Overview
Throughout the following section, links to various web pages are provided for reference. Please note that web page addresses change frequently and while the addresses provided were accurate as of the issuance of this Toolkit, if you are unable to access any of the web pages through the links, please refer to the main Social Security website at www.socialsecurity.gov/ssi and navigate to the information you are seeking.
Before reading this section, please review the basics of Supplemental Security Income (SSI) and the New York State Supplement Program (SSP) in the main section of the tool kit and/or on the programs’ websites.
Eligibility Requirements for Supplemental Security Income
Since SSI is a needs-based program, financial eligibility for SSI depends on what an individual owns and how much income they have. A child can qualify for SSI benefits if they meet Social Security’s definition of disability for children, and if their income and resources fall within the eligibility limits. The Social Security Administration (SSA) also considers the family’s household income, resources and other personal information. A child must be disabled or blind to be eligible for SSI benefits.
For SSI purposes, a child is an individual who is neither married nor head of the household and who:
- Is under age 18
- Is under age 22 and is a student regularly attending school, including a vocational training institution designed to prepare the individual for a paying job
A child under age 18 is considered disabled if they have a physical or mental condition or conditions that can be medically proven and that result in marked and severe functional limitations. The conditions must have lasted or be expected to last at least 12 months or to end in death. If the individual is between the ages of 18 and 22, the adult disability definition applies (see SSI eligibility requirements in the tool kit.)
The forms SSA-3820-BK (https://www.ssa.gov/forms/ssa-3820.pdf) Disability Report – Child and SSA-3881-BK (https://www.ssa.gov/forms/ssa-3881.pdf) Questionnaire for Children Claiming SSI Benefits must be completed when applying for SSI benefits for children with disabilities. For a disabled child, SSA needs the names, addresses, and telephone numbers of people (teachers, caregivers) who can provide information about how the disabled child’s medical condition affects their day-to-day activities. In addition, a copy of an Individualized Education Plan (IEP) from their school is required. For more information, see https://www.ssa.gov/ssi/text-child-ussi.htm.
Calculation of SSI Payments
The amount of the SSI payment follows the same rules as for an adult. SSA calculates the amount based on the child’s income and living arrangement. If a child is working, information about earned income by students is available at:
https://www.ssa.gov/ssi/spotlights/spot-student-earned-income.htm.
Since most children reside with a parent who supports them, the Value of the One Third Reduction and In-kind Support and Maintenance usually apply.
Deeming Eligibility Guidelines
If a child is under age 18, not married, and lives at home with parents who do not receive SSI payments, a portion of the parents’ income or resources may be considered available to the child in determining their financial eligibility for SSI. This is called deeming. Basic information on deeming can be found at https://www.ssa.gov/ssi/spotlights/spot-deeming.htm.
SSI verifies the age and marital status of an eligible child to determine whether the child is eligible for parental deeming. In New York State, the parent’s income and resources are subject to deeming if they live in the same household with an SSI-eligible child and is one of the following:
- The natural parent of the child
- An adoptive parent
- The spouse of the natural or adoptive parent (including a relationship in which the natural or adoptive parent lives with someone and they hold themselves out as a married couple when they are not (e.g., common-law marriage, also known as a “holding out” relationship)
Under deeming, deductions are allowed for the parents and for other children living in the home. After these deductions are subtracted from income and resources, the amount remaining is used to decide if the child meets the SSI income and resource requirements for a monthly benefit. The effective month for deeming of a parent’s income and resources to an SSI eligible child is based on the individual’s circumstances, and is one of the following:
- The month after the month the child comes home to live with the parent(s) (e.g., the month following the month the child comes home from the hospital after their birth)
- The month of birth if the child is born in the parent’s home
- The month after the month of adoption (the month of adoption is the month the adoption becomes final)
- The month after the month of marriage (e.g., when a natural or adoptive parent marries) or the month after the month a parent begins living in a “holding out” relationship
Waiver of Parental Income
The Social Security Administration does not deem parental income and resources to any child under age 18 who meets all the following:
- Is disabled
- Received, at any time in the past, at least one month’s SSI payment (including the state supplement) while residing in or admitted to a hospital, extended care facility, nursing home, or intermediate care facility that is a certified inpatient provider under a Medicaid state plan
- Is eligible for Medicaid under a state home care plan – for SSI purposes, state home care plans are those:
- Approved by the Secretary of Health and Human Services under the provisions of section 1915(c) of the Social Security Act relating to waivers (e.g., HCBS Waiver)
- Or authorized under section 1902(e)(3) of the Social Security Act
- Would be ineligible for SSI benefits because of deemed parental income or resources or would be eligible for an SSI payment lower than $30.00
The eligible child's own income and resources affect SSI eligibility and payment in the usual manner. For example, if the child's countable income (excluding deemed income) exceeds the federal payment limit, the child's eligibility is suspended for excess income. The eligibility requirements for SSI benefits under the waiver of parental deeming provision must be met in the computation month. SSI will determine changes in living arrangements and the value of in-kind support and maintenance for these children as if the usual deeming rules applied.
