Disability Benefits: How You Qualify | Disability Benefits | SSA

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Families who have children or family members with special needs face financial challenges that can be overwhelming. 

For example, the advocacy organization Autism Speaks estimates the lifetime cost of caring for a person with autism at $1.4 million. That cost can almost double if the person is impacted by an intellectual disability (having an IQ under 70).   

Most families don’t have the income or personal savings to meet these challenges. That’s why it’s essential to take advantage of all the government benefits that are available to assist families caring for a loved one with special needs. 

If you are caring for a family member with special needs, make sure your financial planning includes these government programs.

Supplemental Security Income Benefits   

Supplemental Security Income (SSI) is a federally funded program administered by the Social Security Administration (SSA).

Blind or disabled children and adults are eligible for SSI benefits, and adults 65 and older who meet the program’s financial criteria. The term “disabled” is different for children and adults.

For children:

  • 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 one year or result in death.

For adults:

  • The adult has physical or mental condition(s) that results in the inability to do any substantial gainful activity and can be expected to result in death, or
  • The condition has lasted, or can be expected to last, for a continuous period of 12 months or more.

Visit the SSI homepage :

  1. Help you complete your application.
  2. Make an appointment and pay for a medical exam if the information you currently have isn’t sufficient.
  3. In some cases, pay for your travel to the exam.

Social Security Disability Insurance 

Social Security Disability Insurance (SSDI) is an earned benefit funded by the Social Security tax fund and targeted to people whose physical or mental impairments prevent them from engaging in their normal occupation or other work. That means, even if an individual meets the SSI definition of disabled, that person must have sufficient Social Security work experience to qualify for payments.   

The program includes the Disabled Adult Child (DAC) provision, under which an adult disabled before age 22 may be eligible for child benefits if a parent is deceased or starts receiving retirement or disability benefits. This is called a “child’s benefit” because it is based on the parent’s Social Security earnings. 

The SSA website provides this example of a DAC benefit:

A worker starts collecting Social Security retirement benefits at age 62. She has a 38-year-old son who has had cerebral palsy since birth. The son/daughter will start collecting a disabled “child’s” benefit on his father’s Social Security record.

It is not necessary that the DAC ever worked. Benefits are paid based on the parent’s earnings record.

  • A DAC must not have substantial earnings. The amount of earnings we consider substantial increases each year. In 2022, this means working and earning more than $1,350 (or $2,260 if you’re blind) a month.

In this case, the adult child is eligible even though he has not worked or contributed to Social Security. Adult children who work can still receive benefits as long as their earnings remain below a level the SSA considers “substantial,” which in 2020 was set at anything over $1,260 a month.

Check out the SSA guidelines to learn more about SSDI benefits, eligibility, and application process.

Get professional support

The SSI and SSDI benefits are just some of what’s available from the government to assist families with special needs. Medicare and Medicaid include provisions that can provide additional financial assistance.

Even though the SSA website is easy to navigate, these benefits can be complex and challenging to understand. One of the best ways to ensure your loved one receives all their eligible benefits is to work with an advisor who has professional credentials and experience working in special needs planning. 

SHOP

Estimated wait for a state agency is three to five months.  However, for certain conditions, SSI payments can be paid right away, and for up to six months, while the state agency is deciding whether your child qualifies as being disabled.

Here are some of the conditions that may qualify:

  • Total deafness

• Down syndrome

• Severe intellectual disability (child age 4 or older)

• Cerebral palsy

• Total blindness

 • Symptomatic HIV infection

• Muscular dystrophy

 • Birth weight below 2 pounds, 10 ounces — SS Administration (Social Security Administration) evaluates low birth weight in infants from birth age 1, looking for failure to thrive in infants and toddlers from birth to age 3. They use the infant’s birth weight as documented by an original or certified copy of the infant’s birth certificate or medical records signed by a physician.

 If your child has one of the qualifying conditions, they can get SSI payments right away. However, if the state agency ultimately decides that your child’s disability is not severe enough for SSI, you won’t have to pay back the SSI payments that your child got.  

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