every year based on cost-of-living increases. Check with your local Social Security office to find out more about the SSI benefit levels in your state.
Rules For Children Under 18Most children do not have their own income and do not have many assets. However, when children under age 18 live at home (or are away at school but return home occasionally and are subject to parental control), we consider the parent's income and assets when we decide if the child qualifies. We refer to this process as deeming of income and assets.
Check with your Social Security office for information about your child's specific situation and for a full explanation of the deeming process.
Rules For Children 18 And OlderWhen a child turns 18, we no longer consider a parent's income and assets when we decide if he or she can get SSI. A child who was not eligible for SSI before his or her 18th birthday because a parent's income or assets were too high may become eligible at 18. On the other hand, if a child with a disability who is getting SSI turns 18, continues to live with his or her parent(s), but does not pay for food or shelter, a lower payment rate may apply.
How We Decide If A Child Is Disabled For SSIWhile your local Social Security office decides if your child's income and assets are within the SSI limits, all documents and evidence pertaining to the disability are sent to a state office, usually called the Disability Determination Service (DDS). There, a team, comprised of a disability evaluation specialist and a doctor, reviews your child's case to decide if he or she meets our definition of disability.
If the available records are not thorough enough for the DDS team to make a decision, you may be asked to take your child to a special examination that Social Security will pay for. It is very important that you do this, and that your child puts forth his or her best effort during the examination. The results of the examination will not be considered valid unless your child puts forth his or her best effort. Failure to attend the examination, or invalid results due to poor effort, could result in an unfavorable decision.
Defining DisabilityTo understand how Social Security evaluates disabilities in children, you must first understand how Social Security defines disability in general.
To qualify for a Social Security or SSI disability benefit, a person must have a physical or mental impairment that is expected to keep him or her from doing any substantial work for at least a year. (Generally, a job that pays $500 or more a month is considered substantial work.) Or a person must have a condition that is expected to result in his or her death.
Deciding SSI Disability For Children Under 18Of course, a child's disability cannot be evaluated using these work-related adult criteria. The law states that a child will be considered disabled if he or she is not working and has an impairment that is as severe as one that would disable an adult. This means the condition must limit the child's ability to function like other children of the same age so much that the impairment is comparable to one which would make an adult disabled. To make this decision, the disability evaluation specialist first checks to see if the child's disability can be found in a specific listing of impairments that is contained in Social Security's regulations, or if the condition is equal to an impairment that is on the list. These listings are descriptions of symptoms, signs, or laboratory findings of physical and mental problems, such as cerebral palsy, mental retardation, or muscular dystrophy, that are severe enough to disable a child. If the symptoms, signs, or laboratory findings of the child's condition are the same as, or equal to, the listing, he or she is considered disabled for SSI purposes.
If a disability cannot be established using the listing criteria, then the disability evaluation team will assess the child's ability to function in everyday life. Children are considered disabled for SSI purposes if their impairment substantially reduces their ability to do the things and behave in the ways that children of a similar age normally do.
To determine the child's ability to function, the disability evaluation team obtains evidence from a wide variety of sources who have knowledge of how your child functions on a day-to-day basis, and how your child has functioned over time. These sources include, but are not limited to, the doctors and other health professionals who treat your child, teachers, counselors, therapists, and social workers. A finding of disability will not be based solely on your statements or on the fact that your child is, or is not, enrolled in special education classes.
A Special Message To Parents Of Children With Severe DisabilitiesThe disability evaluation process generally takes several months. But the law includes special provisions for people (including children) signing up for SSI disability whose condition is so severe that they are presumed to be disabled. In these cases, SSI benefits are paid for up to six months while the formal disability decision is being made. (Of course, these payments can only be made if the child meets the other eligibility factors explained on Following are some of the disability categories in which we can presume the child is disabled and make immediate SSI payments:
- HIV infection
- Deafness (in some cases)
- Cerebral Palsy (in some cases)
- Down Syndrome
- Muscular Dystrophy (in some cases)
- Significant mental deficiency
- Diabetes (with amputation of one foot)
- Amputation of two limbs
- Amputation of leg at the hip
If we make these special payments, and if we later decide that the child's disability is not severe enough to qualify for SSI, the benefits do not have to be paid back.
