When a Child Receiving SSI Disability Becomes an Adult: Age 18 Redeterminations

Generally, when children who receive Supplemental Security Income (SSI) disability benefits turn 18, Social Security will reevaluate them as adults. The "age 18 redetermination" takes place because Social Security assesses disability differently for adults and children.

Because of the differences in the disability criteria, there's a chance your child could lose SSI benefits after an age 18 redetermination. This article will discuss the differences in Social Security's disability criteria for children and adults and how the age 18 redetermination process works—including some special considerations Social Security uses to ensure fairness.

Transitioning from Children to Adult SSI Requirements

The requirements for evaluating a child versus an adult are similar, but not the same. Social Security's list of impairments (the Blue Book) explains what it takes to be considered disabled for each listed condition. Both adults and children can qualify for benefits by meeting or equaling a specific listing.

But the Blue Book contains two lists—one for adults and another for children. For many conditions, the criteria needed to meet a listing differ somewhat between the two lists.

And both children and adults can sometimes qualify for disability benefits without meeting or equaling a listing. Children can qualify for SSI if Social Security finds their daily functioning limited (called being "functional equivalent" to the listings).

For children granted SSI benefits this way, the assessment will change when turning 18 because they must now meet the adult criteria. And the adult criteria is based on the ability to do work activities—that is, being able to function in the workplace.

This difference is due to the different expectations placed on children versus adults—children generally aren't expected to work to support themselves, while nearly all adults are. So, an adult evaluation focuses on the ability to work, while a child's evaluation focuses on functional limitations.

SSI's Age 18 Redetermination Process

If your child's been getting SSI benefits and is turning 18, you'll receive a written notice from Social Security that it's time for a redetermination. The letter will explain that, to keep getting Social Security benefits after turning 18, your child must be reevaluated using the adult disability standards. The age 18 redetermination process has four basic steps:

1. You and your child will have an eligibility interview with a Social Security representative at your local field office (in person or by phone). The representative will fill out the necessary redetermination forms during your interview.
2. Your child's non-medical eligibility will be reevaluated (including your current residency, income, and resources).
3. DDS (your state's disability determination services office) will conduct a medical evaluation of all your child's current impairments (which could include a consultative exam).
4. Social Security will issue a written decision (a new determination letter).

If Social Security finds that your child still qualifies for SSI, disability benefits will continue uninterrupted.

If Social Security determines your child no longer qualifies for SSI after turning 18, your child's benefits will end after a two-month grace period. But you can appeal a denial of benefits after an age 18 redetermination.

Meeting or Equaling a Listing as a Young Adult

Children who were receiving SSI because they met or equaled the requirements of a listing will likely also be able to meet an adult listing. The listings in the childhood Blue Book are quite similar to those in the adult Blue Book, often using the same language.

But even where they differ, the listings are intended to be equally severe. So if your child's condition still meets the requirements of the childhood listing, your child's condition will usually meet the adult disability listing too.

In some cases, an impairment is listed in the childhood Blue Book but has no corresponding adult listing. When that happens, you'll need to show Social Security that your child can't work because of their limitations.

SSI and Turning 18: Functional Equivalency vs. Inability to Work

Not every child was granted SSI benefits because they met a listing. Some children qualified for disability benefits because they were found to have limitations that were functionally equivalent to the listings. This means they had marked or severe limitations in areas like learning and using information or focusing on and completing tasks. (Read more about how the SSA decides whether a child has impairments that are functionally equivalent to the listings.)

Children who don't meet an adult listing can continue receiving SSI benefits after turning 18 by getting a "medical-vocational allowance." Instead of considering a child's ability to function at home or school, the medical-vocational allowance focuses on a person's ability to function in the workplace.

Social Security determines whether an adult can work enough to earn a living using a Residual Functional Capacity (RFC) assessment. Your child's RFC will be based on both exertional and non-exertional functional limitations.

For disabled children turning 18, the normal assessment done for adults might not fully explore their level of impairments. Social Security recognizes the differences between children turning 18 and adult SSI applicants and gathers information for assessing a young adult's limitations differently.

What Social Security Considers at an Age 18 Redetermination

As part of an SSI age 18 redetermination, Social Security will try to determine your child's potential to work and earn a living. The agency will assess their ability to work based on the following:

• Functioning in educational programs. Social Security will look at how your child did in educational programs, including school, because impairments found here will likely translate into difficulties in the workplace. Social Security will consider issues like:
  
  • difficulty paying attention in class
  • trouble interacting with other classmates, and
  • physical limitations noted in the classroom.
• Community experiences, including on-the-job training and work experience (including volunteering). Social Security will look at how your child performed in the community, including any disability-related accommodations or support the child needed. Social Security will also consider the following:
  
  • treatments your child received during this time (including medications), and
  • the effects of the treatment, both good and bad.
• Work-related stress. Social Security will consider statements about your child's ability to handle stress in the community (from sources familiar with the young adult).

