benefits for children with disabilitites

7/29/2019 Benefits for Children With Disabilitites

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Benefts For

Children WithDisabilities2012


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Contacting Social Security

Visit our websiteOur website, www.socialsecurity.gov,

is a valuable resource for informationabout all of Social Securitys programs.At our website you also can:

Apply for retirement, disability, andMedicare benefi s;

Review your Social SecurityStatement;

Get the address of your local SocialSecurity offce;

Request a replacement Medicarecard; and

Find copies of our publications.

Call our toll-free numberIn addition to using our website, you

can call us toll-free at 1-800-772-1213.

We treat all calls confdentially. We cananswer specifc questions from 7 a.m.to 7 p.m., Monday through Friday.Generally, youll have a shorter waittime if you call during the week after

Tuesday. We can provide informationby automated phone service 24 hoursa day. If you are deaf or hard of hearing,you may call our TTY number,1-800-325-0778.

We also want to make sure youreceive accurate and courteous service.That is why we have a second SocialSecurity representative monitor sometelephone calls.
http://www.socialsecurity.gov/http://www.socialsecurity.gov/applyforbenefitshttp://www.socialsecurity.gov/applyforbenefitshttp://www.socialsecurity.gov/mystatementhttp://www.socialsecurity.gov/mystatementhttp://www.socialsecurity.gov/mystatementhttp://www.socialsecurity.gov/mystatementhttps://secure.ssa.gov/apps6z/FOLO/fo001.jsphttps://secure.ssa.gov/apps6z/FOLO/fo001.jsphttps://secure.ssa.gov/apps6z/FOLO/fo001.jsphttps://secure.ssa.gov/apps6z/FOLO/fo001.jsphttp://www.socialsecurity.gov/medicarecardhttp://www.socialsecurity.gov/medicarecardhttp://www.socialsecurity.gov/pubshttp://www.socialsecurity.gov/pubshttp://www.socialsecurity.gov/medicarecardhttps://secure.ssa.gov/apps6z/FOLO/fo001.jsphttp://www.socialsecurity.gov/mystatementhttp://www.socialsecurity.gov/applyforbenefitshttp://www.socialsecurity.gov/


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Whats Inside

Introduction . . . . . . . 4

Supplemental SecurityIncome (SSI) payments for

children with disabilities . .5

Social Security DisabilityInsurance (SSDI) benefitsfor adults disabled

since childhood . . . . . . 11

Applying for SSI paymentsor SSDI benefits and how

you can help 12

Employment supportprograms for young people

with disabilities

14Medicaid and Medicare 16

Childrens Health

Insurance Program . . . . 17

Other health care services 18


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Introduction

This booklet is for the parents,caregivers or representatives ofchildren younger than age 18 whohave disabilities that might makethem eligible for Supplemental

Security Income (SSI) payments. It isalso for adults who became disabledin childhood and who might beentitled to Social Security DisabilityInsurance (SSDI) benefts. (We call

this SSDI beneft a childs beneftbecause it is paid on a parents SocialSecurity earnings record.)

This booklet will help youdecide if your child, or a child youknow, might be eligible for SSI orSocial Security.


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Supplemental Security Income(SSI) payments for childrenwith disabilities

SSI makes monthly payments topeople with low income and limitedresources who are 65 or older, or

blind or disabled. Your child youngerthan age 18 can qualify if he or shemeets Social Securitys defnition ofdisability for children, and if his orher income and resources fall withinthe eligibility limits. The amountof the SSI payment is different fromone state to another because somestates add to the SSI payment. Yourlocal Social Security offce can tellyou more about your states totalSSI payment.

SSI rules about income

and resourcesWhen we decide if your child canget SSI, we consider your childsincome and resources. We alsoconsider the income and resources of

family members living in the childshousehold. These rules apply if yourchild lives at home. They also apply ifhe or she is away at school but returnshome from time to time and is subject

to your control.If your childs income and resources,

or the income and resources offamily members living in the childshousehold, are more than the amountallowed, we will deny the childsapplication for SSI payments.


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We limit the monthly SSI paymentto $30 when a child is in a medical

facility where health insurance paysfor his or her care.

SSI rules about disabilityYour child must meet all of

the following requirements to beconsidered disabled and thereforeeligible for SSI:

The child must not be working andearning more than $1,010 a monthin 2012. (This earnings amountusually changes every year.) If heor she is working and earning thatmuch money, we will fnd that

your child is not disabled. The child must have a physical or

mental condition, or a combinationof conditions, that results inmarked and severe functional

limitations. This means that thecondition(s) must very seriouslylimit your childs activities.

The childs condition(s) must havebeen disabling, or be expected to bedisabling, for at least 12 months; ormust be expected to result in death.

If your childs condition(s) resultsin marked and severe functional

limitations for at least 12 continuousmonths, we will fnd that your childis disabled. But if it does not result inthose limitations, or does not resultin those limitations for at least 12

months, we will fnd that your childis not disabled.


