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Obtaining SSI Benefits for Disabled Children in Florida

In Florida, children under the age of 18 may qualify for disability benefits through the Supplemental Security Income (SSI) program.  The SSI program is a federal program that provides benefits to needy disabled children and adults.  A child must satisfy both financial need requirements and medical disability requirements to be eligible.

Non-medical requirements for SSI children’s cases

The SSI program for disabled children, like the program for disabled adults, has income and asset requirements that the child’s family must meet.  Because minor children are dependents of their parents, the Social Security Administration considers the parents’ income and assets.  If the parents’ income or assets exceed the permitted amounts, the child will not be eligible for SSI no matter how disabled he or she may be.

Medical disability requirements for SSI children’s cases

The Social Security Administration has a specific and restrictive definition of “disabled” in children’s cases. A child under 18 is disabled, according to Social Security regulations, if the child has a “medically determinable physical or mental impairment or combination to impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than twelve months.”

A child will not qualify for SSI simply because the child’s doctor says he is disabled, or because the child has a specific diagnosis such as autism, or because he or she attends a special school or special education classes.

Three-step sequential evaluation process

Instead of the five-step sequential evaluation process that the Social Security Administration uses for adults, the evaluation process for children has only three steps.  It omits steps four and five which consider whether an applicant can perform past jobs or any other jobs, which, of course, would make no sense for children.

Step 1:  Is the child engaging in substantial gainful activity?  Like adult applicants, a child must not have a job that involves more than minimal activities or that pays more than a minimal monthly amount specified by the Social Security Administration.

Step 2:  Does the child have a severe impairment?  Again, like adult applicants, the child must have a severe medically determinable impairment.  This means he or she must have a physical or mental condition that can be established through medically acceptable diagnostic techniques and that is more than mild or slight.

Step 3:  Does the child’s impairment meet, medically equal, or functionally equal a listed impairment?  Here is where the sequential evaluation process for children differs somewhat from that for adults.  Social Security regulations known as the Listings of Impairments contain criteria for assessing the severity of a number of common physical and mental conditions.  Separate listings apply to children’s impairments.  If the child’s medical findings and symptoms meet or medically or functionally equal these criteria, the child will be awarded benefits.

Functional equivalence in children’s Florida SSI cases

Children’s SSI cases often require a functional equivalence assessment. To functionally equal the listings, a child’s impairment must result in “marked” limitations in two domains of functioning or an “extreme” limitation in one domain.  The Social Security Administration uses the following six domains:

  1. Acquiring and using information,
  2. Attending and completing tasks,
  3. Interacting and relating with others,
  4. Moving about and manipulating objects,
  5. Caring for yourself, and
  6. Health and physical well-being.

The Social Security Administration compares the functioning of the child in each of these domains to the functioning of other children his or her age. The critical element in evaluating the severity of a child’s limitations is how appropriately, effectively, and independently the child performs age-appropriate activities.

“Marked” limitation means a limitation that is “more than moderate” but “less than extreme.” A “marked” limitation in a domain occurs when your child’s impairment interferes seriously with his or her ability to independently initiate, sustain, or complete activities.

“Extreme” limitation means a limitation that is “more than marked.” “Extreme” limitation is the rating given to the worst limitations. However, “extreme limitation” does not necessarily mean a total lack or loss of ability to function. A child has an “extreme” limitation in a domain when his or her impairment interferes very seriously with the child’s ability to independently initiate, sustain, or complete activities.

Evidence considered by Social Security in children’s Florida SSI cases

When you apply for Florida SSI benefits for your child, you will be asked for detailed information about the child’s medical condition and how it affects his or her ability to function on a daily basis. You will also be asked to give permission for the doctors, teachers, therapists and other professionals who have information about your child’s condition to send the information to the Social Security Administration.

Evidence of a child’s functioning can come from a wide variety of sources. The Social Security Administration will consider all of the relevant evidence it receives about a child’s functioning to understand how the impairment affects the child’s day-to-day activities.  Some relevant sources include:

  • Medical records.
  • Written opinions from your child’s doctors covering his or her diagnosis, prognosis, treatment, response, and limitations.
  • All types of school records and reports such as—
    • Report cards.
    • School attendance records.
    • School disciplinary records.
    • Educational evaluations that were done of your child.
    • Individualized Family Service Plans (IFSP) and Individualized Education Programs (IEPs).

If you have any of these records, you can submit them to the Social Security Administration to speed up the evaluation process.

Immediate Florida SSI payments available for some severely disabled children

For some severe medical conditions, the Social Security Administration makes SSI payments available right away and for up to six months while the Florida Division of Disability Determinations decides if your child is disabled.

Following are some conditions that may qualify:

  • Total blindness.
  • Total deafness.
  • Severe mental retardation (child age 7 or older).
  • Birth weight below 2 pounds, 10 ounces.
  • Cerebral palsy.
  • Down syndrome.
  • Muscular dystrophy.
  • HIV infection.

If your child has one of the qualifying conditions, he or she will get SSI payments right away. However, the Florida Division of Disability Determinations may finally decide that your child’s disability is not severe enough for SSI. If that happens, you will not have to pay back the SSI payments that your child got.

Florida SSI attorneys offer assistance with children’s cases

SSI children’s cases are particularly challenging.  If you are the parent or guardian of a seriously disabled child, are not already represented by a Florida SSI attorney, and want our evaluation, give us a brief description of your claim using the form to the right.  Or you may contact us at:

Lillesand & Associates, P.A.
Clearwater Florida disability attorneys
E-mail us

Clearwater Office
635 Court St, Ste 202
Clearwater, Florida 33756
Phone: (727) 330-7895