Learning Disabilities and Social Security Disability Benefits

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 success 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 Disability Programsshutterstock_181599206

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.

 

Author: Lisa Giorgetti, Community Liaison, Social Security Disability Help   
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Comments

  1. After skimming through all of the stories people have on here, I would like to suggest that maybe a good place to start is with the State Department of Mental Health. Our state DMH has two divisions; one for psychiatric services and the other is for Developmental Disabilities.
    The Division of Developmental Disabilities helps to connect people to resources in their communities as well as assisting people with the various state and federal resources available. The email from LDA copied below is great information to start accessing new resources.

    I’m sorry for the rant, just had to let people know these resources are out there.
    “LDA OF AMERICA SAYS:
    March 29, 2018 at 1:06 PM
    Your story of your granddaughter’s struggles is a difficult narrative to read. She must really be resilient to have made it through all she has since at least the age of five. It’s great that she has such a caring grandparent to support and love her! It’s most likely true that she could do well with a lot of one-on-one time with a professional who works with that population. You’ve probably already run the gamut of the search for appropriate and effective resources in your area. Some communities have programs that support community living resources. These can include supported living (from minimal assistance to full-time, live-in support to assist individuals living in their own home), personal care (providing assistance with daily living activities in their own home), and case management (coordination of services and community resources, advocacy, planning, and monitoring and evaluation of services provided). Some of these services may be based on the degree of disability or disabilities, but all are worth exploring as potential resources. You might search online for “supported living services” plus the name of your granddaughter’s city and state and see if there are those types of resources in your area. Your local Department of Human Services may also know of local resources to check out. If you are not sure about her diagnosis, maybe you can ask to see a copy of her latest disability documentation so you’ll know better what she may or may not be eligible to request. It’s good to know she has you as an advocate!”

    A few notes:
    When accessing state services, please keep in mind that many times, caseloads run high; it may take a while to get through the admissions process, and getting assigned to a case manager.

    Be patient, but don’t be afraid to speak up to get what you need, or the person you are advocating for.

    If you think someone is not helping you, try to be kind and patient, but remember, everyone has a supervisor!

    *No matter how old someone is, it is never too early to introduce employment skills.

    *Always educate people with disabilities to advocate for themselves, and to be able to identify safety issues, what is abuse/neglect, theft, conversion etc. (this is important when living in supported living arrangements; especially if the person with disabilities is desperate to have friends to the point of being taken advantage of).

    *Unless someone has modified their rights in the legal system, people with disabilities have the same rights as everyone else. There is no reason that anyone cannot live in a community of their choice and live the life they want to live; it is only a matter of having the right supports in place.

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