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Providing information aboutyour childs condition

When you apply for benefts foryour child, we will ask you fordetailed information about the childsmedical condition and how it affects

his or her ability to function on adaily basis. We also will ask youto give permission for the doctors,teachers, therapists and otherprofessionals who have information

about your childs condition to sendthe information to us.

If you have any of your childsmedical or school records, pleasebring them with you. This will

help speed up the decision onyour application.

What happens next?We send all of the information

you give us to the DisabilityDetermination Services in yourstate. Doctors and other trained staffin that state agency will review theinformation, and will request yourchilds medical and school records,and any other information needed todecide if your child is disabled.

If the state agency cannot make

a disability decision using only themedical information, school recordsand other facts they have, they mayask you to take your child for amedical examination or test. We will

pay for the exam or test.


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We may make immediate SSIpayments to your child

It can take three to fve monthsfor the state agency to decide if yourchild is disabled. However, for somemedical conditions, we make SSI

payments right away and for up tosix months while the state agencydecides if your child is disabled.

Following are some conditions thatmay qualify:

HIV infection; Total blindness;

Total deafness;

Cerebral palsy;

Down syndrome; Muscular dystrophy;

Severe intellectual disorder(child age 7 or older); and

Birth weight below 2 pounds,10 ounces.

If your child has one of thequalifying conditions, he or shewill get SSI payments right away.

However, the state agency mayfnally decide that your childsdisability is not severe enough forSSI. If that happens, you will nothave to pay back the SSI payments

that your child got.


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SSI disability reviewsOnce your child starts receiving

SSI, the law requires that we reviewyour childs medical condition fromtime to time to verify that he or sheis still disabled. This review mustbe done:

At least every three years forchildren younger than age 18whose conditions are expectedto improve; and

By age 1 for babies who are gettingSSI payments because of their lowbirth weight, unless we determinetheir medical condition is notexpected to improve by their frst

birthday and we schedule thereview for a later date.

We may perform a disability revieweven if your childs condition is notexpected to improve. When we do areview, you must present evidencethat your child is and has beenreceiving treatment that is consideredmedically necessary for your childs

medical condition.


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What happens when yourchild turns age 18

For disability purposes in the SSIprogram, a child becomes an adult atage 18, and we use different medicaland nonmedical rules when deciding

if an adult can get SSI disabilitypayments. For example, we do notcount the income and resourcesof family members when decidingwhether an adult meets the fnancial

limits for SSI. We count only theadults income and resources. Wealso use the disability rules for adultswhen deciding whether an adultis disabled.

If your child is already receivingSSI payments, we must review thechilds medical condition when heor she turns age 18. We usually dothis review during the one-year

period that begins on your childs18th birthday. We will use the adultdisability rules to decide whetheryour 18-year-old is disabled.

If your child was not eligible forSSI before his or her 18th birthdaybecause you and your spouse hadtoo much income or resources, heor she may become eligible for SSI

at age 18.For more information, ask forSupplemental Security Income(SSI)(Publication No. 05-11000).
http://www.ssa.gov/pubs/11000.htmlhttp://www.ssa.gov/pubs/11000.htmlhttp://www.ssa.gov/pubs/11000.htmlhttp://www.ssa.gov/pubs/11000.htmlhttp://www.ssa.gov/pubs/11000.html


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Social Security DisabilityInsurance (SSDI) benefts foradults disabled since childhood

The SSDI program pays beneftsto adults who have a disability thatbegan before they became 22 years

old. We consider this SSDI beneftas a childs beneft because it ispaid on a parents Social Securityearnings record.

For a disabled adult to becomeentitled to this child beneft, one ofhis or her parents:

Must be receiving Social Securityretirement or disability benefts; or

Must have died and have workedlong enough under Social Security.

These benefts also are payable toan adult who received dependentsbenefts on a parents Social Security

earnings record prior to age 18, if heor she is disabled at age 18. We makethe disability decision using thedisability rules for adults.

SSDI disabled adult child benef

tscontinue as long as the individualremains disabled. Your child doesnot need to have worked to getthese benefi s.


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How we decide if your child isdisabled for SSDI benefts

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

the application to the DisabilityDetermination Services in your statethat makes the disability decisionfor us. For detailed informationabout how we evaluate disability for

adults, ask for Disability Benefts(Publication No. 05-10029).

Applying for SSI paymentsor SSDI benefts and how

you can helpYou can apply for Social Security

or SSI payments for your child bycalling Social Security toll-free at

1-800-772-1213 or by visiting yourlocal Social Security offce. If youare applying for SSI payments foryour child, you should have his orher Social Security number and birth

certifcate with you when you apply.If you are applying for SSDI beneftsfor your child, please have your ownSocial Security number with you inaddition to the childs Social Security

number and birth certifcate.
http://www.ssa.gov/pubs/10029.htmlhttp://www.ssa.gov/pubs/10029.htmlhttp://www.ssa.gov/pubs/10029.htmlhttp://www.ssa.gov/pubs/10029.htmlhttp://www.ssa.gov/pubs/10029.htmlhttp://www.ssa.gov/pubs/10029.html


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You can help us make a decision by:

Telling us as much as you

can about your childsmedical condition(s);

Giving us the dates of visits todoctors or hospitals, the patientaccount numbers for any doctorsor hospitals, and any otherinformation that will help us getyour childs medical records; and

Providing us copies of any medical

reports or information that youalready have in your possession.

