Social Security evaluates disability differently for children than for adults.

For adult disability cases, the primary focus is on whether or not the person’s medical impairments are severe enough to prevent full-time employment.

For children’s SSI cases, the focus is on their activities in six broad domains of functioning.

In children’s cases, in order to determine disability, the decision maker must decide whether the child’s impairments meet or functionally equal one of the impairments listed in social security’s regulations.

First, the focus is on how appropriately, effectively and independently the child can function in comparison with children of the same age without any impairments.

Next, the focus is on rating the level of the child’s functioning in each of the six “domains”. These domains are:

1) Acquiring and using information,

2) Attending and completing tasks,

3) Interacting and relating with others,

4) Moving about and manipulating objects,

5) Caring for yourself, and

6) Health and physical well-being.

These six domains are set forth in the Code of Federal Regulations at 20 CFR 416.926a(b)(1).

In order to functionally equal one of the listed impairments, the child must have “marked” limitations in two or more of the six domains, or “extreme” limitations in one or more of the domains.

The domain of health and physical well-being is different from the other five domains. It relates to the cumulative effect of a child’s physical and mental impairments on his or her physical health. The other domains relate to the child’s abilities.

In the domain of health and physical well-being, social security looks at symptoms such as dizziness, fatigue, shortness of breath, allergic reactions, recurrent infections, nausea, reduced stamina, and so forth.

They will look at the consequences of treatments, such as side effects of medications and recovery time from intensive therapies.

Of course, a child’s impairments may affect more than one domain. Social security will consider the effects of impairments on all of the domains — this is not considered “double weighing.”

Some examples of limitations in the domain of health and physical well-being are:

Generalized symptoms (such as tiredness that accompanies depression),

Somatic complaints related to an impairment (such as epilepsy),

Chronic medication side effects (such as dizziness),

The need for frequent treatment ,(such as multiple surgeries or chemotherapy),

Periodic exacerbations (such as pain flare ups in sickle cell anemia), and

The need for intensive care as a result of being medically fragile.

See Social Security Ruling (SSR) 09-8p.

The rules for children’s SSI cases can be tricky and it is often helpful to consult an experienced attorney in such cases, rather than attempting to go it alone.

This material should not be construed as legal advice for any particular fact situation, but is intended for general informational purposes only. For advice specific to any individual situation, an experienced attorney should be contacted.