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Supplemental Security Income (SSI)
Supplemental Security Income (SSI)
Supplemental Security Income (SSI) provides resources to low income families of disabled children. Children are considered to be disabled if he/she has a medically
determined physical or mental impairment that results in marked or severe limitations in age appropriate function and the
condition lasted or is expected to last at least a year or is expected to cause death within a year.
SSI resources include the following:
- Monthly cash payments based on family income;
- Qualifies the child for Medicaid in many states; and
- Refers to the Title V agency in some states.
Families with incomes that aren't low enough to qualify for Medicaid or SCHIP may qualify for SSI. The financial and resource
eligibility criteria for SSI are extremely complicated. Individuals must be a US citizen or naturalized citizen although children
authorized to remain in the US by Immigration and Naturalization Services may qualify. To determine eligibility: see all
SSI, Supplemental Security Income services providers (8) in our database.
Disability determinations are generally made by a disability determination service (DDS) and can take several months. However,
if a child has a diagnosis that provides for presumptive eligibility (see Diagnoses for which SSI Eligibility is Presumptive), a letter from the doctor certifying the diagnosis and its severity will allow for the patient to begin to receive services
for up to 6 months while the application is being processed.
When a family files an application with the Social Security Administration (SSA), it is first reviewed to determine if the
child qualifies based upon financial and citizenship information. If a child meets financial and citizenship criteria, information
about the child is gathered from the parents and other sources (e.g., past medical records) and forwarded to the Department
of Developmental Services (DDS) where eligibility is then determined.
A report submitted by the medical home to the DDS can greatly facilitate this process. In the report, the clinician should provide an impartial summary of the child's diagnostic and functional information without
attempting to determine eligibility. If the available information is insufficient to determine eligibility, the DDS can arrange
for a consultative exam at the expense of the agency. This exam may be performed by the child's primary clinician or an independent
party. The primary goal of the process is to determine if the child's impairment is the same as or "medically or functionally
equivalent" in severity to one of the conditions on the
Social Security Listing of Impairments (child).
If eligibility is denied, the family may appeal. Appeals may be successful but must be filed within 60 days - 34% of the appeals
filed in 1999 were successful. In some cases it is possible to request continuation of benefits during the appeals process
but this must be done within 10 days and carries some risk of needing to pay back the benefits if the appeal is denied. Information
on the appeals process may be found at the
Social Security Administration. See
[Committee: 2001].
Page Bibliography
Committee on Children With Disabilities.
American Academy of Pediatrics: The continued importance of Supplemental Security Income (SSI) for children and adolescents
with disabilities.
Pediatrics.
2001;107(4):790-3.
PubMed abstract
This AAP statement provides an excellent base for understand what SSI is, what it does, what children are likely to qualify,
and the basics of the application process. Knowing this information will greatly enhance your ability to help families get
into the system quickly.
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