If your child has a mental or physical condition that limits their activities, they may be eligible for financial assistance and medical care from the government.
Supplemental Security Income (SSI) pays monthly benefits to people with limited income and resources who are disabled. In this article, we’ll discuss how to qualify, what you’ll get if you win, the application process, and steps you can take to strengthen your child’s case.
Does my child qualify for financial assistance?
To qualify for SSI, your family must meet two sets of criteria. One has to do with your child’s medical condition, the other has to do with your family’s financial status.
Medical requirements for SSI
First, your child must have a mental or physical condition that has lasted, or is expected to last, for more than one year.
This condition must significantly interfere with their ability to function at the level of other children the same age. There are a few ways to establish this:
- Their condition meets the requirements described in the SSA’s Blue Book listings. The blue book outlines impairments that automatically deem someone disabled. If their condition is not included, they can still qualify if their condition is equivalent in severity to one on the list.
- You can demonstrate how your child’s limitations severely affect their ability to function on a daily basis. You’ll prove these things by sending your child’s medical records and other documentation to the SSA (we’ll discuss what documents you’ll need to send to them later).
Most importantly, your child must be receiving medical care. We’ll go over more about this in a later section.
Financial requirements for SSI
Next, your child must not be working and earning over about $1,350/month. They must also have few resources available to them. The SSA will take parental income and resources into consideration when determining whether a child is eligible for SSI.
These rules are complicated and vary case-by-case. A general rule of thumb: Parental income should be below $35,000 annually for a single parent household and $45,000 for 2+ parent households.
What will we get? How much do we get?
If they’re approved, your child will get a monthly check from the SSA. In most states, SSI recipients can also get Medicaid for help paying medical bills. Many states also provide supplemental payments, food stamps, and other social services to SSI recipients. Even if your child isn’t eligible for SSI, they might still be eligible for Medicaid (contact your state Medicaid agency for help).
The amount of money your child receives from SSI each month depends on the resources available to them. The SSA determines this during the application process. The maximum amount your child can receive from SSI is $841/month.
How do we apply for disability benefits?
The SSA doesn’t make getting approved for SSI easy, and it’s important to stay organized throughout the process.
First you’ll collect the necessary documentation and prepare to file your application.
The paperwork the SSA will ask for includes but is not limited to:
- Names, addresses, and phone numbers of every doctor, therapist, hospital, and clinic that has seen or treated the child for at least the last year
- Medical records, including the dates the child was seen or treated and the child’s patient ID numbers, if you know them
- Medication the child is taking
- The child’s medical assistance number, if they have one
- Names, addresses, and phone numbers of any schools the child attended in the past 12 months—including names of teachers, psychologists, counselors, speech therapists or other therapists who saw or treated the child
- The child’s Individualized Family Service Plan (IFSP) for early intervention, or Individualized Education Plan (IEP) for special education services, if the child has one or used to have one
- Names, addresses, and phone numbers of any social service programs and the name of caseworkers who have information about the child
- Name, address, and phone number of another adult who helps care for the child and can help the SSA obtain information
- Names, addresses, and phone numbers of any employers the child has had
- An original or certified copy of the child’s birth certificate—or proof of U.S. citizenship or legal residency if the child was born in another country
- Names and Social Security numbers for all children and adults who live in the household
- Proof of current income for the child and family members living in the household—including pay stubs, self-employment tax returns, unemployment or other program benefits, child support
- Proof of resources for the child and parents living in the household—including bank account statements, life insurance policies, certificates of deposit, stocks or bonds
Once you’ve gathered your records, you can submit your application online or in person. We recommend calling your local SSA office and setting up an appointment to file your application in their office. That way, you have a chance to speak with someone face-to-face if you get stuck on a question. To file online, you’ll need to set up an account on ssa.gov.
After you apply, you’ll need to keep the SSA updated on your child’s medical treatment by sending them new records and medical information; completing and sending back all follow-up paperwork; and attending a consultative exam with an SSA doctor.
One additional tip: Before you apply, check the SSA’s Compassionate Allowance List. If your child’s condition is on the list, you should let the local SSA office; their application will be fast-tracked.
You might get denied and could need to file for reconsideration. Unfortunately, the SSA denies most cases the first and second time around, regardless of how strong your child’s case may be.
At this point, we recommend working with a lawyer; they charge nothing unless you win, and they’re crucial to your success if you have to make your case before a judge (83% of people have a lawyer at the hearing stage, and you’re three times more likely to win with one on your side). At Atticus, we can give you free legal advice and help you find the right representation for your case, for free. You can get in touch with our team by completing our two-minute intake quiz.