Children With HIV InfectionChildren with HIV infection may differ from adults in the way the infection is acquired and in the course of the disease. DDS disability examiners and doctors have been provided with extensive guidelines to use when evaluating claims for children involving HIV infection.
Some children may not have the conditions specified in our current guidelines for evaluating HIV infection, but may have other signs and symptoms that indicate an impairment that affects their ability to engage in activities expected of children of the same age. As indicated earlier, this kind of evidence may help show that your child is disabled for SSI purposes.
Social Security Benefits For Older Children With Disabilities And For Adults Disabled Since Childhood
NonMedical RulesAs indicated earlier, a child under the age of 18, including a child with a disability, qualifies for Social Security benefits simply because he or she is a minor child of a retired, disabled, or deceased worker. In other words, we don't consider a child's disability when deciding if he or she can get Social Security dependent's or survivor's benefits.
However, when a child who is getting a dependent's or survivor's benefit from Social Security reaches 18, those benefits generally stop unless one of the following conditions is met:
- The child is a full-time student in an elementary or high school. In this case, benefits continue until age 19; or
- The child is disabled. In this case benefits can continue as long as the child remains disabled, even into his or her adult years.
Many times, an individual 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 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 DisabledWe 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. Briefly, 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 $500 or more per month is considered substantial.)
The individual's condition is compared to a listing of impairments that are considered to be severe enough to prevent an individual from working for a year or more. If the individual is not working and has an impairment that meets or is equal to 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, a person is found to be unable to do any substantial work, then he or she would qualify for disability benefits from Social Security.
You can apply for Social Security or SSI benefits for your child by calling or visiting your local Social Security office. You should have the 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 the 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 medical records or helping us get them. When you file, you will be asked to provide names, addresses, and telephone numbers of all doctors, hospitals, clinics, and other specialists your child has visited.
In addition, if your child is under age 18 and applying for SSI, you will be asked to describe how your child's disability affects his or her ability to function as a child of similar age normally would. Therefore, we will ask you to provide the names of teachers, day care providers, and family members who can give us information about how your child functions in his or her day-to-day activities. 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 DDS's 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 claim faster.
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 in such a situation can get Medicare if a parent is getting Social Security or has worked enough to be covered by Social Security.
Other Health Care ServicesIf 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 inpatient 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.
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:
- Understanding Social Security (Publication No. 05-10024)
- Retirement (Publication No. 05-10035)
- Survivors (Publication No. 05-10084)
- Disability (Publication No. 05-10029)
- SSI (Publication No. 05-11000)
- Medicare (Publication No. 05-10043)
- SSI For Groups And Organizations (Publication No. 05-11015)
(Many of these publications are available in Spanish.) To get copies of these and other publications or to learn more about benefits for children with disabilities, call or visit your local Social Security office.
Social Security publications are also available to users of the Internet. Type: http://www.ssa.gov to access the Internet and these publications.
Or you can call our toll-free number 1-800-772-1213 . You can speak to a representative between 7 a.m. and 7 p.m. each business day. Our 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. When you call, have your Social Security number handy.
If you have a touch-tone phone, recorded information and services are available 24 hours a day, including weekends and holidays.
People who are deaf or hard of hearing may call our toll-free TTY number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days.
The Social Security Administration treats all calls confidentially whether they're made to our toll-free numbers or to one of our local offices. But we also want to ensure that you receive accurate and courteous service. That's why we have a second Social Security representative monitor some incoming and outgoing telephone calls.
Social Security Administration
SSA Publication No. 05-10026