F.Fraud and Other Crimes

86  |  NOLO’S GUIDE TO SOCIAL SECURITY DISABILITY



file and redo the determination, ignoring

the false information.

It is a crime to do any of the following:

• furnish false information in connection

with your Social Security records or to

obtain someone else’s records

• use an SSN obtained through false

information

• use someone else’s SSN

• disclose or force the disclosure of or use

an SSN in violation of U.S. law

• forge or falsify SSA documents

• conspire over a false claim

• knowingly buy, sell, or alter an SSN

card, or

• process an SSN card or counterfeit an

SSN card.

Civil penalties can also be imposed for

fraud. In 2006, Public Law 108-203 was

amended to impose civil penalties (up to

$5,000 per occurrence) for not notifying

the SSA of changed circumstances that

affect eligibility or benefit amounts.

These penalties apply when a person or

organization knew or should have known

that a withheld fact could affect benefits

and that the failure to come forward was

misleading. For example, penalties would



apply if an individual who has a joint bank

account with a beneficiary continues to

receive the beneficiary’s Social Security

checks after the beneficiary’s death, or if an

individual receives benefits under one SSN

while working under another SSN.

Civil penalties may also apply for

engaging in the following activities:

• selling services to the public that are

available for no cost from SSA, unless

clearly disclosing that fact

• converting a beneficiary’s benefit to a

third party

• claiming that your services are

endorsed by the SSA, including the

misleading use of SSA symbols or

emblems, and

• marketing products or services using

certain prohibited words (such as

“Death Benefits Update,” “Federal

Benefit Information,” “Funeral

Expenses,” or “Final Supplemental

Program”).

You should be aware of these changes

because they are meant to protect the

public, including Social Security disability

beneficiaries.



l



C H A P T E R



Disability Benefits for Children

A. Three Benefit Programs for Children......................................................................................88

1. SSDI Auxiliary Benefits for Children Under 18................................................................88

2. SSDI Benefits for Adults Disabled Since Childhood.....................................................89

3. SSI Benefits for Children..............................................................................................................90

B. Applying for SSDI or SSI Benefits...............................................................................................90

C. Disability Evaluation....................................................................................................................... 103

1. Disability in Children for SSI................................................................................................... 104

2. Disability in Adult Children for SSDI.................................................................................. 106

D. Continuing Disability Reviews for SSI Children............................................................. 107

E. Other Health Care Concerns..................................................................................................... 108

1.Medicaid............................................................................................................................................ 108

2. Children With Special Health Care Needs...................................................................... 108

3. Children in Certain Medical Care Facilities.................................................................... 108

4.Medicare........................................................................................................................................... 109



3



88  |  NOLO’S GUIDE TO SOCIAL SECURITY DISABILITY



A



bout 1,000,000 children receive

disability benefits from the Social

Security Administration (SSA).

This chapter is for the parents and caregivers

of children—generally considered to be

people under the age of 18—with disabilities,

and for the parents and caregivers of adults

who have been disabled since childhood.

Although some of this information

appears in other chapters, we bring it

together here to provide one place for

important information needed by caregivers

of children.

The person who handles the benefits on

behalf of a child is called, in Social Security

lingo, the representative payee, and must be a

responsible person. The representative payee

is usually a child’s parents.



CAUTION

The representative payee is not

the same as the authorized representative.

An authorized representative is any person,

including an attorney, named in writing by

the claimant/recipient, to act in place of the

claimant/recipient in pursuing his or her rights

under the Social Security Act.



You can use the information in this

chapter to understand the kinds of Social

Security Disability Insurance (SSDI)

and Supplemental Security Income (SSI)

available to an eligible child and to learn

how the SSA evaluates disability claims for

children.



A. Three Benefit Programs

for Children

There are three ways a child might be eligible

for SSDI or SSI benefits.



1. SSDI Auxiliary Benefits for

Children Under 18

Although this is a book about disability

benefits, children eligible for dependents’ or

survivors’ benefits need not be disabled. A

child is eligible for Social Security benefits

simply because he or she is the dependent of

someone receiving disability benefits or the

surviving child of someone who died while

receiving benefits.

Social Security dependents’ benefits are

available to unmarried children under the

age of 18 based on the record of a parent

who collects Social Security retirement or

disability benefits. Social Security survivors’

benefits are available also to children

under the age of 18 based on the record of a

deceased parent who was entitled to Social

Security retirement or disability benefits.

On the record means benefits are paid based

on the earnings record of someone else—

the insured worker who paid enough Social

Security taxes to qualify for SSDI benefits.

Parent means biological parent, adoptive

parent, or stepparent.

Child dependents’ and survivors’ benefits

are known as auxiliary benefits, because

they are based on the disability and earning

record of a parent, not a child’s disability.







CHAPTER 3  |  DISABILITY BENEFITS FOR CHILDREN  |  89



The theory behind the benefits is that

a disabled parent needs more money to

take care of dependent children, and that

a surviving spouse of a deceased disabled

worker needs more money to take care of

children.

A child found to be eligible for these

benefits can receive them until he or she

turns 18—or 19 if he or she is a full-time

student in elementary or high school. For

full-time students, twice a year—at the

beginning and end of the school year—the

SSA sends the student a form asking whether

he or she is still in school. The SSA may

terminate benefits if the student (or living

parent) doesn’t send back a completed form.

If the child turns 19 during a school term,

the SSA can continue the benefits for up to

two months to allow the student to complete

the term. Before turning 19, a student may

receive benefits during a vacation period of

four months or less if he or she plans to go

back to school full time at the end of the

vacation.

If the student leaves school, changes from

full time to part time, or changes schools,

the student or parent must notify the

SSA immediately. Also let the SSA know

if the student is paid by an employer for

attending school. A student over 18 who

stops attending school generally can receive

benefits again if upon returning to school

full time before age 19. The student must

contact the SSA to reapply for benefits.

If your stepchild receives benefits on your

earnings record, and you and the child’s



parent divorce, the stepchild’s benefit will

end the month following the month the

divorce becomes final. (This is not the case

with biological or legally adopted children.)

You must notify the SSA as soon as the

divorce becomes final.



2. SSDI Benefits for Adults

Disabled Since Childhood

Social Security dependents’ or survivors’

benefits normally end when a child reaches

age 18, or age 19 if the child is a full-time

student. If the young adult is disabled,

however, the benefits can continue as long

as the recipient is disabled.

The rules require both of the following:

• The disability began prior to age 22.

• The recipient is the child of someone

receiving Social Security retirement

or disability benefits or of someone

who was insured for Social Security

retirement or disability benefits but is

now deceased.

Someone who qualifies is said by the SSA

to be an “adult child,” or “adult disabled

since childhood.” Although most recipients

of these benefits are in their 20s and 30s,

the benefit is considered a “child’s benefit”

because of the eligibility rules.

Sometimes, a person doesn’t become

eligible for a disabled “child’s benefit” until

well into adulthood.

EXAMPLE: John retires and starts collecting



Social Security retirement benefits at age

62. He has a 38-year-old son, Ben, who has