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SOCIAL SECURITY DISABILITY (SSI)


AND

ADHD - Attention Deficit Hyperactivity Disorder

This information may help claimants with representation, as well as claimants who are not represented by an attorney or non attorney representative. Understanding how the Social Security Disability system works can make the difference between winning or not winning the continuing disability benefits and backpay to which a person is entitled. To win a claim for ongoing and past due benefits, claimants should learn about the disability process to improve their chances of winning.
In Social Security's Listing of Impairments manual there is a special section for ADHD, more specifically referred to as Attention Deficit Hyperactivity Disorder. The disability listing is 112.11, and it indicates the following:

Attention Deficit Hyperactivity Disorder: Manifested by developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity.

The required level of severity for this disorder is met when the requirements in both A and B are satisfied.

The "A" criteria is as follows.

A. Medically documented findings of all three of the following:

1. Marked inattention; and

2. Marked impulsiveness; and

3. Marked hyperactivity;

The "B" criteria for this listing has to do with "conditions resulting from ADHD" which a claimant must have for an ADHD case to be won. There are actually two sets of conditions, one for children under 3, the other for children 3 to 18.

We'll only discuss the "B" criteria for the latter group since children under 3 have such a limited chance of approval based on the ADHD disability listing.





Getting awarded social security benefits for ADHD


For children (3-18) to receive SSI disability benefits based on this disorder, they must---in addition to possessing 1. marked inattention, 2. marked impulsiveness, and 3. marked hyperactivity---have at least two of the three following conditions, resulting from ADHD:


1. Marked impairment in age-appropriate cognitive/communication function.

2. Marked impairment in age-appropriate social functioning.

3. Marked impairment in age-appropriate personal functioning.



For each of these marked impairments (conditions resulting from ADHD is a good way to think of them), there must exist supporting documentation.

Supporting documentation, of course, 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.
  • The results of standardized testing - such as achievement testing and IQ testing.

How difficult is it for a child to be approved for disability benefits under the Social Security Administration's ADHD listing?


In all candor, it is somewhat difficult.

Part of the problem with winning disability approvals based on this impairment 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 examiner at DDS (disability determination services) reviews a claimant's medical records and then, after speaking with an in-house 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, DDS will have on staff an M.D.--- a Psychiatrist---who performs essentially the same duties).

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 the assessment made by the disability examiner. (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 physical impairment cases, 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.

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 case based on the recorded opinions of other individuals and then use that amalgamated opinion to determine if a claimant is eligible to receive disability benefits...or not. In many people's eyes, this type of evaluation system has all the legitimacy of a rumor twice removed.

In actuality, the only objective standards for evaluating ADHD disability claims are as such: a student's school records and the results of standardized psychological testing.

And this bears out in nearly all instances. For whether or not a child is found eligible for disability benefits almost always depends on their academic status, i.e. how they well they are doing in school.





Why is the "school work" factor so important in ADHD cases?


It is important for the same reason that the ability (or inability) to work is so important in adult cases. 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 (the SGA income amount, which is currently $940.00 per month, gross). 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.

To win disability benefits from the Social Security Administration based on attention deficit, or ADHD, a child must have meaurable functional deficits, in the context of school performance.



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ATTENTION DEFICIT HYPERACTIVITY DISORDER




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