Litigating a Childhood Social Security Claim

by Linda Ershow-Levenberg, Certified Elder Law Attorney (C.E.L.A.)
February 2008

Requirements and Criteria for Filing

Disability benefits may be available under the Social Security system to individuals who can no longer work due to severe disability. There are times when the disabled person cannot qualify for benefits on his own earnings record, because he did not work the required 40 quarters to be "insured" under this system. In some cases, children who are disabled can become eligible for disability benefits from Social Security if they are the qualified dependent of an insured individual.

The fundamental requirements are:

An application must be filed
The applicant must be disabled as defined by Social Security law
The applicant must be dependent upon an insured individual
If older than 22, the disability must have begun before age 22.

How is an application filed?

It is filed online at the Social Security website www.ssa.gov or at the local SSA office. Medical records must be provided, along with the documentation of the pertinent "vital statistics," such as birth certificate, citizenship papers, death certificate, proof of residency, etc.

What does "disabled" mean?

A. If the dependent child is over age 18, the customary five-step analysis is applied

Is the applicant engaged in Substantial Gainful Activity (SGA)? If yes, the applicant is Not Disabled despite having severe medical impairments. SGA generally refers to physically or mentally active work for gain, and there are minimum earnings threshold which are adjusted in the regulations each year.
Does the applicant have a severe, medically-determinable impairment? If not, the applicant is Not Disabled. Objective medical evidence is necessary to establish severity and the type(s) of impairment.
Does the severe impairment meet or medically equal the criteria in the Listings of Impairments, which are very specific impairments contained in the regulations? If yes, the applicant is Disabled.
If not, what is the applicant's Residual Functional Capacity (RFC) for work? This refers to exertional capability and postural limitations. Does the individual have the RFC to perform his or her Past Relevant Work (PRW), which refers to the work s/he performed during the previous 15 years? This inquiry looks at the skills which the applicant has acquired and whether they are Transferrable to other work that individual has the capacity to perform. If not, does the individual have the RFC to perform other work that exists in significant numbers in the national economy? If not, the applicant is Disabled. If Yes, then the applicant is Not Disabled despite having certain severe medical impairments.
If the dependent child is under age 18, there is generally no "Past Relevant Work, so transferrability of skills is irrelevant. The applicant must prove that s/he lacks the "residual functional capacity" for any full range of "substantial gainful activity," whether that activity involves sitting at a work station for 2 hours at a time, extensive walking around, lifting and carrying, and the like.

Who can be the "insured individual?"

Parent or grandparent or step-parent
Entitled to receive retirement benefits or
Entitled to receive disability benefits or
Has died, but was entitled to retirement or disability benefits at time of death.

What does "dependent" mean?

Living with or supported by the insured individual at time of application

Receiving at least ½ of his support from the insured individual for at least one year prior to the date of application or prior to the death of the insured individual

What about adopted children?

The adoption must take place before the insured individual was eligible to receive disability or retirement benefits.

What if the insured individual is the grandparent?

Dependent grandchild must begin living with the insured, eligible grandparent before age 18, and must live with that grandparent in the United States.

Grandchild must be receiving at least ½ his support from the grandparent for one year before the date the grandparent became eligible to receive benefits or did having been eligible to receive benefits.

Medical documentation is required.

If the claimant seeks to receive child's disability benefits based on a disability that began before age 22, it will be necessary to assemble objective medical documentation from the treating physicians, consulting or treating specialists, and other specialists involved in the child's life such as therapists, educators, vocational evaluators, special education instructors, etc. The Social Security Administration isrequired to defer to the opinions of treating specialists who have established doctor-patient relationships with the claimant and whose opinions are supported by the objective evidence in the charts.

What causes child's benefits to terminate?

There can come a time when child's disability benefits end. The child may continue to receive benefits until the child:

Dies, or
Marries, or
Turns 19 if s/he is a full-time student, or
Turns 18 and is no longer disabled, or
Turns 18 and is no longer a full-time student, or
Three months after the disability ceases, for a child who became disabled before age 22.

Supplemental Security Income Benefits

In certain circumstances, the disabled child cannot obtain Social Security Disability child's benefits on the earnings record of an insured individual, because required criteria are not met.

If the child himself (if over 18) or the person on whom the child is dependent (if under 18) meets the stringent financial criteria of the SSI rules, the child can become eligible for Supplemental Security Income benefits, or SSI. As a result of eligibility for SSI, the claimant will receive Medicaid benefits for health coverage. The child cannot have more than $2,000 in countable, available resources in his or her name.


