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Applying for Social Security Disability Benefits for a Child with Apraxia

If your child has apraxia of speech – either as a primary condition or associated with another condition – then he or she may be eligible to receive disability benefits through the Social Security Administration’s (SSA’s) Supplemental Security Income (SSI) program and/or Social Security Disability Insurance (SSDI) program.

Apraxia may significantly impact your son or daughter’s ability to function on a level similar to his or her peers. Specialized therapy, assistive technology, and other necessary services can be very costly.  If  you cannot afford to support their specific needs, you may qualify for Social Security Disability benefits on his or her behalf.

A few things to remember:

  • A diagnosis does not automatically make your child eligible.
  • The impact of the diagnosis or disability on your child’s ability to function in a number of life areas will be considered.
  • Only children who are found to be “severely” affected by their disability, as per guidelines of the SSA, are eligible.
  • Your child and family will need to meet financial requirements.

Basic Eligibility for Benefits

A child under the age of 18 typically qualifies for Supplemental Security Income (SSI) rather than Social Security Disability Insurance (SSDI). This is because the SSDI program requires past employment and a specific amount of taxes paid into the system. However, if a child’s parent currently receives SSDI, the disabled child may be eligible for dependent benefits under that parent’s name. If you feel that your child may qualify for dependent benefits under a parent or guardian, contact the representative who handles the eligible parent’s claim.

SSI, on the other hand, pays benefits to elderly or disabled individuals (including children) who have access to very limited income. There are no work-related requirements for SSI.  SSI provides both cash and health insurance benefits.

There are two sets of eligibility criteria for receiving SSI: (1) financial criteria, based on the income and resources of the child and family; and (2) medical criteria about the child’s impairment or combination of impairments.

Financial Criteria

To qualify, applicants must meet very specific financial requirements. In the case of a child, a parent or guardian’s income will be evaluated. Learn about the specific financial limits, here: http://www.socialsecurity.gov/ssi/spotlights/spot-deeming.htm.  If the child is eligible based on the families income, that is only the first step.  The child must then be found to have a severe disability.

SSA considers your financial resources are items like employment income, bank accounts, stocks, bonds, and property. Your personal belongings, the family home and care usually do not count.

(Special note:  Many states do have what are called “Medicaid Waivers“.  These waivers are unique to each state and often have waiting lists, however, they often set aside financial requirements for those with very severe disabilities so that the child is able to receive medical insurance benefits.)

Medical Criteria

In addition to the financial requirements listed above, there is also a basic definition of disability that your son or daughter must meet. This is defined by the SSA as follows:

  • He or she has a medically determinable physical or mental impairment (or combination of impairments); and
  • The impairment(s) results in marked and severe functional limitations; and
  • The impairment(s) has lasted (or is expected to last) for at least one year or to result in death

Medical Requirements

If your child meets the basic definition of disability, his or her condition will be evaluated based on very specific medical requirements. These requirements can be found in the SSA’s guide of potentially disabling conditions, known as the blue book.  Although Childhood Apraxia of Speech—or CAS—is not listed in the SSA’s blue book, your child may still qualify for disability benefits.

There are two ways in which your child may qualify for SSI without meeting a blue book listing:

  1. Match the specific medical criteria listed under a separate but similar listing.  Professionals may find that CAS most closely matches blue book listing 111.09- Communication Impairment Associated with a Documented Neurological Disorder. Under this listing, the SSA requires the following criteria:
  • Documented speech deficit which significantly affects the clarity and content of the speech; or
  • Documented comprehension deficit resulting in ineffective verbal communication for age; or
  • Impairment of hearing as described under the criteria in 102.10 or 102.11.

If CAS occurs with another medical condition, your child may qualify for disability based on the other condition, but the SSA will also take into account all issues, including those created by CAS.

  1. Provide evidence that, despite not meeting a blue book listing, your child’s impairment causes significant difficulty completing age-appropriate activities of daily living.

Preparing to Apply for Benefits

The first step toward applying is to schedule your appointment with the SSA. It will probably take some time before there is an available appointment date. While waiting for your appointment collect all of the necessary documentation, including:

  • medical records
  • school records,
  • And any other information that points to the limitations and challenges your child faces on a daily basis.

It can be very helpful to have your child’s physician write a summary letter or report to outline in one place all of the ways that your child is impacted by their disability.  You can provide them with a list of the issues and also this document describing criterian from the SSA publications for medical professionals.  This is the time to truly describe any activity impacted by your child’s disability (for example:  is unable to communicate pain, hurt, or illness; has no intelligible speech to communicate; etc.)

Also take the time to review the child disability starter kit.

What to Expect from the Application and Review Processes

Once you complete the initial application, it might be months before your receive a decision. You should be prepared to face the possibility that your child might be denied. If this happens, you have a chance to appeal. You have 60 days from receiving the denial to file an appeal.

Although the application process can seem complicated and overwhelming, disability benefits are often a necessary lifeline for many families. Once you are awarded benefits, you will be able to better support your child’s needs.

For more information about applying for disability benefits, visit Social Security Disability Help.

 

© Apraxia-KIDS℠ – A program of The Childhood Apraxia of Speech Association (CASANA)
www.apraxia-kids.org