NOTE: You do not need torequest information from yourchilds doctors. We will contactthem directly for any reportsor information that we needto make a decision about yourchilds disability.

If your child is younger than age18 and applying for SSI, you will needto provide records that show yourincome and resources, as well as thoseof your child. We also will ask you to

describe how your childs disabilityaffects his or her ability to functionon a day-to-day basis. In addition, wewill ask for the names of teachers, daycare providers, and family members

who can provide information abouthow your child functions. If you haveany school records, you should bringthem to the interview.

In many communities, specialarrangements have been made withmedical providers, social service


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agencies and schools to help us getthe evidence we need to process

your childs claim. However, yourcooperation in getting records andother information will help us fnishour job more quickly.

Employment supportprograms for young peoplewith disabilities

We have many ways to encourage

young people who are receiving SSIpayments or SSDI benefts and whowant to go to work.

Under SSI: When we fgure your childs

monthly SSI payment, we do notcount most of your childs income.If your child is younger thanage 22 and a student who regularly

attends school, we exclude evenmore of his or her earnings eachmonth. In 2012, disabled studentsyounger than age 22 may exclude$1,700 of their monthly earnings,with an annual limit of $6,840,when counting their income forSSI purposes. These limits mayincrease each year.

With a Plan to Achieve Self-Support(PASS), a child who is age 15 orolder can save some income andresources to pay for education andother things needed to be able to

work. We do not count the savedincome when we fgure yourchilds income for SSI purposes.


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We do not count the saved incomeand resources when we fgure the

amount of your childs payment. Because of a medical condition(s),

your child may need certain itemsand services in order to work,such as a wheelchair or a personal

assistant. When fguring yourchilds SSI payment, we will notcount some or all of the amountpaid for these items and services inyour childs earnings.

Your child older than age 15may get help with rehabilitationand training.

Medicaid coverage will continue

even if your childs earnings arehigh enough to stop the monthlySSI payment as long as the earningsare under a certain amount.

Under SSDI: An adult disabled before age

22 can get the same help withwork expenses explained abovefor an SSI child, and help with

rehabilitation and training. Cash benefts may continue until

the individual can work on aregular basis.

Medicare may continue forup to 93 months (seven years,nine months).

You can get more informationabout these programs at our website,

www.socialsecurity.gov, or by callingus toll-free at 1-800-772-1213.
http://www.socialsecurity.gov/http://www.socialsecurity.gov/http://www.socialsecurity.gov/


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Medicaid and Medicare

Medicaid is a health care programfor people with low incomes andlimited resources. In most states,children who get SSI paymentsqualify for Medicaid. In many states,

Medicaid comes automaticallywith SSI eligibility. In other states,you must sign up for it. And somechildren can get Medicaid coverageeven if they do not qualify for SSI.

Check with your local Social Securityoffce, your state Medicaid agency, oryour state or county social servicesoffce for more information.

Medicare is a federal healthinsurance program for peopleage 65 or older and for people whohave been getting Social Securitydisability benefts for at leasttwo years.

There are two exceptions to thisrule. Your child can get Medicareimmediately if he or she:

Has a chronic renal disease and

needs a kidney transplant ormaintenance dialysis; or

Has Lou Gehrigs disease(amyotrophic lateral sclerosis).


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Childrens HealthInsurance Program

The Childrens Health InsuranceProgram enables states to providehealth insurance to children fromworking families with incomes too

high to qualify for Medicaid, but toolow to afford private health insurance.The program provides coverage forprescription drugs, vision, hearingand mental health services and is

available in all 50 states and theDistrict of Columbia. Your stateMedicaid agency can provide moreinformation about this program,or you can get more informationabout coverage for your children atwww.insurekidsnow.govon theInternet or by calling 1-877-543-7669.
http://www.insurekidsnow.gov/http://www.insurekidsnow.gov/


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Other health care services

When your child gets SSI, we willrefer you to places where you can gethealth care services for your child.These services are under the Childrenwith Special Health Care Needs

provision of the Social Security Act.These programs are usually managedby state health agencies.

States call these services by manydifferent names, including Childrens

Special Health Services, ChildrensMedical Services and HandicappedChildrens Program. Most programsprovide services through clinics,private offces, hospital-basedoutpatient and inpatient treatmentcenters, or community agencies.

Even if your child does not get SSI,one of these programs may be able to

help you. Local health departments,social service offces, or hospitalsshould be able to help you contactyour local Children with SpecialHealth Care Needs program.


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Social Security AdministrationSSA Publication No. 05-10026

ICN 455360Unit of Issue - HD (one hundred)June 2012 (Jan. 2012 edition may be used)

Printed on recycled paper

benefits for children with disabilitites

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