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Mental Conditions in Children Applying for SSI Disability Benefits

By R. M. Bottger

            Children under the age of 18 can apply for Supplemental Security Income (SSI) disability benefits.  SSI is a need-based program.  The child’s parents or guardians must have below a certain level of income and resources.  To apply for SSI benefits for your child, call or visit your local the Social Security Administration office.

            A diagnosis alone is not enough information for the Social Security Administration to decide whether or not your child is disabled due to a mental condition.  This applies to all mental conditions in children including attention deficit hyperactivity disorder (ADHD), attention deficit disorder (ADD), autism, depression, mental retardation, learning disabilities, and any other mental disorder.  What the Social Security Administration needs to know is the severity of your child’s condition.  How does your child’s condition affect his ability to function?  What is your child unable to do that other children his or her age normally do?

            To evaluate your child’s condition, the Social Security Administration will want all of your child’s medical records.  Usually, the Social Security Administration will want all of your child’s records beginning one year prior to the date you filed the application for disability benefits and continuing to the present.  The Social Security Administration will want all records from pediatricians, neurologists, psychiatrists, psychologists, counselors, hospitals, and any place else your child has received treatment or evaluation.  The Social Security Administration will write to these sources requesting copies of your child’s medical records.  However, if you want to make sure the Social Security Administration actually receives everything, you can obtain copies of your child’s records and give them to Social Security Administration yourself.  (For more information, see What Medical Records Should You Submit When You Apply for Disability Benefits.)

            If your child is school-aged, the Social Security Administration will want copies of your child’s school records in order to evaluate the severity of your child’s mental condition.  The Social Security Administration will want copies of all existing records such as grade reports, attendance records, IEP’s, standardized testing, and psychological testing.  The Social Security Administration will  send the school a form for your child’s teacher or counselor to fill out about how well your child is functioning in school.  You can help by making sure your child’s school returns this information in a timely fashion.  School records play a crucial role in the final decision in cases involving mental allegations.  Although your child may be having severe mental problems at home, if his or her mental problems are not causing severe problems with his or her functioning at school, then your child will not be found disabled.  (For more information about what Social Security needs from your child’s school, see School Records and Supplemental Security Income Disability.)

            If your child’s medical records do not have enough information to decide whether or not your child is disabled, the Social Security Administration will schedule an examination for your child.  The Social Security Administration will pay for any examination or testing that it schedules for your child.  (See Examinations Scheduled for You by SSA for Your Disability Claim.)  Mental status examinations and tests of intellectual functioning are the most common types of examinations in children with mental impairments.  The Social Security Administration may send your child for intelligence testing at the Social Security Administration’s expense even if your child’s school records contain intelligence testing.  There are several possible reasons the Social Security Administration might want additional testing.  For example, the Social Security Administration wants the testing to be fairly current.  Generally, for children under the age of seven years, the Social Security Administration will want testing that was performed in the last year.  For children seven years and older, the Social Security Administration will generally want records performed in the last two years.  If the intelligence testing in your child’s school records is older than that, the Social Security Administration will want new testing.  The Social Security Administration wants intelligence testing performed using one of the following tests: WAIS-III (for people age sixteen years and up), WISC-III (for children under age sixteen), the Stanford-Binet (for all ages), and the Leiter (for those who are hearing impaired or cannot speak English).  The Social Security Administration uses other tests for children too young to be in school.  If your child’s school performed intelligence testing using a different test, the Social Security Administration will want new testing.  The Social Security Administration requires testing performed by a psychologist.  If your child’s school records include testing performed by a psychometrist or other person, the Social Security Administration will want new testing.  If there is evidence that your child did not cooperate fully with the school testing, the Social Security Administration will want a new test.

The Social Security Administration will have you fill out a Function Report form.  This form asks you about what your child is and is not able to do.  You will be given a form tailored to your child’s specific age group.  Take your time when filling out this form.  This is your opportunity to tell the Social Security Administration what your child is unable to do because of his or her condition. 

            When evaluating your child’s condition, the Social Security Administration will look at his or functioning in a number of areas. 

In children from birth up to age 3, the Social Security Administration looks at the areas of motor development, cognitive/communication function, and social function.

In children from age 3 to age 18, the Social Security Administration looks at 4 areas: cognitive/communication function, social function, personal function, and concentration/persistence/pace.  Cognitive/communication looks at intellectual functioning and ability to communicate (including speech problems).   Social functioning looks at the child’s ability to get along with other children, family members, and adults outside the family.  Personal function looks at the child’s ability to handle feeding, grooming, and avoiding dangers.  Concentration, persistence, and pace looks at the child’s ability to pay attention, his or her ability to persist at a task and not give up to easily, and his or her ability to complete tasks in a reasonable amount of time. 

The Social Security Administration looks for inconsistencies between the medical evidence, school records, and daily activities as described on the Function Report form.  For example, I once had the case of a teenage girl whose father said she was severely depressed.  She was seeing a psychiatrist and taking an antidepressant; the girl and her father had told the psychiatrist that she was severely depressed.  The father put on the Function Report form that when she wasn’t at school she just stayed in bed all the time.  However, her school records showed that she was making A’s and B’s, she was in many clubs, she had many friends, she didn’t have any discipline or behavioral problems, and she worked the concession stand at sporting events every weekend.  Her teachers specifically stated that they did not know of any physical or mental impairments in this teenager.  As   you might guess, I denied this claim.  Let me give you another example, I saw a disability claim on a teenager who had dropped out of school.  Psychological testing showed that he had an Intelligence Quotient (I.Q.) of 53.  Normally, an I.Q. of 53 would be considered disabling. However, on the Function Report the parent had stated the teenager had a part time job making change for customers at a local video arcade.  The parent specifically said that customers would give him dollar bills of various dominations and that he would break the bill so that the customer would have change to play the video games.  Our psychologist on staff in my office said that someone with an I.Q. of 53 would not be able to perform that job; the psychologist deemed the intelligence testing to be invalid.  The claim was denied. 

Let me say that children with only the severest mental conditions are found to be disabled.  Lots of children who are in learning disabled classes for reading or math are denied.  Just because a kid is in some kind of special education class does not mean that the Social Security Administration will decide the child is disabled.  Most attention deficit hyperactivity disorder cases are denied.  The kids who are being found disabled are very severely limited.

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