What Happens When a Child Receiving SSI Disability Turns 18

Generally, when minor children who receive Supplemental Security Income (SSI) disability benefits turn 18, Social Security will reevaluate them as adults. This is called a “redetermination,” and it happens because Social Security’s medical definition of disability is different for adults than it is for children. Even if your child medically qualifies for disability as an adult, they may no longer meet the financial criteria for SSI, a needs-based benefit.

Because of these key differences in getting disability as an adult, there’s a possibility that your child could lose their SSI benefits once they turn 18. If you’ve received a notice that your child will be undergoing a redetermination, it’s important to know what the adult requirements to receive SSI are and how you can show Social Security that your child is still eligible for disability benefits.

What Qualifies You for SSI at 18?

The major difference between qualifying for SSI as an adult versus as a child is that Social Security can now evaluate your disability in the context of whether you can work or not. For children under 18, the agency takes into consideration factors such as their ability to hit developmental milestones relative to other children their age.

But once a child reaches 18, Social Security can assess their limitations as they pertain to the ability to work full-time—specifically, whether they have a medically determinable impairment that keeps them from performing substantial gainful activity for at least one year.

This difference is due to the different expectations placed on children versus adults—children aren’t expected to work to support themselves, while nearly all adults are. So, an adult evaluation focuses on their ability to work, while a child’s evaluation focuses more on their growth compared to their peers, how they’re doing in school, and how they’re developing socially.

Childhood Listings vs. Adult Listings

Both children and adults may be found disabled if they meet the requirements of a listed impairment. Listed impairments are medical conditions that Social Security considers especially serious, so if your child has certain specific findings in their medical record, they can be found disabled by “meeting a listing.”

Adults can also meet a listing, although the criteria for the adult listings aren’t always exactly the same as those for the childhood listings. So even though your child met the requirements for a childhood listing, they may no longer meet the requirements of the adult listing for the same impairment. You can compare the relevant childhood listings with the adult listings, looking for any differences in criteria between the two. If you can provide new medical evidence showing that your child meets an adult listing, they have a better chance at keeping their benefits.

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.

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 an adult’s ability to function in the workplace. Social Security determines whether adults can work full-time by incorporating their exertional and non-exertional limitations in a short statement of restrictions called a residual functional capacity (RFC) assessment. Children who’ve just turned 18 can get disability if their RFC rules out even the most basic sedentary jobs.

How the SSI Age 18 Redetermination Process Works

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. Your state’s Disability Determination Services (DDS) 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.

Factors Social Security Will Consider 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. This includes any problems 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. This includes any treatments, such as medications your child received during this time, and any 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.

Medical and Educational Evidence Used in 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 support your child’s physical or mental limitations, the agency will also consider the opinions of people who know your child well, such as pediatricians and teachers.

Doctor’s statements are particularly persuasive to Social Security, especially those who’ve treated your child for a long time and who’ve seen how your child’s needs have changed as they’ve grown up. Other health care professionals, such as physical therapists or social workers, can also carry weight for an 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 provide in-depth details about how your child's physical limitations could keep them from performing certain job tasks.)

Social Security will also consider statements from people who’ve had contact with your child on a regular basis, including you (the parents or guardians), relatives, or family friends who are close to your child. The people who know your child best might see struggles and limitations that aren’t evident to those who only see your child on particular occasions.

Lastly, teachers and other educational professionals who work with your child in school programs on a daily basis can often provide information that’s not otherwise available. Teachers’ evaluations and Individual Education Plans (IEPs), will be considered in the age 18 redetermination. (And just because children meet their IEP goals doesn’t necessarily bar them from continuing to receive disability benefits.)

How Long Does an Age 18 Redetermination Take?

Social Security doesn’t provide agency data tracking how long age 18 redeterminations take, nor is there a hard deadline for DDS to conclude the redetermination. It’s probably fair to say that an age 18 redetermination takes about as long as any initial adult disability determination, meaning you can probably expect a decision in three to six months (depending on the workload at your DDS).

What Are Some Common Reasons SSI Benefits Are Terminated After an Age 18 Redetermination?

The most common reason why Social Security child SSI benefits end when the child turns 18 is that they don’t meet the adult medical definition of disability—that is, Social Security thinks that they can do some kind of full-time work. Other reasons why SSI benefits may end after age 18 is that the child doesn’t financially qualify for SSI any longer or that they didn’t respond to Social Security’s requests for additional information.

How to Keep SSI After Your Child Turns 18 Using a Section 301 Exception

If, after an age 18 redetermination, Social Security 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 therefore 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 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 this dependents’ benefit, 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.)

Do I Need Legal Help for My Child’s Age 18 Redetermination?

It’s unlikely that you’ll need to get legal help for the redetermination process unless you want to appeal a cessation of benefits. In that case, it might be a smart move to get a consultation with an experienced disability attorney. Many offer free consultations, so it doesn’t hurt to ask around to find a lawyer who could help you reinstate your child’s disability benefits (or explore other options, if necessary).