1. Social Security and Supplemental Security Income (SSI) for Children with Disabilities
Supplemental Security Income or SSI is a cash assistance Program
Administered by the Federal Government
Started in 1974
Replaced Federal/State matching program of adult assistance for aged, blind and disabled

2. How is SSI Different from Social Security?
Limited Income and Resources
SSI not based on work
Medicaid eligible
Food stamp eligible in some cases
65, blind or disabledFunded by general revenues

3. SSI-Who can receive it? Blind/Disabled-any age
Limited income/resources
Citizenship/Residency
Age 65 or older
Basic purpose of SSI is to assure a minimum level of income to people who are aged, blind or disabled and have limited income and resources
Several basic principles underlie the SSI program:
Law provides payments to be made to aged, blind and disabled persons whose income and resources are below specific limits.
A person’s right to SSI benefits are defined in Title XVI. If an individual disagrees with a decision on his case, he can obtain an administrative review of the decision and if still unsatisfied, initiate court action.
Eligibility requirements and federal income floor are identical wherever the person operates. States have the option of adding a state supplement to the federal portion of SSI.
SSI paid out on 1st of the month.
SSI financed from U.S. general funds not from Social Security or Medicare funds.
Under Section 1634 of the Social Security Act, states may contract to have SSA make Medicaid eligibility determinations. An SSI application serves as an application for Medicaid benefits. States still issue Medicaid cards or notices based on information furnished to them via the State data exchange or SDX system
SSI recipients have the option in certain cases of applying for food stamps at the Social Security office. All such applications are forwarded to the Food Stamps offices, which make a determination of eligibility.

4. Citizenship/Residency
U.S. or N. Mariana Islands resident &
Must be a U.S. citizen/national or,
Permanent resident w/40 credits or,
Refugee/asylee (limit of 7 years) or,
Receiving SSI on or before 8/22/96
In addition to categorical and need criteria, individuals applying for SSI need to meet the following eligibility requirements:
Be a resident of the United States or the Northern Mariana Islands or be a child who is a U.S. citizen and lives outside the United States with a parent in the U.S. Armed Forces and
Must have permanent lawful residence in the United States with 40 work credits or
Must be a refugee under section 207 of the INA or asylee under section 208 of the INA or must have been receiving SSI as a non-citizen on August 22, 1996.

5. Definition of Disability
Physical or mental impairment that keeps a person from performing “substantial work”
Condition expected to last 12 months or result in death
For child-impairment must result in “marked or severe functional limitations” and be expected to last 12 months or result in death
A person 18 years old or older is considered disabled if he or she is unable to engage in substantial gainful activity due to a physical or mental ailment which can be expected to last 12 months or longer or result in death.
For those under 18, the condition must result in marked or severe functional limitations and be expected to last 12 months or longer.

6. Definition of Blindness
Corrected vision of 20/200 or less in better eye
Field of vision less than 20 degrees
A blind individual is defined as having 20/200 or less in the better eye with corrective lens or a person with tunnel vision of 20 degrees or less.

7. Presumptive Disability
Up to 6 months of SSI based on disability if applicant has one of 15 conditions
Determination is made by local Social Security office
If there is a likelihood that case will be approved, DDS can also make a presumptive decision

8. Disability Determination
Approval or disapproval decisions are made in Austin by Disability Determination Services (DDS)
Can be expedited through Electronic Records Express (ERE)
“Blue Book” (Disability Evaluation Under Social Security) available online at :

9. Compassionate Allowances
Over 200 rare diseases and cancers
Expedited decisions on these cases
List of impairments found at:
More diseases and conditions to be added over time

10. Limited Income
Countable income must be below $733 per month for an individual (2016)
An eligible individual cannot have monthly countable income in excess of the current federal benefit rate or FBR of $512 (for the year 2000) per month
The income of an eligible couple cannot exceed $769 per month.
These federal benefit rates are set by statute and subject to increases due to the cost of living adjustments set by Congress. These amounts may be supplemented by individual states.

11. Deeming of Income
If child is under 18, not married and living with parents, portions of their income and resources are treated as though they were the child’s. This called “deeming.”

12. Deeming Not Applicable
Child 18 yrs. or older
Children living in institutions
Children eligible for Medicaid under a State home care plan.
Child not living with either parent
Child whose parent receives TANF and other income used to compute PIM payment

13. Types of Income
Unearned income includes pensions, alimony, support payments, rents, interest, annuities etc.
Earned income means wages, self employment net earnings, royalties, Sheltered Workshop payments etc.

14. Limited Resources $2000 for an individual
Resources (assets) of parents are considered to belong to the child until he/she turns 18
For SSI purposes, a resource means cash or other liquid assets and any other real or personal property that an individual owns or could convert to cash to obtain support and maintenance.
For an individual the resource limit is $2000 while for a couple the figure is $3000.

