Social Security: 10026

8/14/2019 Social Security: 10026

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Benefts For

Children WithDisabilities2008



Contacting Social Security

Visit our websiteOur website, www.socialsecurity.gov ,

is a valuable resource or inormationabout all o Social Security’s programs.At our website you also can:• Applyforcertainkindsofbenets;

• GettheaddressofyourlocalSocialSecurityofce;

• Requestimportantdocuments,suchas a Social Security Statement, areplacement Medicare card or a lettertoconrmyourbenetamount;and

• Findcopiesofourpublications.Call our toll-ree number

In addition to using our website, youcan call us toll-ree at 1-800-772-1213.

Wecananswerspecicquestionsfrom 7 a.m. to 7 p.m., Monday through Friday.We can provide inormation by automat-ed phone service 24 hours a day. (Youcan use our automated response system

totellusanewaddressorrequestareplacement Medicare card.) I you aredea or hard o hearing, you may callour TTY number, 1-800-325-0778.

We treat all calls confdentially. Wealsowanttomakesureyoureceiveaccurate and courteous service. Thatis why we have a second SocialSecurity representative monitor some

telephone calls.

http://www.socialsecurity.gov/




Introduction 4

Supplemental Security Income(SSI) payments or childrenwith disabilities 5

Social Security DisabilityInsurance (SSDI) beneftsor adults disabled sincechildhood 11

Applying or SSI paymentsor SSDI benefts and howyou can help 12

Employment supportprograms or young peoplewith disabilities 14

Medicaid and Medicare 16State Children’s HealthInsurance Program 17

Other health care services 18

What’s inside



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Introduction

Thisbookletisfortheparents,caregivers or representatives ochildren under age 18 who havedisabilitiesthatmightmakethemeligible or Supplemental SecurityIncome (SSI) payments. It is alsoor adults who became disabledin childhood and who might beentitled to Social Security DisabilityInsurance (SSDI) benefts. (We callthis SSDI beneft a “child’s” beneftbecause it is paid on a parent’sSocial Security earnings record.)

Thisbookletwillhelpyoudecide

ifyourchild,orachildyouknow,might be eligible or Social Securityor SSI.

S o c i a l S e c u r i t y



Supplemental Security Income

(SSI) payments or childrenwith disabilities

SSImakesmonthlypaymentstopeople with low income and limited

resources who are 65 or older, orblind or disabled. Your child underage18canqualifyifheorshemeetsSocial Security’s defnition o dis-ability or children, and i his or her

income and resources all withinthe eligibility limits. The amounto the SSI payment is dierent romone state to another because somestates add to the SSI payment. Your

local Social Security ofce can tellyou more about your state’s totalSSI payment.

SSI rules about incomeand resources

When we decide i your child canget SSI, we consider your child’sincome and resources. We also con-

sider the income and resources oamily members living in the child’shousehold. These rules apply i yourchild lives at home. They also applyi he or she is away at school but

returns home rom time to timeand is subject to your control.

I your child’s income andresources, or the income andresources o amily members livingin the child’s household, are more

5w w w . s o c i a l s e c u r i t y . g o v





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than the amount allowed, we willdeny the child’s application or SSIpayments.

We limit the monthly SSI pay-ment to $30 when a child is ina medical acility where health

insurance pays or his or her care.

SSI rules about disabilityYour child must meet all o

thefollowingrequirementstobeconsidered disabled and thereoreeligible or SSI:

• Thechildmustnotbeworkingand earning more than $940 a

month in 2008. (This earningsamount changes every year.) Iheorsheisworkingandearningthat much money, we will fndthat your child is not disabled.

• Thechildmusthaveaphysicalormental condition, or a combina-tion o conditions, that results in“markedandseverefunctionallimitations.” This means that thecondition(s) must very seriouslylimit your child’s activities.

• Thechild’scondition(s)musthavelasted, or be expected to last,

atleast12months;ormustbeexpected to result in death.

I your child’s condition(s) resultsin“markedandseverefunctionallimitations” or at least 12 continuous

months, we will fnd that your childis disabled. But i it does not result in




those limitations, or does not last orat least 12 months, we will fnd thatyour child is not disabled.

Providing inormation aboutyour child’s condition

When you apply or benefts oryourchild,wewillaskyoufordetailed inormation about thechild’s medical condition and how itaects his or her ability to unctiononadailybasis.Wealsowillaskyou to give permission or the doc-tors, teachers, therapists and otherproessionals who have inormationabout your child’s condition to sendthe inormation to us.

I you have any o your child’smedical or school records, pleasebring them with you. This will

help speed up the decision on yourapplication.

What happens next?We send all o the inormation

you give us to the DisabilityDetermination Services in yourstate. Doctors and other trainedsta in that state agency will

review the inormation, and willrequestyourchild’smedicalandschool records, and any otherinormation needed to decide iyour child is disabled.

