Benefits For 

Children With 

Disabilities

2012
Contacting Social Security

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What’s Inside

Introduction . . . . . . . 4

Supplemental Security 

Income (SSI) payments for 

children with disabilities . . 5

Social Security Disability 

Insurance (SSDI) benefits 

for adults disabled 

since childhood . . . . . . 11

Applying for SSI payments 

or SSDI benefits and how 

you can help . . . . . . . . . . . . . 12

Employment support 

programs for young people 

with disabilities . . . . . . . . . . . 14

Medicaid and Medicare . . . . . 16

Children’s Health 

Insurance Program . . . . 17

Other health care services . . . 18
4

Introduction

This booklet is for the parents, 

caregivers or representatives of 

children younger than age 18 who 

have disabilities that might make 

them eligible for Supplemental 

Security Income (SSI) payments. It is 

also for adults who became disabled 

in childhood and who might be 

entitled to Social Security Disability 

Insurance (SSDI) benefits. (We call 

this SSDI benefit a “child’s” benefit 

because it is paid on a parent’s Social 

Security earnings record.)

This booklet will help you 

decide if your child, or a child you 

know, might be eligible for SSI or 

Social Security.
5

Supplemental Security Income 

(SSI) payments for children 

with disabilities

SSI makes monthly payments to 

people with low income and limited 

resources who are 65 or older, or 

blind or disabled. Your child younger 

than age 18 can qualify if he or she 

meets Social Security’s definition of 

disability for children, and if his or 

her income and resources fall within 

the eligibility limits. The amount 

of the SSI payment is different from 

one state to another because some 

states add to the SSI payment. Your 

local Social Security office can tell 

you more about your state’s total 

SSI payment.

SSI rules about income 

and resources

When we decide if your child can 

get SSI, we consider your child’s 

income and resources. We also 

consider the income and resources of 

family members living in the child’s 

household. These rules apply if your 

child lives at home. They also apply if 

he or she is away at school but returns 

home from time to time and is subject 

to your control.

If your child’s income and resources, 

or the income and resources of 

family members living in the child’s 

household, are more than the amount 

allowed, we will deny the child’s 

application for SSI payments.
6

We limit the monthly SSI payment 

to $30 when a child is in a medical 

facility where health insurance pays 

for his or her care.

SSI rules about disability

Your child must meet all of 

the following requirements to be 

considered disabled and therefore 

eligible for SSI:

•	 The child must not be working and 

earning more than $1,010 a month 

in 2012. (This earnings amount 

usually changes every year.) If he 

or she is working and earning that 

much money, we will find that 

your child is not disabled.

•	 The child must have a physical or 

mental condition, or a combination 

of conditions, that results in 

“marked and severe functional 

limitations.” This means that the 

condition(s) must very seriously 

limit your child’s activities.

•	 The child’s condition(s) must have 

been disabling, or be expected to be 

disabling, for at least 12 months; or 

must be expected to result in death.

If your child’s condition(s) results 

in “marked and severe functional 

limitations” for at least 12 continuous 

months, we will find that your child 

is disabled. But if it does not result in 

those limitations, or does not result 

in those limitations for at least 12 

months, we will find that your child 

is not disabled.
7

Providing information about 

your child’s condition

When you apply for benefits for 

your child, we will ask you for 

detailed information about the child’s 

medical condition and how it affects 

his or her ability to function on a 

daily basis. We also will ask you 

to give permission for the doctors, 

teachers, therapists and other 

professionals who have information 

about your child’s condition to send 

the information to us.

If you have any of your child’s 

medical or school records, please 

bring them with you. This will 

help speed up the decision on 

your application.

What happens next?

We send all of the information 

you give us to the Disability 

Determination Services in your 

state. Doctors and other trained staff 

in that state agency will review the 

information, and will request your 

child’s medical and school records, 

and any other information needed to 

decide if your child is disabled. 

If the state agency cannot make 

a disability decision using only the 

medical information, school records 

and other facts they have, they may 

ask you to take your child for a 

medical examination or test. We will 

pay for the exam or test.
8

We may make immediate SSI 

payments to your child

It can take three to five months 

for the state agency to decide if your 

child is disabled. However, for some 

medical conditions, we make SSI 

payments right away and for up to 

six months while the state agency 

decides if your child is disabled.

