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How does the Social Security Administration evaluate SSI Child Cases?

There are four steps to evaluating whether your child is entitled to SSI child disability benefits.

1.Is your child working at the Substantial Gainful Activity (SGA) level? Please see my blog dated September 18, 2010, www.kathleenflynnlaw.com for a more detailed explanation of how SSA examines work activity. In 2012, any child under the age of 18 earning more than $1,010 a month before taxes, will be declared not disabled.

2.Does your child have a medically determinable mental impairment (s) or physical impairment (s) or combination of impairments?

Most SSI child cases that are filed meet this standard.

3.Do(es) your child’s mental condition (s) or physical condition (s) Meet or Medically Equal the requirements of a Child Medical Listing of Impairments?

The Medical Listings for children can be technical. Thus, child cases may be reviewed by medical experts hired by the GA Department of Labor, Disability Adjudication Services (DAS) at the initial or reconsideration levels. Medical experts are contracted by the Office of Disability Adjudication and Review (ODAR) at the hearing level. These medical experts could include but are not limited to psychologists, psychiatrists, pediatricians or, in rare cases, a specialist such as a cardiologist.

Because these medical experts receive modest compensation, they usually testify by phone, as opposed to traveling to the hearing office. Unfortunately, the medical expert is not always sent a copy of the complete exhibit file to review or if exhibits are submitted after a copy of the file has been sent to the medical expert, he/she may not be sent updated exhibits. Therefore, it is always a good idea to ask which exhibits the medical expert has and compare the number of exhibits against your own.

Visit my website at www.kathleenflynnlaw.com for the Child Medical Listings of Impairments for each of the major body systems that cause marked and severe functional limitations in children.

4.Do(es) your child have a mental or physical condition that Functionally Equals a Medical Listing of Impairments?

If your child’s mental or physical impairment(s)does not meet or equal one of the Child Medical Listings (only a medical expert can determine if your child’s medical conditions equals one of the Medical Listings for children per social security regulations),then the Adjudicator or ALJ will determine if the functional limitations caused by your child’s mental or physical impairment(s) are the same as the disabling functional limitations of any Child Medical Listing, and, therefore, are functionally equivalent to the Child Medical Listings. In other words, the combined effects of your child’s different impairments will be considered to determine disability.

In order to Functionally Equal a Child Medical Listing, the Adjudicator or ALJ will determine if your child’s mental or physical impairment (s) results in TWO MARKED limitations or ONE EXTREME limitations in the following areas:

1. Acquiring and using information

2. Attending and completing tasks

3. Interacting and relating with others

4. Moving and manipulating others

5. Caring for yourself

6. Health and physical well-being

There are various ways that your child’s mental or physical condition(s) can result in a marked or extreme limitation in the above categories. Observations noted in questionnaires from teachers, after school tutors or daycare providers, Individual Education Programs (IEPs), behavioral modification plans, or Section 504 plans from schools, as well as findings addressed in our forms completed by treating sources such as pediatricians, specialists, physical therapists, speech-language pathologists, psychologists, psychiatrists, etc. are important in developing your child’s case. Of course, at the hearing, testimony from the child, parent or another essential witness can help convince an ALJ that your child(s) mental or physical impairment(s) Functionally Equal a Child Medical Listing.

Many of the parents, whom I represent, want their child to receive Supplemental Security Income (SSI), in order to afford private tutors, after school or summer programs or more specialized treatment. If your child is awarded SSI, then a separate bank account must be set up in your name, as well as your child’s name. SSI back pay can only be spent on things for your child. If you have a question about what you can use your child’s SSI back pay for, you should ask the person handling your child’s case at your local Social Security District Office. For additional questions, please call our office at (404)-479-4431 or visit our website at www.kathleenflynnlaw.com.

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