All of these factors will help Social Security to get a better picture of how your child will be able to manage in a work environment.

Evidence Used for an SSI Age 18 Redetermination

The evidence that's used for children turning 18 is somewhat different from the evidence used in adult cases. In addition to medical records that can provide the medical evidence and reasoning behind your child's limitations, Social Security needs to know how those medical issues impact your child's abilities. To get a clearer picture of your child's abilities, the agency will also consider the opinions of people who know your child well.

Doctors' statements. Social Security will consider the opinions of the doctor(s) treating your child regarding the severity of your child's impairments and how those impairments affect your child's ability to do work.

Statements of other health care professionals. Statements from certain other health care professionals wouldn't always be considered by Social Security for an adult redetermination. But for a child turning 18, the agency will consider opinions from the following:

• physical therapists
• occupational therapists
• chiropractors
• social workers, or
• other individuals who provide some level of medical care to the child.

Social Security will consider these providers' opinions about your child's impairments and their effects on the child's ability to work. These opinions carry more weight in the age 18 redetermination because they can offer important insight into how your child will adapt to a work environment.

For example, a physical therapist could talk in depth about a child's physical limitations and how such limitations could hinder the child's ability to perform certain job tasks.

Observations of family and friends. Social Security will also consider statements from those who have contact with your child on a regular basis, including:

• you (the parents)
• family friends, and
• others close to your child.

The people who know your child best can provide strong insight into the severity of the child's impairments and the impact those impairments have on your child's level of functioning. You and others who are close to your child might see struggles and limitations that aren't evident to those who only see your child on particular occasions.

Statements from school programs, including teachers' evaluations. The people who work with your child in school programs on a daily basis can often provide information that's not otherwise available. If your child still has an Individual Education Plan (IEP), that will be considered as well. (And just because children meet their IEP goals doesn't necessarily bar them from continuing to receive disability benefits.)

Keeping SSI After Turning 18 Under a Section 301 Exception

If an age 18 redetermination finds that your child doesn't meet the adult requirements for disability, your child might be able to keep getting SSI under what's called a "Section 301 exception." To qualify for continued payments under Section 301, both of the following must be true:

• Your child is currently participating in an appropriate vocational rehabilitation program or similar service that started before the month the child's benefits end, and
• Social Security must agree that continued participation in the program will increase your child's likelihood of becoming self-sufficient (and thus, will no longer need disability).

If your child's in a qualifying program, SSI benefits will continue until the child leaves the program. Some of the kinds of vocational rehab programs that will qualify under Section 301 include the following:

• an individualized education program (IEP) (from age 18 through 21)
• Social Security's Ticket to Work program
• a vocational rehabilitation agency program that uses an individualized plan for employment (IPE)
• support services using an individualized written employment plan, and
• Social Security's Plan to Achieve Self-Support (PASS).

Disabled Adult Child Benefits Under SSDI

SSI isn't the only disability benefits program available to young adults who can't work because of a disability. Some adult children (18 or older) can get benefits through a qualified parent (including adoptive and step-parents).

If one of your child's parents is receiving Social Security disability insurance (SSDI) or retirement benefits, your disabled adult child might also qualify for benefits based on the disabled or retired parent's work record. To qualify for these "auxiliary benefits," your disabled adult child must:

• be over the age of 18
• be unmarried
• have a disability that began before age 22, and
• have a parent who currently receives Social Security benefits or was insured for Social Security benefits at the time of their death.

There are some advantages of getting SSDI benefits instead of SSI, including the following:

• no limit to the unearned income your child can receive
• no cap on the amount of resources (assets) your adult child can own, and
• a higher benefit amount than SSI.

(Learn more about getting SSDI benefits for your disabled adult child.)

Keeping Social Security Benefits After Turning 18

The SSI disability benefits your child receives are no doubt important to cover everyday expenses, but your child's continued eligibility for those benefits will always be redetermined upon turning 18. And Social Security will evaluate your child as an adult. Fortunately, Social Security understands that and considers anyone from 18 to 25 to be a young adult. So, to ensure fairness when deciding if a child's SSI disability benefits should continue or stop, Social Security provides a unique redetermination process for children turning 18.

_{Updated February 6, 2023}