Children’s disability cases are SSI, or Supplemental Security Income, cases. This means that the child’s family must meet certain needs based criteria, in addition to establishing that the child has a disability.
In determining disability for children, social security determines first whether the child is engaged in substantial gainful activity. Next, they will determine if the child has a medically determinable physical or mental impairment that results in severe functional limitations.
In making this determination, social security will decide whether the child’s impairments meet or medically equal the criteria set forth in one of the Listings of impairments outlined in social security’s rules and regulations. If not, social security will determine whether the child’s limitations caused by a medical impairment “functionally equal” one of the listings.
In order to determine “functional equivalence”, social security looks at the “whole child.” (No splitting the baby as Solomon proposed in ancient times). In other words, a fact finder will look at all of the child’s activities 24/7, whether it be in the home, at school, or in the community. They will look at all areas of activities the child cannot do, or is limited in doing compared with other children of the same age without a medical impairment.
In making this determination, social security looks at the child’s functioning in six broad domains of activity. The adjudicator will look at whether the child functions in these domains in an effective, independent, and age-appropriate manner. These domains are intended to encompass all of what a child can or cannot do.
Functional equivalence is established if a child had “marked” limitations in two domains, or “extreme” limitations in one domain.
The six domains are:
1) Acquiring and using information,
2) Attending and completing tasks,
3) Interacting and relating with others,
4) Moving about and manipulating objects,
5) Caring for yourself, and
6) Health and physical well-being.
The domain of acquiring and using information refers to a child’s ability to learn new information and apply it in a variety of contexts, not just school or academic settings.
Different kinds of impairments, both physical and mental, can affect a child’s functioning in this domain. Some examples include, but are not limited to: traumatic brain injury, meningitis, and cerebral palsy.
Social security will only consider limitations in this domain if they are caused by a medically determinable impairment. However, while all children struggle in this domain from time to time, a child with significant but unexplained limitations may have an impairment that was not alleged or has not been diagnosed. Adjudicators should be sensitive to this fact and seek to more fully develop the evidence where appropriate.
Some kinds of evidence that can be important in assessing a child’s functioning in this domain include, but are not limited to: a child’s school record, special education services, and other accommodations a child may receive in an academic setting. However, for various reasons, some children’s limitations may go unnoticed for a long period of time.
It bears emphasizing again that social security will not consider a child’s limitations in this area if there is no medically determinable impairment.
A child may have an impairment that affects his functioning in more than one domain. For example, a child with a physical impairment who is limited in the domain of moving about and manipulating objects, may also experience debilitating pain which limits her ability to focus and concentrate and, thus, limits her functioning in the domain of acquiring and using information as well.
Assessing the effects of a child’s impairments across all domains is not considered “double-weighting.”
There is a fairly wide range of development that is considered normal for children.
Some limitations in the area of acquiring and using information (which are age sensitive; I.e., what may be normal for pre-school children may not be appropriate for school aged children, include, but are not limited to:
Does not demonstrate an understanding of words that describe concepts such as space, size, or time (for example, inside/outside, big/little, day/night).
Cannot rhyme words, or the sounds in words.
Has difficulty remembering what was learned in school the day before.
Does not use language appropriate for age.
Is not developing “readiness” skills the same as peers (for example, learning to count, reading ABCs, scribbling).
Is not reading, writing, or doing arithmetic at appropriate grade level.
Has difficulty comprehending written or oral instructions.
Struggles with following simple instructions.
Talks in only short, simple sentences.
Has difficulty explaining things.
See Social Security Ruling (SSR) 09-03p.
If you need help with a child’s disability case, please give me a call.
This material should not be construed as legal advice for any particular fact situation, but is intended for general informational purposes only. For advice specific to any individual situation, an experienced attorney should be contacted.