We frequently receive questions from parents wondering if their child with ADHD is eligible to receive Social Security Disability Benefits. Unfortunately, there is no simple answer to this question. ADHD does not automatically qualify a child for Social Security Disability Benefits. Whether or not a child is eligible would depend on the severity of symptoms. In order to qualify a child must be disabled and have "marked and severe functional limitations." According to the Social Security Administration (SSA), the definition of a disability is:
- The child must have a physical or mental condition(s) that very seriously limits his or her activities; and
- The condition(s) must have lasted, or be expected to last, at least 1 year or result in death.
What does this mean?
Children with ADHD must showed marked impairment in inattention, impulsiveness and hyperactivity. In addition to this, there must be documented and marked impairment in at least two of the following:
- Age-appropriate cognitive/communication function
- Age-appropriate social functioning
- Age-appropriate personal functioning
This means that ADHD must severely impact a child's ability to learn, play, socialize or engage in other activities that would be considered normal daily activities for a child in the same age-group. The evaluation should take into consideration that the impairment is present in normal circumstances. In other words, if your child receives accommodations at school, consideration should be given without the services in place.
How are children assessed for SSDI?
When a claim is submitted to the SSA, it is assigned to a disability examiner. For cases involving ADHD, the examiner is probably has at least a Ph.D. in psychology and may consult with a psychiatrist during the assessment. Initially, all medical and academic records and documentation is reviewed.
Because there is no physical test for ADHD, the information the examiner has is based on the opinions of others. He or she may rely heavily on how the child performs in school and on any notations made by the teachers. He or she will make a determination as to whether the ADHD causes impairment severe enough to be considered marked impairment.
How do you apply for SSDI?
You can apply in several different ways:
- You can apply in person at your local Social Security Office
- You can apply over the phone by calling 1-800-772-1213 or for hard of hearing 1-800-325-0778
- You can complete the Child Disability Report online, although you will still need to contact the SSA to complete the application, either in person or over the phone
In order to complete the initial application and the Child Disability Report, you will need the following information:
- Name of child, date of birth and social security number
- Your name, address, phone number and email address (if you have one)
- The name and address of an additional person who has knowledge of the child's condition
- The date of original diagnosis, a description of symptoms, when symptoms began, how the ADHD impacts the child's daily activities
- The name, address and phone numbers for all schools the child has attended in the past year
- A listing of all behavioral and learning tests that have been completed, including the dates of testing
- If the child has held a job, a description of the job and the name and address of the employer
- The names, addresses and phone numbers for all doctors, hospitals, clinics your child has been seen in for this specific condition along with the dates of treatment and the reason for each visit
- Information on any medical test, including the name of the test, the date the test was done and the name of the medical provider who ordered the test
- The name of any prescription medication the child is taking and the name of the medical professional who prescribed the medication
- The name of any non-prescription medication the child takes
You do not need to supply full medical records. The SSA will contact the medical professionals on your list to request a copy of the records. It is important, therefore, to be accurate with correct spellings of names, addresses and phone numbers. Errors can delay the review process.
If you need to attend an interview, you should bring all of the above information, plus:
- Any medical records you have
- Medical assistance number, if your child is on Medicaid
- A copy of your child's Individualized Educational Plan (IEP) if he or she has one or copies of any requests you have made for educational services
- Names, addresses and phone numbers of any social workers or case workers who have been working with your child
- Names, addresses and phone numbers of any other adults who help care for your child
- Your child's birth certificate
- Proof of income if your child is or was working
- Proof of income for all household members
- Proof of financial resources of household members, including bank accounts, life insurance policies, stocks, bonds
If you don't have all of the information before the interview, make sure you still attend. The SSA may be able to help you gather additional information.
If your child is denied benefits you can appeal the decision. The entire process can take several months or, if appeals are necessary, it could take years.
If your child is approved to receive benefits, the SSA may request a review to verify your child is still disabled. These review can occur every three years for children under the age of 18. If your child's disability is going to be reviewed, you will need to supply information about ongoing treatment.
"Benefits For Children With Disabilities," 2011, Jan, SSA Publication # 05-10026, Social Security Administration
"FAQ About ADHD and Disability Benefits," Date Unknown, ADDitude Editors, ADDitude Magazine
"What You Will Need," Date Unknown, Social Security Administration