1. Common Challenges With Supplemental Security Income (SSI)
Sarah Patience Fay, Esquire
Culbertson Law Group, P.L.L.C.

2. Background
In 2011, I earned my law degree from Barry University School of Law in Orlando. Directly out of law school, I started working for Culbertson Law Group, P.L.L.C.
I limit my practice to exclusively representing claimants seeking Social Security Disability benefits throughout all stages of the disability process.
I have successfully represented hundreds of claimants in their Social Security appeals to federal court.  I have also successfully briefed cases before the Eleventh Circuit Court of Appeals. 
In December 2016, I became a Board Certified Advocate in Social Security Disability by the National Board of Trial Advocacy. Currently, there are only 9 board certified Social Security attorneys in the state of Florida.

3. What is SSI?
It is a federal program designed to help aged, blind, and disabled people, who have little or no income; and
It provides cash to meet basic needs for food, clothing, and shelter.
This is generally the program that you would apply for if you have a disabled child.
In order to qualify, SSA must find that your child meets the medical requirements for disability and your family must meet certain financial requirements.

4. Disability Social Security’s definition of disability for children is:
The child must have a physical or mental condition(s) that very seriously limits his or her activities; and
The condition(s) must have lasted, or be expected to last, at least 1 year or result in death.
Essentially, it does not matter what your child is diagnosed with. SSA is looking at how the disability affects your child’s ability to function in comparison to other children his/her age.

5. Before You Apply
Gather as much information as you can related to your child’s impairments and treatment.
A good starting point is SSA’s SSI Child Disability Starter Kit.

6. How Do I Apply?
An application for SSI benefits can only be made in-person at a local SSA office or over the phone with the SSA administration.
You can complete a paper SSI application at home and then bring it to your local SSA office.
Please make sure to get a stamped copy as your proof of filing.
The paper application looks intimidating. It is 23 pages long. Fill out as much information as you can. Social Security will give you extra time to get any necessary missing information and in some cases, they will assist you in obtaining the missing information.

7. SSI Application

8. SSI Application

9. SSI Application

10. SSI Application

11. SSI Application

12. SSI Application

13. SSI Application

14. SSI Application

15. SSI Application

16. SSI Application

17. SSI Application

18. SSI Application

19. Child Disability Report
This report is completed when you file your application for SSI. It is a 14 page document that has you list all of your child’s medical providers and treatment.
You will need to list all of your child’s medications and any testing they have received.
You will need to provide your child’s school information. Please indicate in this section whether your child has an Individualized Education Plan (“IEP”) or a Section 504 Plan.
This is one of the first questions I ask when talking to a parent about filing a claim for SSI. This is usually one of the strongest pieces of evidence you can have in support for your claim for disability.

20. What happens after I apply?
Unfortunately, there is no time limit on Social Security to make a decision in your child’s claim.
After the application is submitted, Social Security will request any outstanding medical records you identified in your application. After this information is received, your child’s claim will be reviewed.
Compassionate Allowance List
Compassionate Allowances are a way to quickly identify diseases and other medical conditions that, by definition, meet Social Security's standards for disability benefits. These conditions primarily include certain cancers, adult brain disorders, and a number of rare disorders that affect children. The CAL initiative helps SSA reduce waiting time to reach a disability determination for individuals with the most serious disabilities. 

21. What happens if the claim is denied?
If the claim is denied, you need to file a Request for Reconsideration.
Social Security will obtain any updated medical records you identify and then make a new decision. Generally, most Requests for Reconsideration are denied.
If the Request for Reconsideration is denied, you need to file a Request for Hearing Before an Administrative Law Judge.
Be prepared for a long wait if you have to go to a hearing!
Currently, the wait time in the Orlando Hearing Office is approximately 24 months.

22. Hearing
The best chance to be approved for disability occurs at the hearing level.
You should try to find an attorney to help you present your case at the hearing.
Legal Aid is a good resource for assistance.
Obtaining the updated medical records is the most important thing to do prior to attending your hearing.
A lot can happen during the two years that you are waiting for your hearing date. Try and keep track of any doctors, hospitals, testing, therapies, etc. you attend during that time period.
If you do not have an attorney, the hearing office will provide you with a CD with your child’s entire file. REVIEW THE ENTIRE FILE!!!

23. Hearing What happens at the hearing?
Testimony
Outstanding Development
What kind of information does the judge want to know about?
How does your child function in comparison to other children their age?
6 Domains of Functioning
A child must have either an “extreme” limitation in one domain of functioning or two “marked” limitations in two domains of functioning.

