If you think your child has a disability that should qualify for SSI, but your child's physical or mental condition doesn't meet or equal the requirements of a listing from Social Security's "blue book" of disability listings, your child could still be found eligible for SSI disability benefits if he or she "functionally equals the listings." To functionally equal the listings, your child must have an impairment or impairments that are at the same level of severity as impairments found in the listings.
For a child's condition to be considered functionally equal to the listings, your child must have "marked" (severe or serious) limitations in two of six areas of functioning or one "extreme" limitation.
A marked limitation seriously interferes with your child's ability to initiate, sustain, or complete independent tasks. Social Security will look at your child's day-to-day functioning to determine their level of limitation. It is possible for your child to have a single limitation that seriously interferes with their daily lives or have a combination of limitations that seriously limits their functioning.
An extreme limitation is a limitation that very seriously interferes with your child's ability to initiate, sustain, or complete independent tasks. This does not mean that your child must have a total loss of ability to function in one of the areas of functioning; it may be enough to have very serious interference with independently completing an activity. This may become clearer as we explain the areas of functioning below.
There are six areas (called domains) of functioning that Social Security looks at when determining whether or not your child's impairments are functionally equivalent to the listings. These six domains are intended to cover everything that your child can and cannot do. The six domains are described below.
This domain focuses on your child's ability to learn. From birth, children learn from their environment and develop skills by absorbing what is going on around them. As children grow, their ability to communicate shows how they are using the things they have learned. As they attend school, children should be able to demonstrate their ability to learn and use new information through academics, specifically reading, writing, and math. As children grow older, skills learned at school and at home should translate into skills that can be used in the community and at jobs.
Some examples of marked or extreme limitations in acquiring and using information include:
This domain focuses on your child's ability to focus and maintain attention and to start and finish activities at a pace that is normal for children of the same age. As children grow, so should their ability to maintain their attention and complete tasks. During the time they are at school, children should grow in their ability to follow directions, maintain organization of their school material, and complete assignments. This attention should also be carried over to activities outside of school, like home chores and organized activities.
Some examples of "marked" or "extreme" limitations in completing tasks include:
This domain focuses on your child's ability to start and respond to exchanges with other individuals, both socially and for practical purposes. Speech is a big component of this category; others should be able to understand your child most of the time. Close personal relationships with family and friends of the same age should also develop as your child ages, as well as the ability to resolve conflicts with those people. Your child should be increasingly able to express emotions, respond to others' emotions, and understand and respect others' viewpoints. Your child should be aware of and respect the different social rules that exist in different environments (for instance, what is acceptable to do at home as opposed to at school).
Some examples of "marked" or "extreme" limitations in social interactions include:
This domain focuses on how children get physically from one place to another and how they move and handle objects. The expected physical ability of your child ranges with your child's age. As an infant, your child should be able to hold their head up, sit, crawl, and stand while holding onto an object. As the child gets older, he or she should be able to walk and run without assistance, climb stairs, and use playground equipment independently. Fine motor skills, such as using a pencil, moving small game pieces, and using scissors to cut, should also be present. As children get to school age, they should be able to physically keep up with others their age and show proper hand-eye coordination.
Some examples of "marked" or "extreme" limitations in motor abilities include:
This domain focuses on children's ability to take care of themselves both physically and mentally. Specifically, as children grow they should become increasingly independent with regards to making their own decisions. They should also be able to differentiate between right and wrong and understand what types of behavior is acceptable and what is not. Children should understand what their physical and emotional needs are and how to effectively control their thoughts and urges to maintain their wellbeing. Physically take care of themselves on a day-to-day basis is essential, as well as the ability to plan for the future to ensure their wellbeing.
Some examples of "marked" or "extreme" limitations in caring for yourself include:
This domain focuses on everything not covered in the "caring for yourself" section. Social Security looks at the effects of your child's impairments and treatment on your child's ability to function physically. The frequency of flare ups from your child's impairment and the time spent in the hospital for each flare up are looked at, if applicable. The more frequent the flare ups and longer the hospital stays, the more severe the impairment is considered.
Some examples of "marked" or "extreme" limitations in health include:
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