When living with a learning disability, you’re empowered to thrive in all aspects in life despite the challenges that can be faced daily. However, in some situations, adults who suffer from severe learning disabilities can find it difficult to maintain gainful employment to support their families. Also, if you have a child who lives with a severe learning disability, it can be hard finding and affording opportunities for them to succeed both in and out of the classroom.
In either situation, the financial effects can, sometimes, be overwhelming to an individual or a family. The good news is that Social Security Disability benefits can help alleviate this financial strain and provide much-needed medical coverage to help pay for treatments and other medical bills.
The Social Security Administration (SSA) offers two different disability programs including Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both programs provide a monthly payment and medical coverage to severely disabled individuals. In addition to meeting the SSA’s disability criteria to receive such benefits, one must also meet the financial requirements of each respective program.
To be eligible for SSDI benefits, an individual must have worked enough in the past to earn sufficient work credits by paying Social Security taxes. For every $1,200 earned, an individual receives one work credit and can receive a maximum of four work credits per year. If you are 62 years of age, you will need 40 work credits to qualify, 20 of which must have been earned in the last 10 years. If you are under 62 years of age, you can qualify for benefits with fewer credits. The exact number of credits needed is determined by your age.
If an individual doesn’t have enough work credits, or doesn’t have any at all, the SSI program would be ideal. As children typically lack work credits, they would more likely be eligible for SSI. The SSI program is a needs-based program and is based on financial need rather than work history. As of 2014, to qualify for SSI benefits, you must not have a household income exceeding $721 per month as an individual or $1,082 per month as a couple. Household assets must also not exceed $2,000 as an individual or $3,000 as a couple.
For children, only a portion of the household income is deemed to the child, so if you are applying on behalf of a child and the household income exceeds the above-mentioned levels, the child may still be eligible for benefits. Every impaired child’s application is based on a case-by-case basis, as each situation is unique. http://www.disability-benefits-help.org/content/social-security-programs
The Social Security Blue Book
To qualify for disability benefits from the SSA, you will have to prove that you are disabled according to their criteria. That usually means proving that you have a condition that is either listed in the Blue Book and meets the SSA’s Blue Book criteria or that you have a condition that is equal to a section in the Blue Book.
The Blue Book lists all of the conditions that could potentially qualify an individual for Social Security Disability benefits, along with the criteria that must be met with each condition. For example, if an individual wanted to apply for Social Security Disability with Attention Deficit Hyperactivity Disorder (ADHD) they would have to follow the Blue Book guidelines for that condition. ADHD is only listed in the childhood section or the Blue Book under Section 112.00 – Childhood Mental Disorders. As ADHD begins in early childhood, there is no similar section for the adult listings. You could receive benefits with ADHD as an adult, if you’re able to prove that:
- You have had ADHD since childhood, and
- ADHD has impaired your ability to complete schoolwork and to be gainfully employed as an adult.
Specifically, the listing for ADHD is covered in the childhood segment of the Blue Book under Section 112.11 – Attention Deficit Hyperactivity Disorder. According to this section of the Blue Book you must be able to prove that:
- The child has been diagnosed with ADHD that is manifested by developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity; and
- There is medically documented findings of marked inattention, marked impulsiveness, and marked hyperactivity; or
- For older infants and toddlers, gross or fine motor development is at a level generally acquired by children no more than one-half the child’s chronological age, documented by an appropriate standardized test or other medical findings.
Another example would be if an adult with an intellectual disability wanted to apply for benefits. He or she would apply for benefits under Blue Book Section 12.05 – Intellectual Disability. According to this Blue Book, to qualify for benefits under this listing, you would need to be able to prove that:
- You suffer from an intellectual disability that involves significantly sub-average general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period; and
- Mental incapacity is evidenced by dependence upon others for personal needs and inability to follow directions, such that the use of standardized measures of intellectual functioning is precluded; or
- A valid verbal, performance, or full scale IQ of 59 or less; or
- A valid verbal, performance, or full scale IQ of 60 through 70 and a physical or other mental impairment imposing an additional and significant work-related limitation of function; or
- A valid verbal, performance, or full scale IQ of 60 through 70, resulting in at least two of the following:
- Marked restriction of activities of daily living; or
- Marked difficulties in maintaining social functioning; or
- Marked difficulties in maintaining concentration, persistence, or pace; or
- Repeated episodes of decompensation, each of extended duration.
Applying for Social Security Disability Benefits
You can apply for Social Security Disability benefits online or in person at your local Social Security office. Children candidates and their parents or guardians, however, must file their application in person.
When applying for benefits, you will want to gather enough medical evidence to prove that you meet the Blue Book’s criteria for your specific disability. This can include, but isn’t limited to, clinical histories, medical records, lab results, testing results, treatment history, and a written statement from the professionals treating the applicants.
You will be asked to fill out a number of forms during the application process. Be sure to fill out each form in its entirety and with detailed answers to help the SSA understand how your condition prevents you from working, or to prove your child has severe functional limitation. The more detail you can provide, the better the SSA will understand how the condition interferes with the applicant’s daily living activities.
You may also be required to attend a consultative exam. The purpose of this exam is to determine the extent of your disability, not to provide treatment. It’s important to attend any exams that may be scheduled by the SSA as they can have impact on the decision of your claim.
You will receive a decision regarding your claim approximately two to four months from the date of your initial application. If you are awarded benefits, you will be told which benefits you qualify for, how much you will be receiving, and when benefits will begin. If you are denied benefits, you have 60 days from the date of the denial notice to appeal the SSA’s decision. http://www.disability-benefits-help.org/content/application-process
Appealing a Denial of Benefits
If you must appeal a denial, don’t lose faith. A significant percentage of applicants are indeed denied benefits during the initial stage of the application process and go on to successfully obtain benefits through the appeal process. Regardless of how long the appeal process may take, if awarded benefits you will be awarded back pay for the duration of the appeal.
You may want to consider retaining a Social Security Disability attorney for purposes of the appeal process. A disability attorney will not cost you any up-front, out-of-pocket expense. These professionals work on a contingency basis; collecting only 25% of the back pay you are awarded by the SSA with a maximum amount of $6,000. Considering the attorney can mean the difference between a successful appeal and further denial. It’s in your best interests to weigh out the options of legal representation for purposes of your Social Security Disability application process.