SSA: What is Disability?

SSA’s Definition of Child Disability

The Social Security Administration (SSA) defines disability for children as:

• A medically determinable physical or mental impairment (including an emotional or a learning problem) or a combination of impairments,
• Which causes marked and severe functional limitations,
• That has lasted or is expected to last for a continuous period of at least 12 months or is expected to result in death

Medically determinable impairment

• Physical or mental health conditions (including an emotional or a learning problem)
• Must be documented with clear evidence by an acceptable medical source as defined by SSA

Impaired functioning

• For SSA to consider a child “disabled,” the child’s illness must result in impairments of functioning that meet SSA criteria.
• SSA will determine how the child’s functional abilities compare to the functional abilities of a child of the same age who does not have physical or mental impairments.
• It is essential to fully describe and document these impairments (more information on how to do this will be included in Class 5).

SSI for Children

SSA federally funds and administers the child SSI program that provides disability benefits based on need to individuals under age 18.

Brief History of SSI for Children

Before 1972, state and local governments administered welfare programs with varying definitions of disability. Thereafter, SSA created the federal SSI program and standardized the eligibility process, which has evolved. Below are some key SSI changes:

• The most recent change to SSI eligibility criteria for children came in 1990 when the U.S. Supreme Court ruled, in the Sullivan vs. Zebley case, that the definition of disability should be different for children than adults. This ruling further noted that a child's functional limitations should be evaluated as part of the determination process.
  • The definition of disability for children established in this case is the one currently in use.

Differences between Child and Adult SSI

SSA also administers SSI/SSDI disability programs for adults. The following are some key differences to keep in mind:

• For adults, the definition of disability includes an evaluation of the applicant’s ability to work at a substantial gainful level (SGA).
• Children must meet different medical criteria than adults
• SSDI is a program for adults with disabilities, based on earnings and contributions to Social Security through past work.

We will not elaborate on the SSDI program here because children cannot qualify for SSDI benefits.

Providing the Evidence

It may seem apparent to some that an individual is disabled and has limitations in functioning. However, for SSA and DDS to make a disability determination, the application must:

• Document the illness(es) and condition(s); as well as
• Demonstrate that the illness(es) impair(s) functioning

SSA recognizes that a youth under age 18 can have a serious illness or condition and still be able to work and pursue vocational goals. Obtaining SSI does not preclude employment before or after the receipt of benefits. The advantages of employment go beyond generating income to cover the costs of one's basic needs, and include:

• Providing opportunities for youth to shape their own futures and gain skills that benefit their financial and mental well-being;
• A sense of accomplishment and identity; and
• Financial and personal self-sufficiency for unaccompanied youth.

SOAR helps children and youth to access SSI in the hope they will eventually be able to receive these advantages.