15. Resource Exclusions Home where the person lives
Car, depending on use or value
Burial plots for individual and family
Burial funds up to $1500
Life insurance ($1500 or less)
Term insurance (any amount)
Not all of an individual’s resources count in determining SSI eligibility. There are some exclusions authorized by Federal laws, Title XVI of the Social Security Act and by certain court cases. These include:
An individual’s home including adjacent land if the home is the principal place of residence.
Property of a trade or business needed for self-support
One automobile regardless of value, if used to provide necessary transportation, employment or to obtain medical treatment. If an automobile cannot be excluded on this basis , any market value in excess of $4500 would be counted.
Disaster relief
Burial spaces and burial funds up to $1500. The value of burial spaces for an individual, his/her spouse and for any member of the immediate family is excluded. This encompasses grave sites, vaults, crypts, caskets, mausoleums, urns and other burial containers.
Burial funds must be designated as specifically for burial and cannot be commingled with non-burial assets
Only life insurance which an individual owns and that has cash surrender value can be a resource if the cash surrender value exceeds $1500

16. Living Arrangements Determine amount of SSI that a person will receive
Factors like sharing of expenses, rental liability, separate purchase or preparation of food, institutionalization, home ownership can affect determination

17. Medicaid
In most states including Texas, eligibility for SSI means Medicaid coverage
Medicaid is a federal/state program administered by the states
Eligibility is made on a month to month basis

18. Redeterminations
Non-medical review of case can be yearly or less often depending on income and other factors
Can be done by phone or in office
Failure to respond to redetermination request will result in suspension of SSI benefits and Medicaid coverage

19. Continuing Disability Review (CDR)
SSA re-evaluates medical condition every three, five or seven years according to a recipient’s disabling condition
SSI recipients who turn 18 must have their disability reviewed using adult standards. If approved, benefits will continue

20. SSI Work Incentives Impairment related work expenses
Blind work expenses
Plan for achieving self support (PASS)
Continued Medicaid eligibility (1619 b)
Student Earned Income Exclusion
SSI work incentives offer a way to continue receiving Supplemental Security Income checks while a person works.
Impairment related work expenses deduct the cost of certain items and services needed to work from a person’s gross earnings These could include attendant care, residential modifications, certain medications and diagnostic procedures not covered by Medicaid.
Blind work expenses include Federal, state, local and Social Security taxes, visual and sensory aids, translation of material into Braille, guide dog expenses, transportation to and from the workplace.
For those who have a plan to get an education or receive vocational training toward a career goal, SSI allows an individual to set up a PASS or Plan for Achieving Self-Support
Medicaid coverage can continue even if an individual’s earnings become too high to receive an SSI cash payment. Under Section 1619 (b) if a person is disabled, has been eligible for an SSI cash payment for at least a month, meets all other eligibility rules including the resource test and has insufficient income to replace SSI, Medicaid and publicly funded Attendant care, he/she may continue to receive Medicaid coverage provided the income is under the threshold amount.

21. Student Income Exclusions
Under age 22
Must be in college at least 8 hrs per week
Grades 7-12 at least 12 hours per week
Up to $1780 earned income not counted to a yearly maximum of $7180

22. Plan for Achieving Self Support (PASS)
Designed for applicant
Specify work goal in writing
Specific timetable
Money/resources used to reach goal
Needs SSA approval

23. SSI/SSDI Work Incentives
Many programs to assist Social Security and SSI beneficiaries with disabilities to return to work
Description of these is available in the “Red Book”
This is available online at SSA’s website:

24. SSI Recipients’ Responsibilities:
Report changes in income/resources/living arrangements
Inform SSA if they leave the U.S. or Northern Mariana Islands
Report entry or departure from an institution
Inform SSA about changes of address

25. Social Security Benefits
Social Security payments based on wages of the worker
Children with disabilities can only draw Social Security benefits on a parent’s record if the parent is currently receiving Social Security benefits or is deceased and had sufficient work credits under Social Security

26. Social Security Benefits
Children with disabilities can also receive their own Social Security benefits if they have worked and acquire “insured status” under Social Security
Child who is 18 yrs old or older that has a disability that began before age 22 can file for Disabled Adult Child (DAC) benefit under their parent if that parent is receiving SS benefits or is deceased and has sufficient work credits

27. Social Security Benefits
Disabled Adult Children and individuals receiving Social Security Disability benefits are entitled to Medicare coverage after 24 months
Resources (Assets) are not a factor for Social Security eligibility

28. Social Security Work Incentives
Trial Work period
Extended Period of Eligibility
Continuation of Medical Coverage
Impairment Related Work Expenses (IRWE)
Ticket to Work (TTW)
Subsidies and Special Conditions

29. Medicare Part A covers hospital expenses. Deductible is $1288
Part B covers 80% of the doctor expenses after deductible of $166 for the year. Premiums are $ per month
Part C is Medicare advantage plan. These include Medicare managed-care plans, PPO’s, fee for service plans and specialty plans.

30. Medicare Part D covers a major portion of prescription drug costs
Monthly premium is about $34
Extra help to pay premium, deductible and co-pays for Part D available for qualified Medicare beneficiaries through Social Security

31. Need More Information?
Go to Social Security website at:
Call Social Security Monday through Friday from 7:00 am-7:00 pm

32. Need More Information?
Go to Medicare’s website at : or
Call Medicare at MEDICARE ( ) This is a 24/7 number.

33. Thank You!