24. Domains of Functioning
Acquiring and Using Information
Attending and Completing Tasks
Interacting and Relating with Others
Moving About and Manipulating Objects
Caring for Yourself
Health and Physical Well-Being

25. Acquiring and Using Information
In this domain, Social Security is evaluating how well a child is able to acquire or learn information, and how well a child uses the information he/she has learned.
Examples of documentation that can show limitations in this domain
IEPs
Report cards
Teachers’ observations
Standardized testing
Being held back a grade

26. Attending and Completing Tasks
In this domain, Social Security is evaluating how well a child is able to focus and maintain attention, and how well he/she is able to begin, carry through, and finish activities, including the mental pace at which he/she performs activities and the ease of changing activities.
Examples of documentation that can show limitations in this domain
IEPs
Report cards
Teachers’ observations
Standardized testing
Medication side effects

27. Interacting and Relating With Others
In this domain, Social Security is evaluating how well a child is able to initiate and sustain emotional connections with others, develop and use the language of the community, cooperate with others, comply with rules, respond to criticism, and respect and take care of the possessions of others.
Examples of documentation that can show limitations in this domain
504 Plans
Teachers’ observations
School discipline records
Detentions/suspensions
Police reports
Speech impairments

28. Moving About and Manipulating Objects
In this domain, Social Security is evaluating how well a child is able to move his/her body from one place to another and how a child moves and manipulates objects.
Examples of documentation that can show limitations in this domain
Neurological impairments
Musculoskeletal impairments
Physical deformities
IEPs
Teachers’ observations

29. Caring for Yourself
In this domain, Social Security is evaluating how well a child maintains a healthy emotional and physical state, including how well a child satisfies his/her physical and emotional wants and needs in appropriate ways.
Examples of documentation that can show limitations in this domain
IEPs
Limitations in the ability to feed, dress, toilet, or bathe self age-appropriately
Engaging in self-injurious behavior
Refusal to take medications
Baker Acts
Disturbances in eating or sleeping patterns

30. Health and Physical Well-Being
In this domain, Social Security is evaluating the cumulative physical effects of physical and mental impairments and any associated treatments or therapies on a child’s health and functioning that were not considered in the evaluation of the child’s ability to move and manipulate objects.
This domain addresses how recurrent illness, the side effects of medications, and the need for ongoing treatment affect the child’s health and sense of physical well-being.

31. After the Hearing
The judge will likely not make a decision at the hearing. Unfortunately, there is no time limit on them to issue their decision.
The average wait time used to be approximately 30 days. Currently, you can expect to wait at least 90 days to receive the written decision.
If the claim is approved, the local Social Security office will contact you to begin processing the payments.

32. If the claim is approved, what do I need to do?
Interview regarding finances, assets, and living arrangements
Payee and accounting
Notice of Award
Maximum monthly SSI payment is $750
Medicaid
Continuing Disability Reviews

33. If the claim is denied, what do I need to do?
You can file an appeal to the Appeals Council in Falls Church, Virginia.
At this stage, the issue is NOT whether your child is disabled.
The average wait time for this appeal used to be 18 to 24 months.
Currently, appeals are taking about 8 to 10 months to process.
The Appeals Council can deny the appeal, enter a favorable decision, or remand the case back the judge for a new hearing.
If it is denied, the claim can be appealed to the United States District Court.

34. 2017

35. Orlando Hearing Office
AVERAGE STATISTICS
Office
Judges
Avg. Hearing Wait Time
Average Processing Time
Dispositions Per Day Per ALJ
Cases Dismissed
Cases Approved
Cases Denied
Orlando 17
21.0 months
649 days
2.2
21%
47%
33%
Florida
18.9 months
624 days
1.9
22%
44%
34%
National Average:
17.3 months
577 days
43%
36%

36. Orlando Hearing Office
Hearing Wait Time:
21.00 months
Dispositions Per Day Per ALJ
2.24
Average Processing Time
649 days
Cases Pending
11127
Dispositions
2872
New Cases
2250
Hearings In Person
80%
Video Hearings
20%

37. Orlando Administrative Judges
Full Name
Dismissed
Approved
Denied
Judge Michael Calabro
16%
58%
27%
Judge Kevin J Detherage
38%
46%
Judge Kathleen H Eiler
34%
50%
Judge Jeffrey A Ferguson
20%
73% 7%
Judge Eric S. Fulcher
15%
44%
41%
Judge Pamela Houston
19%
42%
40%
Judge Emily Kirk
60% 0%
Judge Barry C LaBoda
29%
11%
Judge Bruce Landrum
12%
Judge Janet Mahon
23%
57%
Judge Maria T Mandry
62%
18%
Judge Angela L Neel
31%
Judge Julio Ocampo
25%
33%
Judge E Rodriguez-Quilichini
48%
Judge Emily R Statum
43%
Judge Pedro Tejada-Rivera
35%
53%
13%
Judge Douglas A Walker
51%
36%

38. Disabled Adult Child’s Benefit
If the parent is deceased or starts receiving retirement or disability benefits, their adult child may be eligible for Disabled Adult Child’s Benefits on their earnings record.
The adult child must go through the same adult five step sequential evaluation process to prove they are disabled; and
The adult child must prove their impairment was disabling prior to the age of 22.
This is why it is so important to establish disability sometime between the ages of 18 to 22.
The disability must be continuous.
Medicare coverage

39. General Tips
Remember, you are dealing with a governmental agency. If feasible, mail everything certified return receipt and keep copies of all correspondence with the agency.
SSA is underfunded and understaffed.
If you speak with a representative at Social Security, make sure to get their name and extension.
Do not be afraid to ask to speak to a supervisor.
You can ask SSA the same question ten times and receive ten different responses from ten different representatives. 
Reach out to Legal Aid or Community Legal Services for assistance.

40. References https://www.disabilityjudges.com/state/florida/orlando