Following are some conditions that 

may 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 the 

qualifying conditions, he or she 

will get SSI payments right away. 

However, the state agency 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.
9

SSI disability reviews

Once your child starts receiving 

SSI, the law requires that we review 

your child’s medical condition from 

time to time to verify that he or she 

is still disabled. This review must 

be done:

•	 At least every three years for 

children younger than age 18 

whose conditions are expected 

to improve; and

•	 By age 1 for babies who are getting 

SSI payments because of their low 

birth weight, unless we determine 

their medical condition is not 

expected to improve by their first 

birthday and we schedule the 

review for a later date.

We may perform a disability review 

even if your child’s condition is not 

expected to improve. When we do a 

review, you must present evidence 

that your child is and has been 

receiving treatment that is considered 

medically necessary for your child’s 

medical condition.
10

What happens when your 

child turns age 18

For disability purposes in the SSI 

program, a child becomes an adult at 

age 18, and we use different medical 

and nonmedical rules when deciding 

if an adult can get SSI disability 

payments. For example, we do not 

count the income and resources 

of family members when deciding 

whether an adult meets the financial 

limits for SSI. We count only the 

adult’s income and resources. We 

also use the disability rules for adults 

when deciding whether an adult 

is disabled.

•	 If your child is already receiving 

SSI payments, we must review the 

child’s medical condition when he 

or she turns age 18. We usually do 

this review during the one-year 

period that begins on your child’s 

18th birthday. We will use the adult 

disability rules to decide whether 

your 18-year-old is disabled.

•	 If your child was not eligible for 

SSI before his or her 18th birthday 

because you and your spouse had 

too much income or resources, he 

or she may become eligible for SSI 

at age 18.

For more information, ask for 

Supplemental Security Income (SSI)

(Publication No. 05-11000).
11

Social Security Disability 

Insurance (SSDI) benefits for 

adults disabled since childhood

The SSDI program pays benefits 

to adults who have a disability that 

began before they became 22 years 

old. We consider this SSDI benefit 

as a “child’s” benefit because it is 

paid on a parent’s Social Security 

earnings record.

For a disabled adult to become 

entitled to this “child” benefit, one of 

his or her parents:

•	 Must be receiving Social Security 

retirement or disability benefits; or

•	 Must have died and have worked 

long enough under Social Security.

These benefits also are payable to 

an adult who received dependents 

benefits on a parent’s Social Security 

earnings record prior to age 18, if he 

or she is disabled at age 18. We make 

the disability decision using the 

disability rules for adults.

SSDI disabled adult “child” benefits 

continue as long as the individual 

remains disabled. Your child does 

not need to have worked to get 

these benefi s.
12

How we decide if your “child” is 

disabled for SSDI benefits

If your child is age 18 or older, we 

will evaluate his or her disability 

the same way we would evaluate 

the disability for any adult. We send 

the application to the Disability 

Determination Services in your state 

that makes the disability decision 

for us. For detailed information 

about how we evaluate disability for 

adults, ask for Disability Benefits

(Publication No. 05-10029).

Applying for SSI payments 

or SSDI benefits and how 

you can help

You can apply for Social Security 

or SSI payments for your child by 

calling Social Security toll-free at 

1-800-772-1213 or by visiting your 

local Social Security office. If you 

are applying for SSI payments for 

your child, you should have his or 

her Social Security number and birth 

certificate with you when you apply. 

If you are applying for SSDI benefits 

for your child, please have your own 

Social Security number with you in 

addition to the child’s Social Security 

number and birth certificate.
13

You can help us make a decision by:

•	 Telling us as much as you 

can about your child’s 

medical condition(s);

•	 Giving us the dates of visits to 

doctors or hospitals, the patient 

account numbers for any doctors 

or hospitals, and any other 

information that will help us get 

your child’s medical records; and

•	 Providing us copies of any medical 

reports or information that you 

already have in your possession.

NOTE: You do not need to 

request information from your 

child’s doctors. We will contact 

them directly for any reports 

or information that we need 

to make a decision about your 

child’s disability.

If your child is younger than age 

18 and applying for SSI, you will need 

to provide records that show your 

income and resources, as well as those 

of your child. We also will ask you to 

describe how your child’s disability 

affects his or her ability to function 

on a day-to-day basis. In addition, we 

will ask for the names of teachers, day 

care providers, and family members 

who can provide information about 

how your child functions. If you have 

any school records, you should bring 

them to the interview.

