March 6, 2015

Common Questions Concerning Children’s SSI Claims

In my Social Security disability practice, I meet many parents of children with special needs.  They have heard that Social Security has a program for children with disabilities, but they do not know how to find out more about it.  Here are some answers to some of the most common questions I hear from parents of disabled children.

How do I know if my child meets the requirements for SSI?

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Qualifying for SSI is a two-step process.  SSI, or Supplemental Security Income, is a needs-based program; therefore, your household must fall below a certain amount of income and resources to qualify at the first step.  Unfortunately, there is no hard-and-fast number that I can say, “If you make XX amount of money, you are over the limit” because Social Security’s formula is more complex than that – it depends on the size of your household, your expenses, and the like.  Similarly, there is a limit (currently $2,000 for a single person; $3,000 for a couple) on household resources (the value of the things you own), but there are exemptions for some things like your home and sometimes your vehicle.  Really, the only way you can definitely determine whether you meet the income and resources limits is to talk directly to Social Security.

Once you qualify financially, Social Security determines whether your child meets the medical requirements.  This determination is much less black-and-white than the resources test.  They look at your child’s medical records and determine how her impairments limit her ability to function in six different “domains”: Acquiring and Using Information, Attending and Completing Tasks, Interacting and Relating with Others, Moving About and Manipulating Objects, Caring for Yourself, and Health and Physical Well-Being.

Is it best to work with a lawyer in the process?

In theory, Social Security’s process is designed so you don’t need an attorney.  In fact, for SSI, you typically must complete the initial application by making an appointment directly with Social Security because they have to ask you those income and resource questions.  You can contact Social Security by calling 1-800-772-1213.

The majority of people who apply receive denials of their initial applications, and there is an appeals process.  That point in the process is where I believe an attorney does help quite a bit.  We help you to make sure paperwork gets filed by the deadlines, we follow up with Social Security to make sure that everything is getting processed appropriately, and we prepare you for the administrative hearing.  We request updated medical records, we write a brief to the judge, and we prepare you to appear and testify at the hearing.  I find that many people feel much more comfortable going into the administrative hearing if they have an attorney with them.

What are some common mistakes made in the process?

Probably the biggest mistake I see people make in SSI cases is giving up too soon.  Many people receive the denial of their initial claim and assume there is nothing else they can do, or they think the best thing to do is start a new application.  Even though the appeals process is long and sometimes frustrating, the hearing level statistically gives the best chance of a favorable decision.

My other recommendations – not so much mistakes to avoid as things to do to help your case go as smoothly as possible – include:

  • Provide information to Social Security about all of your child’s medical providers, including therapists and early childhood developmental programs.
  • Make sure to go to all appointments that Social Security schedules for you.
  • Keep Social Security updated about changes to your address or telephone number.
  • Ask your child’s doctors to provide letters stating their opinions of your child’s limitations and prognosis.
  • Make sure you give Social Security a realistic picture of your child’s limitations.  In treatment and day-to-day life, the goal is typically to focus on your child’s strengths, emphasize the positive, and make your child feel like a “normal” kid.  However, Social Security’s rules are based on what keeps your child from being able to do age-appropriate activities.  It can be hard, but be brutally honest about the limitations your child faces every day.

Please remember that my answers are general, and you should not rely on them as legal advice.  We do not have an attorney-client relationship.  However, if you would like to ask more specific questions, or if your child’s claim has been denied, I encourage you to contact an attorney or claimant representative.  Most offer a free consultation and may be able to answer questions you may have.

 

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