Ifthestateagencycannotmakea disability decision using only the






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medical inormation, school recordsand other acts they have, theymayaskyoutotakeyourchildfora medical examination or test. Wewill pay or the exam or test.

We may make immediateSSI payments to your childItcantakethreetovemonths

or the state agency to decide iyour child is disabled. However, weconsider certain medical conditionsso limiting that we expect any oneo them to disable a child. In thesecases,wemakeSSIpaymentsrightaway and or up to six months whilethe state agency decides i yourchild is disabled.

Following are some o thoseconditions:

• HIVinfection• Totalblindness

• Totaldeafness

• Cerebralpalsy

• Downsyndrome• Musculardystrophy

• Severementalretardation (child age 7 or older)

• Birthweightbelow2pounds, 10 ounces

I your child has one o thelimiting conditions that is expectedto disable a child, he or she will getSSI payments right away. However,the state agency may fnally decide




that your child’s disability isnot severe enough or SSI. I thathappens, you will not have to paybacktheSSIpaymentsthatyourchild got.

SSI disability reviewsOnce your child starts receivingSSI,thelawrequiresthatwereviewyour child’s medical condition romtime to time to veriy that he or she

is still disabled. This review mustbe done:

• Atleasteverythreeyearsforchildren younger than age 18

whose conditions are expectedtoimprove;and

• Byage1forbabieswhoare getting SSI payments becauseo their low birth weight, unless

we determine their medicalcondition is not expected toimprove by their frst birthdayand we schedule the review ora later date.

We may perform a disabilityreview even if your child’s conditionis not expected to improve. Whenwe do a review, you must presentevidence that your child is and hasbeen receiving treatment that isconsidered medically necessary foryour child’s medical condition.






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What happens when your

child turns age 18For disability purposes in theSSI program, a child becomes anadult at age 18, and we use dierentmedical and nonmedical rules when

deciding i an adult can get SSIdisability payments. For example,we do not count the income andresources o amily members whendeciding whether an adult meets the

fnancial limits or SSI. We countonly the adult’s income andresources. We also use the disabil-ity rules or adults when decidingwhether an adult is disabled.

• IfyourchildisalreadyreceivingSSI payments, we must reviewthe child’s medical conditionwhen he or she turns age 18. We

usually do this review during theone-year period that begins onyour child’s 18th birthday. We willuse the adult disability rules todecide whether your 18-year-old is

disabled.• Ifyourchildwasnoteligiblefor

SSI beore his or her 18th birthdaybecause you and your spouse hadtoo much income or resources, heor she may become eligible or SSIat age 18.

Formoreinformation,askforSupplemental Security Income (SSI)

(Publication No. 05-11000).


http://www.ssa.gov/pubs/11000.html







Social Security Disability

Insurance (SSDI) beneftsor adults disabled sincechildhood

The SSDI program pays benefts

to adults who have a disability thatbegan beore they became 22 yearsold. We consider this SSDI beneft asa “child’s” beneft because it is paidon a parent’s Social Security earn-

ings record.For a disabled adult to become

entitled to this “child” beneft, oneo his or her parents:

• MustbereceivingSocialSecurityretirementordisabilitybenets;or

• Musthavediedandhaveworkedlong enough under Social Security.

These benefts also are payable to

an adult who received dependentsbenefts on a parent’s SocialSecurity earnings record prior toage 18, i he or she is disabled at age18.Wemakethedisabilitydecisionusing the disability rules or adults.

SSDI disabled adult “child”benefts continue as long as theindividual remains disabled. Your

childdoesnotneedtohaveworkedto get these benefts.






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How we decide i your “child”

is disabled or SSDI beneftsI your child is age 18 or older, wewill evaluate his or her disabilitythe same way we would evaluatethe disability or any adult. We send

the application to the DisabilityDetermination Services in yourstate that completes the disabilitydecision or us. For detailed inor-mation about how we evaluate dis-

abilityforadults,askforDisability Benefts (Publication No. 05-10029).

Applying or SSI payments

or SSDI benefts and howyou can help

You can apply or Social Securityor SSI payments or your child by

calling Social Security toll-ree at1-800-772-1213 or by visiting yourlocal Social Security ofce. I youare applying or SSI payments oryour child, you should have his or

her Social Security number andbirth certifcate with you when youapply. I you are applying or SSDIbenefts or your child, please haveyour own Social Security number

with you in addition to the child’sSocial Security number and birthcertifcate.


http://www.socialsecurity.gov/pubs/10029.html







Youcanhelpusmakeadecisionby:

• Tellingusasmuchasyou can about your child’s medicalcondition(s);

• Givingusthedatesofvisitstodoctors or hospitals, the patient

account numbers or any doctorsor hospitals, and any other inor-mation that will help us get yourchild’smedicalrecords;and

• Providinguswithcopiesofanymedical reports or inormationthat you already have in yourpossession.

