In determining children’s SSI disability cases, social security looks at whether a child is engaged in substantial gainful activity. If not, the next step is to determine if the child’s medical impairments meet or medically equal one of social security’s listings of impairment. This means the child has “marked and severe” limitations.
If the child does not meet or medically equal one of the listings, social security will look at whether or not the child has functional limitations that are “marked” or “extreme”, or “functionally equivalent” to one of the listings.
Unlike in adult disability cases (see Social Security Ruling (SSR) 96-6p), an updated opinion from a medical expert is not necessary in order for an Administrative Law Judge to determine medical or functional equivalence to one of the listings.
In making this determination, social security looks at six broad domains of activity, which are meant to encompass all of a child’s activities, whether at home, at school, or in the community. These six broad 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
Functional equivalence is established if the child has “marked” limitations in two domains or “extreme” limitations in one domain.
However, before considering the domains, social security will look at all of the child’s activities. They will then decide which, if any, of the activities are limited and which domains may be affected by those limitations. They will look at which medical impairments may account for those limitations.
Because social security looks at all of a child’s activities, this is called the “whole child” approach.
On determining a child’s functioning, social security will compare the child’s activities with those of children of the same age without an impairment.
Some activities require abilities in more than one domain. Social security will look the child’s functional limitations across all domains.
An example of an activity that requires two or more abilities is tying shoes. This involves learning and remembering the sequence for something, and thus impacts the domain of acquiring and using information. It involves focusing and attending to the task at hand, thus impacting the domain of attending and completing tasks. It involves using hands and finger, thus impacting the domain of moving about and manipulating objects. It involves taking responsibility for getting dressed, thus impacting the domain of caring for yourself.
See Social Security Ruling (SSR) 09-1p.
Well, that’s a wrap for my eight-part summary of the Social Security Rulings that came out in 2009 regarding childhood SSI cases. I know much of the information is repetitive, but after all, that is the mother of learning.
If you have any questions about a childhood disability SSI case, please feel free to contact me anytime.
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.