Parental Deeming of Income Calculation
The parental deeming amount is calculated based on the following:
- Deduct allocations from unearned income for any non-disabled siblings
- Subtract the $20.00 general income disregard from remaining unearned income to determine the countable unearned income
- Subtract the earned income exclusions from the family's earnings to determine the countable earned income
- Add the countable earned and unearned income to determine the family's total countable income
- Deduct from the total countable income an allocation for the parents' needs, i.e., the FBR for an individual (single parent) or for a couple. Subtract the general income disregard to calculate the child's countable deemed income
- Deduct the amount of the SSI resource limit from the parents' countable resources to determine the value of the parents' resources available for deeming
- Allocate deemed resources equally to all disabled children to determine the child's or children's countable resources
The same process is followed for deeming of parental resources. Examples of income and resource calculations for parental deeming can be found at: https://secure.ssa.gov/apps10/poms.nsf/lnx/0501320500 and https://secure.ssa.gov/apps10/poms.nsf/lnx/0501330280.
Stopping of Parental Deeming
Deeming stops the month after a child turns age 18. Therefore, a child who could not receive SSI because of deeming may be able to get SSI when the child turns age 18.
Deeming also stops when:
- The parent(s) with whom the child resides start receiving SSI themselves;
- The child no longer lives with the parent (usually when they are placed in a residential school from which they do not come home on weekends/vacations and are not in parental control);
- The child is removed from parental control; or
- The child is placed into an ICF.
Changes of a child’s circumstances should be reported to Social Security for them to determine when and if deeming will still apply.
SSI Dedicated Account
SSI requires that a representative payee be named for an eligible child who is under 18. When a child is eligible for certain large past-due payments covering more than six months of benefits, the payments must be paid directly into a separate account in a financial institution. This separate account is called a dedicated account because funds in this account may only be used for certain expenses, primarily those related to the child’s disability. The dedicated account must be maintained separately from any other savings or checking account set up for the child. SSA monitors the expenditure of the funds from the dedicated account on an annual basis.
Information on how funds in a dedicated account may be used can be found at https://www.ssa.gov/ssi/spotlights/spot-dedicated-accounts.htm.
Note: Under OPWDD’s regulations, resources of an individual, including a dedicated account, in an OPWDD-certified residential program cannot be used to pay for medical services if the individual has Medicaid.
Dedicated account rules continue to apply until the depletion of funds or the individual’s benefit eligibility terminates. This includes situations where the individual reaches age 18, continues to be eligible and no longer needs a payee or when a new payee is appointed. The former payee must return conserved dedicated account funds to SSA for reissuance to the new representative payee or the individual. SSA will not reissue the conserved dedicated account funds until the new payee has established a new dedicated account.
Periodic Redetermination of Eligibility Process
SSA periodically reviews the individual’s income, resources, and living arrangement to make sure that they are still eligible for SSI and receive the right amount of SSI benefits. SSA will send inquiries and verification requests to the individual. SSA will also review the income, resources and living arrangements of the parents of a disabled child under age 18 living with them.
Representative Payees are required to report changes in the child’s situation that may affect the child’s eligibility for SSI.
Continuing Disability Review for Children
The law requires SSA to do a period continuing disability review (CDR) to determine whether a child is still disabled. The CDR must be done at least every three years for recipients under 18 whose conditions are likely to improve and not later than 12 months after birth for babies whose disability is based on low birth weight. SSA may also do a CDR for a recipient under 18 whose condition is not likely to improve.
At the time SSA does a CDR, the representative payee must present evidence that the child is and has been receiving treatment that is considered medically necessary and available for their disabling condition. If the child’s representative payee refuses to provide such evidence when requested and there is no good cause for the refusal, SSA may suspend payment of benefits to the representative payee and select another representative payee, if it is in the best interest of the child.
Benefits continue in payment status unless there is strong proof that a child's impairment has medically improved. The parent can file an appeal if they disagree with the determination. Otherwise, benefits stop 3 months after the child is notified that their disability ended.
Disability Redetermination for a Child Approaching Age 18
A disability redetermination is required for an individual who was SSI eligible as a child in the month before they attain age 18. The redetermination is done during the one-year period beginning on the individual’s 18th birthday. SSA uses adult disability rules for the redetermination.
Additional Information about SSI
Information about SSI is available 24 hours a day, including weekends and holidays, at Social Security’s toll-free telephone number, 1-800-772-1213. A service representative is available between the hours of 7 a.m. to 7 p.m. on business days. Lines are busiest early in the week and early in the month. The caller should have the individual’s Social Security number handy when calling.
People who are deaf or hard of hearing may call SSA’s toll-free TTY number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days.
All calls to the Social Security Administration, whether made to the toll-free numbers or to an office, are treated as confidential.
The following are some SSA publications that may be helpful in understanding SSI for Children:
- Child Disability Starter Kit
- Checklist - Childhood Disability Interview
- Medical and School Worksheet - Child
- Working while Disabled – A Guide to Plans for Achieving Self Support – SSA Publication Number 05-11017
- What You Need to Know About Your SSI When You Turn 18 – SSA Publication Number 05-11005
- Benefits for Children with Disabilities – SSA Publication Number 05-10026
The publications can be downloaded from the from the Social Security Administration internet homepage, which is located at www.ssa.gov or www.socialsecurity.gov.