Social Security Disability Law» Children’s SSI

Congress is Suspicious of Children’s SSI Claims

Spencer & Spencer — Tue, 01 Feb 2011 15:00:52 +0000

A Massachusetts state representative has requested a congressional hearing to discuss the potential abuse of Social Security disability benefits (SSI) for children and teens.

Poor Follow-up on Child Disability Claims
One of the complaints about the current child disability system is that once a child is approved for benefits there is usually little to no follow-up as they age. Social Security regularly reviews adult disability recipients, but apparently does not review as many children.

In many cases, children are evaluated at the time they apply for benefits, and then never reviewed again until they reach adulthood. This may allow some children to continue to receive SSI even though their medical condition is no longer disabling.

Could Benefit Abuse Be Harming Children?
Congressman Richard E. Neal of Springfield, MD is spearheading the review of current procedures for approving and evaluating childhood disability benefits. His fear is that in many cases, children are being over diagnosed and medicated in order to qualify for disability benefits. — We believe this will probably turn out to not be true.

One of the most common disabilities that allow children to qualify for disability benefits is ADHD, which is often treated with medication. The congressional hearing will review the possibility that ADHD is being over-diagnosed, and children diagnosed with it are being over-medicated in order to qualify for disability.

Congress is afraid that in a weakened economy, where many families are facing foreclosure, reduced income, or unemployment, some turn to disability benefits as a potential lifeline to provide for their needs.

While there are thousands of truly disabled children, those legitimate cases may soon be under unnecessary scrutiny if the entire system is reviewed for potential abuse.

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How Does Social Security Decide Disability for a Child?

Spencer & Spencer — Tue, 27 Apr 2010 14:24:20 +0000

Deciding whether a child is disabled is very different than it is for disabled adults. With adults, we have to prove that they cannot work.

Children, on the other hand, are compared to other children their age to determine how limited they are by their medical conditions.

The three things Social Security looks at are:

1. any wages the child earns,
2. their ability to function on a daily basis, and
3. whether they meet a listed impairment.

1. Is the child earning SGA?

See our discussion of SGA. This analysis is the same for adults and children. Once it is determined that the child isn’t earning SGA, they move on to step 2.

2. The areas of function are:

Cognitive/Communicative: ability to learn, understand and solve problems.
Motor: gross and fine motor skills.
Social: ability to form and maintain relationships.
Responsiveness to Stimuli (Birth to age 1 only): respond to visual, auditory or tactile stimuli.
Personal: ability to take care of personal needs.
Concentration, Persistence or Pace: ability to sustain attention and concentration.

The requirements for a child to get Children’s SSI are that they must have a “marked” impairment in two areas of function, or an “extreme” impairment in one area.

“Marked” and “Extreme” are defined as:

Marked: a limitation that interferes seriously with the child’s functioning. When a standardized test is used, a valid score which is more than two standard deviations below the norm is a marked limitation. Children younger than 3 have a marked impairment if they are functioning at a level which is more then one-half but less than two-thirds of their age.

Extreme: no meaningful function in this area. When a standardized test is used, a valid score of three or more standard deviations below the norm is an extreme limitation.

Neither of these are easy to prove. Many children are found to have “moderate” limitations in several areas, but no marked or extreme limitations.

And what does this mean for your child’s disability case? It means that getting disability will probably be an uphill battle. Over the past decade or so, Social Security has made it more difficult for children to get SSI.

But this doesn’t mean you should give up.

Medical records, school records and records from therapists such as language, physical and occupational can help. These are generally what we use to show that a child has a “marked” or “extreme” impairment. Testimony from friends and family who have seen the difficulties that the child has can also be helpful.

Knowing what evidence is going to convince a judge that your child has two marked or one extreme limitation(s) is only something that an experienced Social Security lawyer can tell you. Each child is different, and has different levels of limitation.

3. Does your child meet a listed impairment?

If your child doesn’t meet the functional-standard explained above, the next thing to look at is the listing of impairments.

Social Security has a list of impairments that it uses to determine if your child is disabled. If the requirements for any condition are met, then your child will be awarded benefits.

We have handled quite a few children’s SSI cases, and although we have been very successful, they have been some of our more challenging cases.

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What Are My Chances of Winning My Disability Case?

Spencer & Spencer — Tue, 09 Feb 2010 17:29:26 +0000

This is a question we often get from new clients.

Stastically, only about 30-35% of people who apply in Colorado get approved right away.

But for your specific case, the answer is that it is difficult to say without seeing your file. There are many variables that go into winning a Social Security case. A few we look at when we first get a file are:

Are all of your medical records in your file? (The more complete your file is, the better your chances are)
What conditions are making you disabled? (Some conditions are more likely to get you approved)
Do you meet a listing? (If you do, you’re very likely to get approved without having to go to a hearing)
How often are you seeing the doctor? (The more you see the doctor, the better your chances are)
Are your conditions and limitations being documented? (The more documentation you have, the better your chances are)
Do any of your doctors seem supportive of your claim for disability benefits? What additional information can we get from your doctors to help us win your case? (Supportive doctor statements improve your chances)
What did Social Security’s doctors say about your case? (Negative reports from Social Security’s doctors decrease your chances)
What information will we need to combat what Social Security’s doctors have said about your case? What information is on your Work History form? (See our eBook Filing an Application for Social Security)

Once we have that information, we have a better sense of what your chances are, and we can start working on a plan to win your case. And there may be more issues in your case that are specific to your situation.

If you haven’t applied yet, and need some guidance on filing an application for Social Security disability benefits, you may be interested in downloading our free eBook for tips on filing an application for Social Security disability benefits.

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If you'd like to talk to an attorney about your Social Security case, please contact us via e-mail, phone, or the Internet.