Sensory Processing Disorder (SPD) and Social Security Disability Benefits

by Molly Clarke
(Boston, MA)

Applying for Disability Benefits for a Child with a Sensory Processing Disorder

Sensory Processing Disorder (SPD) is a condition that is characterized by a person’s inability to interpret sensory information correctly. SPD affects everyone differently. Some children with SPD may under-respond to stimuli. A child who experiences this may not register extreme temperature or pain. Other children with SPD may over-respond to stimuli to the point where loud sounds or even light touches may cause extreme discomfort.

In extreme cases, a child can be extremely limited by SPD. While there are different therapeutic methods used to treat or manage SPD symptoms—they aren’t all covered by insurance. Costs for therapy, medical attention, and specialized education can quickly pile up. Unfortunately, not all families are able to cover these costs.

If you are the parent of child who has SPD and find that you cannot afford to provide adequate support for his or her special needs, you may qualify for Social Security Disability (SSD) benefits on your child’s behalf.

The following article contains helpful information geared toward families interested in applying for SSD benefits on behalf of a child with SPD.

Technical Requirements

The Social Security Administration (SSA) offers two forms of disability benefits—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI is a type of insurance program that provides benefits to the workers who pay into the program. The only way a child can qualify for SSDI is if a parent or guardian currently receives benefits from this program.

More likely, a child under the age of 18 will qualify for SSI. SSI is a needs-based benefit program that provides assistance to disabled or elderly individuals. To qualify for this program, applicants must meet certain financial criteria. When applying on behalf of a child, a certain amount of the parent or guardian’s income will be allocated to the child. This is called parental deeming. Learn more about the parental deeming and SSI financial requirements, here: http://www.disability-benefits-help.org/blog.

Medical Requirements

In addition to meeting financial requirements, your child must also meet certain medical requirements to qualify for SSI. These criteria can be found in the SSA’s blue book. Essentially, the blue book is a manual of potentially disabling conditions. Under each blue book condition is a list of very specific medical criteria that an applicant must meet to qualify for disability benefits.

Unfortunately, SPD is not listed among the blue book conditions. However, this does not mean that your child will not qualify for financial assistance. If your child’s SPD occurs as a result of or in addition to another condition he or she may qualify under that listing.

If your child doesn’t have another diagnosis, they may still be able to qualify if they can match the criteria of a separate but similar listing. Conditions that are sometimes linked with SPD include, but are not limited to, Autism Spectrum Disorders, Schizophrenia, Post-Traumatic Stress Disorder, ADHD, and Obsessive-Compulsive Disorder. If your child has SPD and/or one of the previously mentioned conditions, he or she may qualify for SSI under one of the following listings:

• 112.00- Mental Disorders
• 112.03- Schizophrenic, Delusional (Paranoid), Schizoaffective, and other Psychotic Disorders
• 112.06- Anxiety Disorders
• 112.10- Autistic Disorder and Other Pervasive Developmental Disorders
• 112.11- Attention Deficit Hyperactivity Disorder

You can read the specific criteria for each of these listings, here: http://www.socialsecurity.gov/disability/professionals/bluebook/112.00-MentalDisorders-Childhood.htm

If your child does not match any blue book listings, the SSA will evaluate five areas to determine whether or not your child is disabled. These include your child's ability to:

• Attend and complete tasks
• Interact and relate with others
• Move about and manipulate objects
• Care for personal needs
• Have good health and physical well-being

If your child has marked limitation in two of these areas, they may qualify for SSI. If they have extreme limitation in only one area, they may also qualify.

Preparing for a Disability Claim

To prepare for the application process, you should collect all of your child’s relevant medical records. If your child meets or matches a blue book listing, be sure to collect medical evidence that demonstrates the listed criteria. If your child does not meet a blue book listing, collect medical evidence that demonstrates limitations in five areas that the SSA will evaluate. This may include clinical histories, lab results, treatment histories, and written statements from treating physicians and other related professionals.

Applying for Social Security Disability Benefits

The initial SSI application for a child is comprised of two forms and a mandatory interview. It is important that you schedule your interview as soon as possible. There may be several months before the next available appointment so the sooner you call, the sooner you will be able to submit your child’s application.

Once you complete your interview and submit your application, you should be prepared to receive a denial. Although you may not be denied, you should still know how to proceed in case you are. Should your child’s claim be denied, you will have 60 days to appeal this decision.

While the application process may seem overwhelming at times, it is important that you stick with it. Once you are awarded benefits you will be able to provide for your child’s needs and spend less time worrying about your finances.

For more information about applying for disability benefits, visit Social Security Disability Help (http://www.disability-benefits-help.org/blog) or contact Molly Clarke at mac@ssd-help.org.