Social Security disability cases filed on the basis of ADHD, or attention deficit hyperactivity disorder, can be hard to win, but it's not impossible. First, keep in mind that children can only qualify for SSI (Supplemental Security Income), not SSDI (Social Security Disability Insurance), and they must come from a low income household to qualify for SSI.
Parents who are convinced their children are disabled as a result of ADHD should keep several things in mind regarding the disability evaluation process and how ADHD cases are viewed and handled. For a child with ADHD to win benefits, it is not enough that the child displays behavior, at home and/or at school, that is indicative of hyperactivity and poor attention. And it is not enough to have been diagnosed with ADHD. It is also not enough to have been prescribed ritalin, or any other medication commonly prescribed for attention deficit problems.
To win disability benefits based on ADHD, in most cases it must be shown that the child is taking medication as prescribed and, despite this, is having significant difficulties with various age-appropriate activities—mainly grade-level school work. The following factors can make or break your child's case.
Because the disability listing for ADHD does not mention medication, whether or not a child is taking medication for ADHD should have little bearing on a disability case. In reality, however, disability claims examiners and administrative law judges (ALJs) always review medical records for indications of prescription drug use. Children have been diagnosed with ADHD but who have not been prescribed medicine might not be considered as affected by ADHD as those that have. (That said, if there is evidence that medication has improved the child's condition, the claims examiner or administrative law judge may find that the child is no longer sufficiently limited to qualify for SSI benefits.)
Social Security's Reasoning: How can a child's difficulties with ADHD be serious if no mental health professional considered the problem serious enough to warrant prescription medication?
Symptoms of "poor attention," "hyperactivity," and "inability to concentrate" written on an SSI application, paired with bad grades, are not enough to get a disability allowance for ADHD. Your child's medical records must have at least one diagnosis of ADHD for such a case to be seen as credible and this diagnosis should, ideally, be based on testing results.
However, an ADHD diagnosis by a family doctor or pediatrician will not usually hold weight with the Social Security Administration (SSA). An "untested" ADHD diagnosis by a family doctor or pediatrician may have little significance even if that doctor prescribes medication. The SSA wants to see that your child was tested for ADHD by a mental health professional, and that the mental health professional gave a diagnosis of ADHD.
Social Security's Reasoning: A diagnosis by a family doctor or pediatrician is not seen as credible, as many doctors diagnose ADHD and prescribe medication simply to satisfy concerned parents.
Have your child tested at school. While testing by a mental health professional can solidly confirm the existence of ADHD in a child claimant, school testing can serve another purpose. School testing can have the effect of determining whether or not a child will receive individualized attention in the classroom and/or be classified as a special needs student. Though the ADHD disability listing does not specifically mention this, both disability claims examiners and administrative law judges (ALJs) examine a child's medical records to see whether children with ADHD are in special or mainstream classes.
Social Security's Reasoning: If a school system does not believe a child's ADHD-related problems are significant enough to warrant special classes, why should a claims examiner or judge consider that child disabled?
Of course, other factors, as specified in the ADHD listing, do come into play for attention deficit claims, such as how well a child communicates, how well a child functions socially, and how well a child takes care of his or her personal needs (dressing, grooming, and related activities).
In the vast majority of disability claims filed for ADHD, the final determination will be based on how well a child does academically in relation to his or her peers, with significant attention paid to whether medication has been prescribed. If a child performs at grade level, it's difficult to make a strong case for awarding disability even though that child's behavior outside the classroom may be very problematic. Likewise, a child whose problems (social, communicative, or cognitive) are manifested only when a prescribed medication regimen is not followed will have a poor chance of winning disability benefits.
For more information and the details of the ADHD listing, see our article on getting disability for ADHD or ADD.