Legal & Planning
What you need to know about Supplemental Security Income (SSI)For many, social security can very confusing. For parents of children with special needs needs there is something called Supplemental Security Income (SSI). This article will attempt to be an in-depth guide on Social Security and how it can effect your family.
What is the Difference Between SSI and the Social Security Disability Insurance program SSDI?We can simplify the difference between the two programs real quickly---SSDI (Social Security Disability Insurance (“SSDI”) pays benefits to individuals and certain members of their family if they are "insured," meaning that you worked long enough and paid Social Security taxes.) does not apply to children with disabilities. The terms are sometimes thrown around interchangeably, but have very different criteria and applications. This article will only focus on Supplemental Security Income (“SSI”) payments to disabled individuals under the age of 18. There are programs for income payments to disabled individuals over the age of 18, but those rules and regulations will not be discussed herein. The entire Social Security Act (42 U.S.C 1381) (the “Act”), and the administration of the voluminous regulations and statutes are far too voluminous and complex to address in an article of this type, when books have been written on the topic.
The ProgramThe Social Security Administration (“SSA”), which has offices in most major U.S. cities, administers the program, amongst other unrelated programs, that provide financial benefits based on disability—this is commonly referred to as the SSI program or Title XVI of the Act (Title XVI appears in the United States Code as §§1381-1383f, subchapter XVI, chapter 7, Title 42. Regulations with respect to this Title XVI are contained in chapter III, Title 20, Code of Federal Regulations.) (hereinafter “SSI” and “Title XVI” will be used interchangeably). The Act and SSA's implementing regulations prescribe rules for deciding if an individual is "disabled." SSA's criteria for deciding disability may differ from the criteria applied in other Government and private disability programs. The child’s parents or guardian’s income and resources must be limited for the child to qualify for benefits.
How is “Disability” Defined for Children?Under Title XVI, a child under age 18 will be considered disabled if he or she has a medically determinable physical or mental impairment or combination of 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 12 months. (See Title 20, Sec. 1614, [42 U.S.C. 1382c]).
What is a "Medically Determinable Impairment"?The regulations define a medically determinable physical or mental impairment as an impairment that results from anatomical, physiological, or psychological abnormalities, which can be shown by medically acceptable clinical and laboratory diagnostic techniques. The medical evidence must establish a physical or mental impairment consisting of signs, symptoms, and laboratory findings-not only by the individual's statement of symptoms. (See Title 20, Sec. 1614, [42 U.S.C. 1382c]. This is the area that causes the most contention during the application process. The current eligibility standards are based on medical, technological, and vocational data from over 30 years ago. (See, The Fake Fix for Disability Insurance, Koenig, Andy, The Wall Street Journal, November 11, 2015).
Medical TreatersA treating source is a claimant's own physician, psychologist, or other acceptable medical source who provides or has provided the claimant with medical treatment or evaluation and has, or has had, an ongoing treatment relationship with the claimant. The treating source is usually the best source of medical evidence about the nature and severity of an individual's impairment(s). If an additional examination or testing is needed, SSA usually considers a treating source to be the preferred source for performing the examination or test for his or her own patient. The treating source is neither asked nor expected to decide whether the claimant is disabled. However, a treating source will usually be asked to provide a statement about an adult claimant's ability, despite his or her impairments, to do work‑related physical or mental activities or a child’s functional limitations compared to children the same age who do not have impairments. The SSA deems acceptable medical sources as:
- licensed physicians (medical or osteopathic);
- licensed or certified psychologists (includes school psychologists, for purposes of establishing mental retardation/learning disorder/borderline intellectual functioning);
- licensed optometrists (for the measurement of visual fields or acuity);
- licensed podiatrists (for purposes of establishing impairments of the foot, or foot and ankle, depending on the State);
- qualified speech-language pathologists (for purposes of establishing speech or language impairments ); and
- other individuals authorized to send us copies or summaries of the medical records from a hospital, clinic, or other health care facility.