For an Appointment Call 732.382.6070	Articles: Litigating a Childhood Social Security Claim
Contact Us Home > Articles from www.finkrosner.com © All Rights Reserved. Related Links: www.NOSSCR.org National Organization of Social Security Claims Representatives www.ssa.gov Social Security Administration Attorney Profiles: Linda Ershow-Levenberg Litigating a Childhood Social Security Claim by Linda Ershow-Levenberg, Certified Elder Law Attorney (C.E.L.A.) February 2008 Requirements and Criteria for Filing Disability benefits may be available under the Social Security system to individuals who can no longer work due to severe disability. There are times when the disabled person cannot qualify for benefits on his own earnings record, because he did not work the required 40 quarters to be "insured" under this system. In some cases, children who are disabled can become eligible for disability benefits from Social Security if they are the qualified dependent of an insured individual. The fundamental requirements are: An application must be filed The applicant must be disabled as defined by Social Security law The applicant must be dependent upon an insured individual If older than 22, the disability must have begun before age 22. How is an application filed? It is filed online at the Social Security website www.ssa.gov or at the local SSA office. Medical records must be provided, along with the documentation of the pertinent "vital statistics," such as birth certificate, citizenship papers, death certificate, proof of residency, etc. What does "disabled" mean? A. If the dependent child is over age 18, the customary five-step analysis is applied Is the applicant engaged in Substantial Gainful Activity (SGA)? If yes, the applicant is Not Disabled despite having severe medical impairments. SGA generally refers to physically or mentally active work for gain, and there are minimum earnings threshold which are adjusted in the regulations each year. Does the applicant have a severe, medically-determinable impairment? If not, the applicant is Not Disabled. Objective medical evidence is necessary to establish severity and the type(s) of impairment. Does the severe impairment meet or medically equal the criteria in the Listings of Impairments, which are very specific impairments contained in the regulations? If yes, the applicant is Disabled. If not, what is the applicant's Residual Functional Capacity (RFC) for work? This refers to exertional capability and postural limitations. Does the individual have the RFC to perform his or her Past Relevant Work (PRW), which refers to the work s/he performed during the previous 15 years? This inquiry looks at the skills which the applicant has acquired and whether they are Transferrable to other work that individual has the capacity to perform. If not, does the individual have the RFC to perform other work that exists in significant numbers in the national economy? If not, the applicant is Disabled. If Yes, then the applicant is Not Disabled despite having certain severe medical impairments. If the dependent child is under age 18, there is generally no "Past Relevant Work, so transferrability of skills is irrelevant. The applicant must prove that s/he lacks the "residual functional capacity" for any full range of "substantial gainful activity," whether that activity involves sitting at a work station for 2 hours at a time, extensive walking around, lifting and carrying, and the like. Who can be the "insured individual?" Parent or grandparent or step-parent Entitled to receive retirement benefits or Entitled to receive disability benefits or Has died, but was entitled to retirement or disability benefits at time of death. What does "dependent" mean? Living with or supported by the insured individual at time of application Receiving at least ½ of his support from the insured individual for at least one year prior to the date of application or prior to the death of the insured individual What about adopted children? The adoption must take place before the insured individual was eligible to receive disability or retirement benefits. What if the insured individual is the grandparent? Dependent grandchild must begin living with the insured, eligible grandparent before age 18, and must live with that grandparent in the United States. Grandchild must be receiving at least ½ his support from the grandparent for one year before the date the grandparent became eligible to receive benefits or did having been eligible to receive benefits. Medical documentation is required. If the claimant seeks to receive child's disability benefits based on a disability that began before age 22, it will be necessary to assemble objective medical documentation from the treating physicians, consulting or treating specialists, and other specialists involved in the child's life such as therapists, educators, vocational evaluators, special education instructors, etc. The Social Security Administration isrequired to defer to the opinions of treating specialists who have established doctor-patient relationships with the claimant and whose opinions are supported by the objective evidence in the charts. What causes child's benefits to terminate? There can come a time when child's disability benefits end. The child may continue to receive benefits until the child: Dies, or Marries, or Turns 19 if s/he is a full-time student, or Turns 18 and is no longer disabled, or Turns 18 and is no longer a full-time student, or Three months after the disability ceases, for a child who became disabled before age 22. Supplemental Security Income Benefits In certain circumstances, the disabled child cannot obtain Social Security Disability child's benefits on the earnings record of an insured individual, because required criteria are not met. If the child himself (if over 18) or the person on whom the child is dependent (if under 18) meets the stringent financial criteria of the SSI rules, the child can become eligible for Supplemental Security Income benefits, or SSI. As a result of eligibility for SSI, the claimant will receive Medicaid benefits for health coverage. The child cannot have more than $2,000 in countable, available resources in his or her name.

Contact Us \| Site Map