In many communities, special 

arrangements have been made with 

medical providers, social service 
14

agencies and schools to help us get 

the evidence we need to process 

your child’s claim. However, your 

cooperation in getting records and 

other information will help us finish 

our job more quickly.

Employment support 

programs for young people 

with disabilities

We have many ways to encourage 

young people who are receiving SSI 

payments or SSDI benefits and who 

want to go to work.

Under SSI:

•	 When we figure your child’s 

monthly SSI payment, we do not 

count most of your child’s income. 

If your child is younger than 

age 22 and a student who regularly 

attends school, we exclude even 

more of his or her earnings each 

month. In 2012, disabled students 

younger than age 22 may exclude 

$1,700 of their monthly earnings, 

with an annual limit of $6,840, 

when counting their income for 

SSI purposes. These limits may 

increase each year.

•	 With a Plan to Achieve Self-Support 

(PASS), a child who is age 15 or 

older can save some income and 

resources to pay for education and 

other things needed to be able to 

work. We do not count the saved 

income when we figure your 

child’s income for SSI purposes. 
15

We do not count the saved income 

and resources when we figure the 

amount of your child’s payment.

•	 Because of a medical condition(s), 

your child may need certain items 

and services in order to work, 

such as a wheelchair or a personal 

assistant. When figuring your 

child’s SSI payment, we will not 

count some or all of the amount 

paid for these items and services in 

your child’s earnings.

•	 Your child older than age 15 

may get help with rehabilitation 

and training.

•	 Medicaid coverage will continue 

even if your child’s earnings are 

high enough to stop the monthly 

SSI payment as long as the earnings 

are under a certain amount.

Under SSDI:

•	 An adult disabled before age 

22 can get the same help with 

work expenses explained above 

for an SSI child, and help with 

rehabilitation and training.

•	 Cash benefits may continue until 

the individual can work on a 

regular basis.

•	 Medicare may continue for 

up to 93 months (seven years, 

nine months).

You can get more information 

about these programs at our website, 

www.socialsecurity.gov, or by calling 

us toll-free at 1-800-772-1213.
16

Medicaid and Medicare

Medicaid is a health care program 

for people with low incomes and 

limited resources. In most states, 

children who get SSI payments 

qualify for Medicaid. In many states, 

Medicaid comes automatically 

with SSI eligibility. In other states, 

you must sign up for it. And some 

children can get Medicaid coverage 

even if they do not qualify for SSI. 

Check with your local Social Security 

office, your state Medicaid agency, or 

your state or county social services 

office for more information.

Medicare is a federal health 

insurance program for people 

age 65 or older and for people who 

have been getting Social Security 

disability benefits for at least 

two years.

There are two exceptions to this 

rule. Your child can get Medicare 

immediately if he or she:

•	 Has a chronic renal disease and 

needs a kidney transplant or 

maintenance dialysis; or

•	 Has Lou Gehrig’s disease 

(amyotrophic lateral sclerosis).
17

Children’s Health 

Insurance Program

The Children’s Health Insurance 

Program enables states to provide 

health insurance to children from 

working families with incomes too 

high to qualify for Medicaid, but too 

low to afford private health insurance. 

The program provides coverage for 

prescription drugs, vision, hearing 

and mental health services and is 

available in all 50 states and the 

District of Columbia. Your state 

Medicaid agency can provide more 

information about this program, 

or you can get more information 

about coverage for your children at 

www.insurekidsnow.gov on the 

Internet or by calling 1-877-543-7669.
18

Other health care services

When your child gets SSI, we will 

refer you to places where you can get 

health care services for your child. 

These services are under the Children 

with Special Health Care Needs 

provision of the Social Security Act. 

These programs are usually managed 

by state health agencies.

States call these services by many 

different names, including Children’s 

Special Health Services, Children’s 

Medical Services and Handicapped 

Children’s Program. Most programs 

provide services through clinics, 

private offices, hospital-based 

outpatient and inpatient treatment 

centers, 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 offices, or hospitals 

should be able to help you contact 

your local Children with Special 

Health Care Needs program.
Social Security Administration

SSA Publication No. 05-10026

ICN 455360

Unit of Issue - HD (one hundred)

June 2012 (Jan. 2012 edition may be used)

Printed on recycled paper