Evaluation of a Child's Functional Abilities for SSI Disability Benefits

Social Security uses medical evidence, interviews with friends and family, and school evaluations to determine how appropriately, effectively, and independently a child functions compared to other children who are the same age. (Read the first part of this article to learn about the domains of functioning that Social Security assesses.)

"Whole Child" Approach

To assess whether your child's impairments are functionally equal to the listings, Social Security looks at the "whole child," meaning the agency will take all of the child's limitations into consideration before making a decision regarding whether or not the child's limitations are functionally equal to the listings.

To determine a child's ability to function, Social Security will look at:

• what activities a child can and cannot do
• the limitations or restrictions the child has on his or her activities
• where the child is having difficulties, including at home, in school, and in the community, and
• any help that is needed to complete activities.

Evidence Used

Medical evidence that can be provided to prove the child's decreased functional abilities include:

• medical records
• reports from those who are with the children day to day, and
• comprehensive evaluations from early intervention and school programs, which can include:
  • assessments, both formal and informal
  • observations from teachers
  • interviews with teachers, parents, and others who interact with the child
  • standardized test results, and
  • individual education program (IEP) forms.

Social Security will compare the child's functionality to teachers' expectations of the child, to others with similar limitations (such as other children in special education classes), and to other children the same age who have no limitations.

Examples of Functionally Equivalent Impairments

Again, after considering the above evidence, Social Security will approve disability benefits based on functionally equaling the listing if your child has an extreme limitation in one of the area of functioning or serious limitations in two areas. Sometimes a condition that wouldn't be serious enough on its own to be disabling (for instance, childhood obesity) can help a child functionally equal the listings when combined with other limitations. Below are some examples of impairments that would qualify your child for disability benefits under the theory of "functionally equaling the listings."

• Your child is in need of a liver transplant (or any other major organ).
• Your child is unable to walk without the use of crutches for both arms.
• Your child is completely unable to function independently outside of the home due to severe autism.
• Your child requires full-time (24 hours per day) supervision due to a severe anxiety disorder.
• Your child weighed less than 2.65 pounds at birth (the child will be considered disabled until one year of age).

When Social Security Decides Functional Equivalence

It's unlikely that Social Security will come to the conclusion that your child's condition is functionally equal to the listings without this theory's being argued by a disability lawyer in a written brief. This means that to win under this theory, you would have to apply for SSI disability benefits for your child through Social Security, get denied, and hire a lawyer to represent your child in the appeals process. Before your hearing in front of an administrative law judge (ALJ), your lawyer would write a brief arguing that your child's physical or mental condition is functionally equal to the listings and submit it to the ALJ.

If your child has been denied SSI, consider hiring a Social Security disability lawyer to represent your child at the appeal hearing; when you interview the lawyer, discuss whether your child's condition might be functionally equal to the listings.

To learn more, check out our section on SSI Disability Benefits for Children.

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