NOTE: You do not need to request inormation rom your child’s doc-tors. We will contact them directly

or any reports or inormation thatwe need to make a decision about

your child’s disability.

I your child is younger than age18 and applying or SSI, you willneed to provide records that show

your income and resources, as wellas those o your child. We also willaskyoutodescribehowyourchild’sdisability aects his or her abilityto unction on a day-to-day basis. In

addition,wewillaskforthenameso teachers, day care providers andamily members who can provideinormation about how your childunctions. I you have any school

records, you should bring them tothe interview.






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In many communities, specialarrangements have been made withmedical providers, social serviceagencies and schools to help us getthe evidence we need to processyour child’s claim. However, your

cooperation in getting records andother inormation will help usnishourjobmorequickly.

Employment support

programs or young peoplewith disabilities

We have many ways to encourageyoung people who are receiving SSI

payments or SSDI benefts and whowanttogotowork.

Under SSI:

• Whenwegureyourchild’s

monthly SSI payment, we donot count most o your child’sincome. I your child is youngerthan age 22 and a student whoregularly attends school, we

exclude even more o his or herearnings each month. In 2008,disabled students younger thanage 22 may exclude $1,550 otheir monthly earnings, with

an annual limit o $6,240, whencounting their income or SSIpurposes. These limits increaseeach year.

• WithaPlantoAchieveSelf-Support (PASS), a child who isage 15 or older can save some




income and resources to pay oreducation and other things need-edtobeabletowork.Wedonotcount the saved income when wefgure your child’s income or SSIpurposes. We do not count the

saved income and resources whenwe fgure the amount o yourchild’s payment.

• Becauseofamedicalcondition(s),your child may need certain

items and services in order towork,suchasawheelchairorapersonal assistant. When fgur-ing your child’s SSI payment, wewill not count some or all o the

amount paid or these items andservices in your child’s earnings.

• Yourchildolderthanage15 may get help with rehabilitation

and training.• Medicaidcoveragewillcontinueeven i your child’s earnings arehigh enough to stop the monthlySSI payment, as long as the earn-

ings are under a certain amount.

Under SSDI:• Anadultdisabledbeforeage22

cangetthesamehelpwithworkexpenses explained above or anSSI child, and help with rehabili-tation and training.

• Cashbenetsmaycontinueuntil

theindividualcanworkona regular basis.






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• Medicaremaycontinueforup to 93 months (seven years, ninemonths).

You can get more inormationabout these programs at our website,www.socialsecurity.gov , or by

calling our toll-ree 800 number.

Medicaid and Medicare

Medicaid is a health care program

or people with low incomes andlimited resources. In most states,children who get SSI paymentsqualifyforMedicaid.Inmanystates, Medicaid comes automati-

cally with SSI eligibility. In otherstates, you must sign up or it. Andsome children can get Medicaidcoverage even i they do notqualifyforSSI.Checkwithyour

local Social Security ofce, yourstate Medicaid agency, or your stateor county social services ofce ormore inormation.

Medicare is a ederal healthinsurance program or people age65 or older and or people who havebeen getting Social Security disabil-ity benefts or at least two years.




There are two exceptions to thisrule. Your child can get Medicare ihe or she:

• Hasachronicrenaldiseaseandneedsakidneytransplantormaintenancedialysis;or

• HasLouGehrig’sdisease (amyotrophic lateral sclerosis).

State Children’s Health

Insurance ProgramThe State Children’s Health

Insurance Program enables statesto provide health insurance tochildrenfromworkingfamilieswithincomestoohightoqualify or Medicaid, but too low to aordprivate health insurance. Theprogram provides coverage or

prescription drugs, vision, hearingand mental health services and isavailable in all 50 states and theDistrict o Columbia. Your stateMedicaid agency can provide more

inormation about this program, oryou can get more inormation atwww.cms.hhs.gov/home/schip.asp on the Internet or by calling1-877-543-7669.


http://www.cms.hhs.gov/home/schip.asp



http://www.cms.hhs.gov/home/schip.asp



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Other health care services

When your child gets SSI, we willreer you to places where you canget health care services or yourchild. These services are underthe Children with Special HealthCare Needs provision o the SocialSecurity Act. These programs areusually managed by state healthagencies.

States call these services bymany dierent names, includingChildren’s Special Health Services,Children’s Medical Services andHandicapped Children’s Program.

Most Children with Special HealthCare Needs programs help provideservices through clinics, privateofces, hospital-based outpatientand inpatient treatment centers,

or community agencies.Even i your child does not get

SSI, one o these programs maybe able to help you. Local healthdepartments, social service ofces,or hospitals should be able to helpyou contact your local Childrenwith Special Health Care Needsprogram.




Social Security Administration

SSA Publication No. 05-10026ICN 455360Unit o Issue - HD (one hundred)January 2008 (Destroy prior editions)

Documents

Social Security: 10026