A Supplemental Security Income (SSI) claim for a child is considered differently than an adult disability claim. Social Security has set different rules in place for an SSI claim for a child, but just like an adult disability claim there are prescribed steps that most be followed in the evaluation process. To better understand the process the step-by-step guide from the Social Security follows. It is important to understand that these steps only apply to an SSI claim for a child because adults can also be eligible for SSI, but they must follow the five-step process involved in an adult disability case.
Step 1: Financial screens. Children may not qualify for DI benefits on their own earnings record.15 However, they may qualify for SSI payments on their own in some cases or as part of a unit including their parent(s). For SSI, field offices evaluate income and resource eligibility under a complex set of rules. Field offices also verify whether the child is working at SGA because those up to age 18, some of whom may be working, are evaluated under the determination process for children. If a child is engaging in SGA, the claim is denied and not referred to the DDS.
Step 2: A medical screen to deny applicants without a severe impairment. The DDS denies a child applicant at step 2 if he or she does not have a medically determinable impairment or if his or her impairment(s) is considered not severe. Child applicants are also denied if their impairments fail the duration test; that is, if the impairment (1) is not expected to result in death, and (2) has neither lasted 12 months nor is expected to last for a continuous period of 12 months. If the impairment(s) is considered severe and if any impairment meets the duration test, the claim will proceed to the next step.
Step 3a:16 A medical screen to allow the most severely impaired applicants. If the child has one or more severe impairments, the DDS will decide if any severe impairment meets one of the Listings for children. The Listings cover the major body systems and include descriptions of common physical and mental impairments (such as cerebral palsy, mental disorders, and asthma), along with specific medical severity criteria. As with adults, if the impairment does not meet the Listings, the DDS decides if it medically equals the Listings. If the child has one or more impairments that meet or medically equal the requirement of a Listing and meet the duration requirement, the DDS will find the child disabled and the determination is complete.
Step 3b: Can a severely impaired child function at home, at school, and in the community? If the child has one or more impairments that are severe but do not meet or medically equal a Listing, the DDS will decide whether the impairment or impairments “functionally equal” the Listings. That means that the DDS assesses the effects of any impairment on the child’s ability to function at home, at school, and in the community.
