Why Are Child SSI Cases Turned Down By Social Security?

Why Are Child SSI Cases Often Turned Down By Social Security Disability Examiners?

From my experience as a disability examiner, I found that many children have cases that do not meet the criteria needed to establish a severe impairment. In some cases, it may be because of an overuse of some diagnoses for children.

For example, so many children are given a diagnosis of ADHD these days and I am sure many of these children do not meet or equal any of the child mental impairment listings (this is more likely if the child was given their ADHD or ADD diagnosis by an internist and the child was never given diagnostic testing).

However, having said that, there are certainly many valid child disability claims, and many of these claims are either improperly denied by the social security administration, or are denied for lack of evidence. Which brings us to the next point.

Another reason children receive medical denials is because they do not have enough objective medical information to support the severity of their condition. In some cases, children have a severe impairment but their symptoms are controlled with medication.

Therefore, these children have no significant limitations to their residual functional capacity as long as they are compliant with medication and, thus, their disability claim is denied.

Children who have asthma or ADHD who are compliant with the medication often do not meet the severity of impairment requirements while they are on their medication. Social Security is more concerned with functional capacity than with having a specific impairment.

This is true in both child and adult disability claims. If a child takes their medication and their functional capacity improves to the point that they are able to function normally, Social Security is going to deny their claim based upon the fact that their condition is controlled by medication.

Many SSI children's claims are based upon learning disorders, and medical evidence (i.e. psychological testing, school performance) must support the severity of their allegation of disability. Often, SSI child disability claims have scant objective medical evidence and Social Security must use consultative examinations performed by independent doctors to gather enough information for a medical decision.

Truthfully, though, very few consultative examinations result in a child or adult being approved for disability benefits, unless the child has a condition that is easily discerned through psychological testing or various other forms of non-invasive medical testing.

Social Security has more lenient standards of severity for all children's impairment listings, so it is not that they are harder on children's disability claims.

Note: Many children who receive SSI disability benefits and are awarded based on the children's impairment listing criteria will lose their benefits during their age eighteen redetermination review, because their disability is then evaluated under adult impairment listing criteria.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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