The Difference Between Child SSI and Adult SSI

May 19, 2015

We receive calls every day from concerned parents who have received notices from the Social Security Administration (SSA) explaining that their child’s benefits will be reviewed. The process is called a Continuing Disability Review (CDR). While any disability recipient’s benefits are subject to a periodic CDR, in this article, we will focus on the Child CDR, known as the “Age 18 Redetermination.”

SSA redetermines the medical eligibility of each child SSI recipient when he or she turns 18. To remain eligible, the youth must meet the adult standards of disability, which may be more restrictive than the standards for children. As part of the review, the Government will send notice to the payee, normally the parent or guardian, explaining that the child’s disability will be reviewed under the adult standards.

As an intake attorney at Nash Disability Law (NDL), I hear the concern and fear that many parents and guardians experience when they receive this type of notice. Dealing with a child with significant disabilities or impairments has no doubt been very daunting; navigating the process to receive disability has been daunting as well.

For some parents or guardians, it takes several months or years to even start receiving benefits for their child. The thought of having to go through another review and prove disability is not only overwhelming, but likely feels impossible.

There are many important factors to understand when you receive a CDR. The standard for disability as a child is very different from the standard as an adult. Just because SSI payments cease in adulthood doesn’t mean that your child didn’t have a qualifying condition during his or her youth.

To start, child SSI is awarded to a child whose conditions satisfy the criteria set forth in the “Blue Book,” a manual listing various impairments and required medical findings associated with the impairment. Most children’s impairments do not meet these criteria, so their impairments are evaluated differently – by assessing the functional limitations caused by the impairments; for example, what your child cannot do, has difficult doing, needs help doing, or is restricted from doing because of his impairment. The Government must find that the child has “Marked” or “Severe” limitations in different areas of functioning.

Some children that receive SSI for a learning disability may not necessarily meet the criteria for disability as an adult. This is because adult SSI requires that the individual is unable to sustain work on a competitive basis.

The issue in an adult disability claim is often whether the applicant can perform “simple, unskilled work.” In other words, the government must find that the child who received disability benefits has such significant impairments and symptoms from those impairments, that it would prevent them from doing very simple work, like bagging groceries or working as a night janitor.

With mental limitations including emotional and cognitive disorders, SSA evaluates factors including whether an individual can understand and remember simple instructions; make simple work-related decisions; respond appropriately to supervision and co-workers; and deal with changes in a routine work setting.

Without an evaluation of your child’s situation by an expert, you may have no useful idea as to whether your child’s impairment can satisfy these criteria. Fortunately, the rules of evidence in a Social Security claim are very lax. Social Security accepts evidence from both medical and non-medical sources in evaluating a young adult’s impairment, including family members and educational personnel. It also will accept and review a young adult’s Individualized Education Plan and transition plan to gain insight into your child’s ability to develop skills appropriate to independent work and living situations.

If your child has been denied benefits as an adult and you think that he or she cannot sustain a job on a competitive basis, call NDL today for a free confidential analysis of your child’s claim.

We can review your child’s Individualized Education Plan, psychiatric records, and relevant IQ testing. If your child is incapable of sustaining competitive employment without significant accommodations or assistance from a job coach, you must be prepared to provide compelling evidence to prove and meet this stringent disability standard.

Call our compassionate and competent team of lawyers at Nash Disability Law today so we can help you determine whether your child can receive benefits as an adult.