Shareware Overload Trio 2/Shareware Overload Trio Volume 2 (Chestnut CD-ROM).ISO/dir33/ssi_ssa.zip/05_10026.TXT

Text File | 1994-01-11 | 18KB | 432 lines

File 05-10026.TXT

Uploaded from F.L.I.C.net on 16-NOV-93
1-(607)-272-1549 (7 days-24 hours, 8-N-1)

F.L.I.C.net operated by the:
Finger Lakes Independence Center
607 W. Clinton Street Suite 112
Ithaca NY, 14850
Voice/TTY 1-[phone]
SYSOP: Jon W. Merritt

Virus Scanned, McAfee Associates 9.12 V100

Booklet title: "Social Security And SSI Benefits For Children With
Disabilities."

U.S. Department of Health And Human Services
Social Security Administration
SSA Publication No. 05-10026
January 1992
ICN 455260

About This Booklet

This booklet 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.

About 3.6 million children already get benefits from Social Security
including approximately 450,000 disabled children under the age of 18
who get SSI benefits. This booklet will help you decide if your child,

or a child you know, is eligible for Social Security or SSI.

What's Inside

The Three Ways A Child Can Get Benefits From Social Security Or SSI

SSI Benefits For Children With Disabilities

Non-Medical Rules

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 Childhood

Non-Medical Rules

How We Decide If An Adult Child Is Disabled

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

Medicaid And Medicare

To Learn More About Social Security And SSI

The Three Ways A Child Can Get Benefits From Social Security Or SSI
There are three ways a child might be eligible for benefits from Social

Security or SSI. The three kinds of benefits are:

1) 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.

About 2.6 million children receive dependents or survivors benefits
from Social Security.

2) 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. About 600,000 people receive

"disabled adult child's" benefits.

3) 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.

About 450,000 children with disabilities currently receive SSI
payments.

SSI Benefits For Children With Disabilities

Non-Medical Rules

SSI 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
(see pages 7 and 8) 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 18
Most children do not have their own income and do not have many as
sets. 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 Older
When 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 SSI

While 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 existing records available 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.

Defining "Disability"
To 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 18
Of 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.

A Special Message To Parents Of Children With Severe Disabilities

The 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 6 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 pages 5 and 6).

Following are some of the disability categories in which we can presume
the child is disabled and make immediate SSI payments:

* Deafness+

* Blindness

* Cerebral Palsy

* Down Syndrome

* Muscular Dystrophy+

* Significant mental deficiency

* Diabetes (with amputation of one foot)

* Amputation of two limbs

* Amputation of leg at the hip

+In some cases

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 Infection

Young children with HIV infection differ from adults, or even from
older children (age 13 or older), 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

Non-Medical Rules

As 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 dosen'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 been
mentally retarded since birth. Ben will start collecting a disabled
"child's" benefit on his fathers 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 Securtiy 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 histoy, 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.

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 offlce. You can help
expedite the claims process if you 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.
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.

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 this information, tell the interviewer as
much as you know. If you have any school records, bring them with you
to the interview.

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 would be helpful.

Medicaid And Medicare

Medicaid is a health insurance program for people with low incomes
and limited assets. In most States, children who get SSI benefits
qualify for Medicaid coverage. In many States, this coverage 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 2 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 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:

* Understanding Social Security (Publication No. 05-10024)

* Retirement (Publication No. 05-10035)

* Disability (Publication No. 05-10029)

* Medicare (Publication No. 05-10043)

* SSI For Groups And Organizations (Publication No. 05-11015)

(All of these publications are available in Spanish.)

U.S. Government Printing Office: 1992-312-172/40030