Will I actually win? What determines if I win my case?
It can be tough to win these cases, but it is possible. Here are suggestions for how to strengthen your child’s case:
- Get as much medical treatment for your child as you can, and make sure to stay on top of treatment protocols. If your child isn’t taking their medication because you can't afford it, note this on your application (if an applicant isn’t taking medication it can hurt their case, but the SSA makes exceptions if you cannot afford the medication).
- Be as detailed as possible and avoid answering questions with “yes” or “no”. When discussing your child’s conditions, be honest and don’t exaggerate. For example, when you describe what your child does every day, don’t say “They wake up and sit on the couch.” Instead, write “my child wakes up and I help him get dressed, bathe, eat breakfast and brush his teeth because he cannot complete these tasks on his own. When he goes to school, he is in a special education class full-time and receives 10 hours of speech therapy a week. He is in 5th grade, but reads at the 2nd grade level. At school, he often fights with other students or is violent.”
- Send back all follow-up paperwork on time. After the SSA receives your initial application, they may ask you for other documents such as a function report. It is important to send these back on time, otherwise you might get denied.
- Attend the consultative exam. The SSA may ask you and your child to attend a visit with one of their doctors. These visits can be frustrating because doctors may not listen to all of your concerns but they’re essential to the process. The SSA puts a lot of weight into what their medical experts say, and not attending will likely cause you to get denied. If you need help with transportation, mention this to your local SSA office.
- Make sure you give the SSA correct and updated financial information. The SSA income rules are complicated and it's tough to know how the SSA is going to determine exactly how much your child is entitled to, but your claim can be barred if you provide false information. Collect and organize all of your financial information (proof of income, bank statements) before you apply.
How long will this take?
Unfortunately, this process can be lengthy. It can take 3-5 months for the SSA to determine whether your child is disabled. You should let the SSA know if your phone number or address changes.
For some conditions, the SSA recognizes that you might not be able to wait that long.
The SSA will pay benefits immediately (for up to 6 months, while your application is pending) if a child suffers from:
- HIV infection
- Total blindness
- Total deafness
- Cerebral palsy
- Down syndrome
- Muscular dystrophy
- A severe intellectual disorder (age 7+)
- Low birth weight (below 2 pounds, 10 ounces
If you suspect your child meets this criteria, ask your local SSA office to start your payments automatically.
Can my child get approved if they have a learning disability or mental health disorder?
Your child can get approved for intellectual/learning disabilities, but it can be more difficult to get approved for conditions that don’t manifest physically.
The best evidence to show the severity of a learning disability is your child’s IQ scores, grades, and reports from teachers, counselors, and their doctors. Like we discussed above, if your child has an IEP, you should provide a copy of that too. Even if your child receives good grades or reaches their IEP goals, they may still qualify for disability benefits.
If your child is applying with a mental health condition, it’s ideal for your child to be seeing a psychiatrist and a therapist. Since your child doesn’t have the benefit of scans or tests to show their disability, the SSA needs to rely on notes from their mental health providers.
What happens when my child turns 18?
After your child turns 18, they’ll have to qualify for SSI as an adult. To do this, the SSA will re-evaluate their case to see if their disability meets the requirements of the SSA’s adult definition for disability. The SSA won’t consider your income anymore, but they might lower the amount your child gets per month if they’re receiving food and shelter from you.
What if my child doesn’t qualify, but I’m receiving Social Security disability or retirement benefits?
If your child is under 18 (or 19 if they’re still in high school), they may be able to collect benefits as a dependent under your Social Security record. If you suspect this is the case, call your local SSA office and tell them that you want to apply for dependents benefits for your child.
I need help right now. Is there anything I can do in the meantime?
If your child needs help getting health insurance, you can contact the State Children’s Health Insurance Program (SCHIP) at www.insurekidsnow.gov or call 1-877-543-7669 for information about your state’s program.
For help with food, shelter, or housing you can call 211 or visit 221.org to get connected with resources in your area.
For financial assistance, food pantries, medical care and other free/reduced-cost help, we recommend findhelp.org.
We also recommend continuing to do things that strengthen your child’s case before you apply and while you’re waiting for their application to be processed. We recommend taking time each day to document your child’s symptoms—a few sentences about any daily task that was difficult for them and any new or worsening symptoms.
Make sure you attend all doctor’s appointments and adhere to their treatment protocols. If your child gets additional medical treatment or is hospitalized, send the SSA updated records. If your child isn’t seeing a specialist for treatment, try to make an appointment.