Vol. 6, No. 1 Jan/Feb 1998	Previous Issues Subscribe to AT Messenger Download PDF Viewer
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Financing Assistive Technology

Recovering Kids’ Lost SSI Benefits:
The Advisability of Appeal

Ron Sibert, DATI Funding Specialist

Many families of children who have disabilities struggle financially due to the extra disability-related costs. Even inexpensive technology can be challenging for such families to obtain...even more so when the child is uninsured or when the devices simply are not covered by insurance. When family resources are limited, every dollar counts.

Until recently, the children’s Supplemental Security Income (SSI) program, an important Social Security benefit for youngsters with disabilities and their families, provided additional income to help pay for food, clothing, shelter, and some of those “extra costs” associated with caring for a disabled child. The average benefit amount is $436 per month, or $5,232 annually. Unfortunately, the program underwent significant changes with the passage of the Welfare Reform Act in August of 1996.

In order to qualify for benefits, children must now meet much more stringent disability criteria than they did before. The child’s disability must match or closely approximate (in terms of functional severity) one or more of those on the Social Security Administration’s list of allowable impairments. State disability examiners no longer can qualify children under a wide range of unlisted functional limitations (previously done through the Individualized Functional Assessment [IFA]). If the child fails to qualify for SSI benefits, Medicaid coverage also may be lost when the child does not qualify under other Medical Assistance Program eligibility categories (such as low family income).

The new federal regulations, which took effect in February of 1997, affected more than a quarter (263,000) of the estimated one million-plus children who were receiving SSI benefits at that time. According to Social Security Administration (SSA) estimates, more than half of those, or approximately 135,000 children, were expected to lose their benefits. In addition, they expected to deny half of the new cases reviewed during the six-month period following initial implementation of the changes.[1] When the rules were first executed earlier this year, some advocates were concerned that the SSA had significantly underestimated the number of children that would actually be affected. Since most eligibility redeterminations were to have been completed by August 1997, we can now take a retrospective look at the impact—and we’ll see that the advocates definitely had cause for concern. According to a recent article in the The New York Times, 236,586 children have been reexamined, and 142,395, or 60% of them, lost their disability benefits. In addition, 225,578 new claims, or 68% of those filed since August 1996, were denied.[2]

The good news is that many of these denials are being reversed on appeal. Benefits, including Medicaid, may be retained during the appeal process and restored with a favorable decision. The denials themselves appear to be a product of poor decision making and implementation by SSA employees. As a result, children have prevailed in 57% of the 10,508 appeals decided across the nation to date. The numbers are even more encouraging when we look at individual states. In Illinois, where Social Security officials terminated benefits for 8,625 children, or 70% of those reviewed through November 8th, children won back their benefits in 100% of the 799 cases filed for appeal. Similarly, children have regained benefits in 100% of the appeals decided in Michigan, 92% in Louisiana, 89% in New York, and 88% in New Jersey.[3]

The SSA has issued new forms which clarify points of misinformation, but they were not sent out until August, 1997—too late for many who had already lost benefits and/or missed their appeal deadlines. (Under normal circumstances, parents must file their disputes within 60 days after being notified of termination of benefits in order to appeal. They must file within 10 days of notification in order for benefits to continue over the period in which the appeal is being decided). Since there was no sure way to identify people who had lost benefits because of bad information, Social Security officials say that the agency probably will offer another chance to those who were cut from the rolls and did not appeal.[4]

If your child’s SSI benefits have been denied or discontinued, contact your local or national SSA office to explore your appeal options. If you suspect that the information you have been provided over the phone is inaccurate, request written clarification and/or a copy of the appeal policy itself.

The SSA’s national toll-free number is 1-800-772-1213. The locations and telephone numbers of the local county offices are:

New Castle:
92 Reads Way
New Castle, DE 19720
323-0304

Kent
300 South New St. (voice)
Dover, DE 19901
674-5262 (voice)

Sussex
600 N.DuPont Hwy.
Georgetown, DE 19947
856-9620 (voice)

People using telecommunication devices for the deaf/text telephones may call: 1-800-325-0778 (weekdays 7 a.m.-7 p.m.)

Social Security information is also available to Internet users at the following address on the World Wide Web: http://www.ssa.gov

References:

1. Children’s SSI: New Rules for the Children’s SSI program, Tech Express, Spring, 1997

2. Disabled Youths are Wrongly Cut from Aid Program, The New York Times, November 16, 1997

3. Ibid.

4. Op. Cit.