ADHD: Attention Deficit Disorder & Social Security Disability or SSI
To be considered for disability, a child must have measurable functional deficits in school or be receiving special education.
Attention deficit hyperactivity disorder (ADHD) is a problem some people have with inattentiveness, impulsiveness, and/or hyperactivity. When the problem is predominantly an issue with attention span rather than hyperactivity and impulsivity, it is called attention deficit disorder, or ADD. Many parents apply for disability benefits through the Supplemental Security Income (SSI) program for their child who has been diagnosed with ADHD, in the hopes that they will receive a monthly check to help with care for the child and living expenses. But most children who have been diagnosed with ADHD or ADD will not be granted SSI disability benefits. Only those with the most severe form of ADHD have any hopes of getting benefits.
When Can a Child With ADHD Get Disability?
If the severity of your child’s ADHD meets the Social Security Administration’s impairment listing for Attention Deficit Hyperactivity Disorder, your child will be granted benefits. The disability listing is listing 112.11 of the Children’s Listings, and it indicates the following:
Your child must have all three symptoms of ADHD: severe inattention, impulsiveness, and hyperactivity. These symptoms must cause limiting "conditions resulting from ADHD." There are actually two sets of conditions, one for children under three, the other for children 3 to 18. For children 3-18, to receive SSI disability benefits based on ADHD, they must have severe difficulty compared to other children of their age in at least two of the four following areas, resulting from ADHD:
- cognitive or communicative functions
- social functioning
- personal functioning, or
- concentration, persistence, or pace.
For each of these conditions resulting from ADHD, there must be supporting documentation. Supporting documentation includes:
- medical findings, such as treatment notes written by a doctor, mental health professional, or staff professionals at a mental health facility.
- historical information from parents and teachers, such as teacher reports and evaluations.
- results of standardized testing, such as achievement testing and IQ testing.
Children under three have such a limited chance of approval based on the ADHD disability listing that we won't go into detail. The requirements are similar, but are based on having development in most of the above areas, plus the area of gross and fine motor development, that is usually found in children half the child’s chronological age or younger.
Children can qualify for disability benefits only through the SSI program, which has strict income and assets limits. A child's parental income will be partly counted toward the limit. In addition, older children may not earn more than $1,130 per month at a job (as of 2016). For more information, see our section on SSI eligibility.
How Difficult Is It to Get Benefits for ADHD?
In all candor, it is quite difficult to get disability for ADHD. Part of the problem with winning disability approvals for ADHD has to do with the subjective nature of how the Social Security Administration evaluates ADHD. Exactly how are ADHD claims evaluated? As with every claim for disability, a disability claims examiner at DDS (Disability Determination Services) reviews a claimant's medical records and then, after speaking with an in-house medical consultant, makes a decision on the case.
With ADHD claims, however, the DDS consultant is not a medical doctor, but, rather, a Ph.D. level psychologist (although, at times, the DDS consultant will be a psychiatrist). To a large extent, psychological consultants at DDS do exactly what their medical consultant counterparts do. They read a claimant's records and render a professional opinion--one which may or may not be in agreement with what the disability claims examiner thinks. (In instances where there is disagreement, it is left to the disability examiner to "rethink" his or her analysis of how a claimant's case should be decided.) However, unlike medical doctors who review the physical impairment claims, DDS psychologists rely greatly on the subjective observations of others, teachers primarily, to determine if a child has an impairment and, if so, whether or not the impairment is mild, moderate, or marked (severe).
Observations of behavior, of course, are always open to interpretation, as opposed to objective clinical observations, such as heart rate and blood pressure readings. The short-comings of this kind of system are readily apparent: DDS psychologists develop an opinion about a claimant's Social Security claim based on the recorded opinions of other individuals, and then use that opinion to determine whether a claimant is eligible to receive disability benefits or not. In actuality, the only objective standards for evaluating ADHD disability claims are a student's school records and the results of standardized psychological testing. As a result, whether or not a child is found eligible for disability benefits almost always depends on their academics; that is, how they well they are doing in school.
Why Is the "School Work" Factor So Important in ADHD Claims?
How the child performs at school is important for the same reason that the ability (or inability) to work is so important in adult cases. (You may want to read our article about getting disability for ADHD as an adult.) The Social Security disability system is not really concerned with a claimant's diagnosed condition, but rather the effect that the condition has on a claimant's ability to engage in certain specific activities.
For adults, this means the ability to work while earning at least a certain basic amount. For children, this means being able to adequately perform age-appropriate activities, such as adequate functioning in school. Therefore, to win an ADHD disability claim, it is not simply enough to be given an ADHD diagnosis. A child must also have measurable functional deficits, in the context of school performance.
Social Security is flooded with SSI applications for children with ADHD, and most of them are denied. Only the most severe and well documented cases of ADHD are awarded benefits. To tip the scales in your favor, read our article on factors that can affect the disability decision for ADHD. Most importantly, you should consider hiring a disability representative. Those who hire a lawyer to appeal a denial of benefits for ADHD have a higher approval rate than those who don't, because disability lawyers know how the system works. You can contact a disability lawyer for a free consultation here.
Written by: Tim Moore, former Social Security disability claims examiner