Generally, when children who receive Supplemental Security Income (SSI) disability benefits turn 18, they must be reevaluated as adults in what's called a redetermination, or sometimes an "age 18 redetermination." The way Social Security assesses adult applications for disability is different than how they assess children. Sometimes this can result in a loss of benefits, but Social Security does make some special considerations for this situation to ensure fairness.
The requirements for evaluating a child versus an adult are similar. Adults and children can each qualify for benefits by meeting or equaling a specific listing. But for children who qualified for SSI because their functioning in six domains was inadequate (called being "functionally equivalent to the listings in severity"), the assessment will change. Adults who don't meet a listing are granted disability benefits if their physical or mental limitations affect their ability to do work activities (called a medical-vocational allowance).
This difference is due to the different expectations that are placed on children versus adults; the adult element focuses on work, while the child requirements focus on functioning level. This is done because most children are not expected to work to support themselves, while nearly all adults are. Below are the three elements that can be used to qualify for disability benefits for children and adults.
Below is a comparison of how these elements are evaluated for children and adults.
For children who were receiving SSI because they met or equaled the requirements of a listing, there is a strong likelihood that they will be able to do so with the adult listings. The childhood listings are generally the same as the adult listings, often using the same language, but even where they differ, the listings in the "Childhood Blue Book” and the "Adult Blue Book” are intended to be equally severe. Therefore, childhood impairments that still exist as the child turns 18 and become adults generally transfer into adult impairments that meet disability listings.
In some cases, there is a child's listing for an impairment but no corresponding adult listing. One example is for anorexia and other eating disorders. There is a child's listing for eating disorders, but no adult listing. In that case, the 18-year-old will need to be granted a medical-vocational allowance for eating disorders to continue to receive disability benefits.
As mentioned, there are children who qualified for SSI not because their condition met or equaled a listing but because it was found to be functionally equivalent to the listings. This means that they have marked or severe impairments in at least one aspect of their functioning. As adults, these children who don't meet a listing need to be able to show that they are unable to work in order to get a medical vocational allowance.
Social Security determines inability to work by using a Residual Functional Capacity (RFC) to assess the applicant's exertional and non-exertional limitations.
For disabled children who are turning 18, the normal assessment done for of adults may not fully explore their level of impairments. Social Security realizes this and gathers information for assessing young adults' limitations differently.
For children turning 18, Social Security will look at the following areas to assess their ability to work.
All of these factors will help Social Security to get a better picture of how the child will be able to manage in a work environment.
The evidence that is used for children turning 18 is different from the evidence used in adult cases. In addition to medical records that can provide the medical evidence and reasoning behind a child’s impairments, Social Security needs to know how such medical issues impact the child’s abilities. The sources of evidence Social Security uses for children turning 18 includes the following.
Social Security understands the differences between children just turning 18 and those who are already adults. The agency considers anyone from 18 to 25 to be a young adult. It is because of the similarities between older adolescents and young adults that the agency provides unique assessments to gain a full picture of the young adults and their impairments before deciding whether they are able or unable to work any job and thus that their benefits should be continued or discontinued.