Children who have developmental delays, which can include learning disabilities, mental retardation, cerebral palsy, and other impairments that prevent a child from developing at a rate equal to others their age, often require additional assistance to function well at school, including medical treatments or therapies to increase their functioning. These additional treatments and therapies can be financial straining on families. Supplemental Security Income (SSI) is available to children who qualify.
When your child is struggling with a disability and is denied disability benefits through SSI, it can be very frustrating as a parent. There are several reasons why children are denied benefits, and the reason they are denied will affect the actions that you take. Below are some of the reasons children are denied benefits.
Once you understand why your child was denied benefits, you must make a decision as to whether or not you are going to appeal the decision. Please be mindful that you need to give Social Security notice of your intention to appeal in writing. You have 60 days to do this from the day you received the denial notice, or you will lose the ability to appeal your decision. If you fail to appeal, you will need to reapply in order for your child to receive disability benefits.
When your child is denied SSI benefits, there are four steps that can be taken in order to get SSA's decision reversed. Hopefully, the first step will be successful and you will not need to further appeal the benefits decision.
For more information on each level of appeal, see our article on the four levels of Social Security appeals.
For children who are denied disability claims for developmental delays, the key area of concern for winning an appeal is the medical record. Whether the record was not properly "developed" (meaning SSA did not collect all of the needed medical records) or the records do not say what is needed (because the child did not receive treatment or visit a psychologist or psychiatrist frequently) or the records failed to show the extent of your child's impairments or limitations, it is essential that you take the time to collect the medical records that you need to support your child’s case. This may include asking your child's doctor or psychologist to write a statement about how your child's delays negatively affect his academic and social functioning.
For children, there are other records that can be used beyond medical records to prove a child’s functional limitations. These other records include:
It is important to provide your records to Social Security prior to your child's hearing in order to allow the ALJ time to review and properly consider the new evidence in your case.
To decide if your child should receive SSI benefits, the ALJ will compare your child level of functioning to teachers' expectations of your child, to others with similar limitations (such as other children in special education classes), and to other children the same age who have no limitations. For more information on this analysis, see our articles on: