Elder Law

Social Security?s New Rulings Clarify How The Agency Determines Childhood Disability Under the ?Functional Equivalence? Rule

By dvanar

On February 17 and 18, 2009, the Social Security Administration (SSA) issued a series of eight Social Security Rulings clarifying and updating the SSA’s process for determining childhood disability under the “functional equivalence” rule. The functional equivalence rule is used to determine if a child meets the SSA’s definition of “disabled” when a child does not have a specific impairment listed in the SSA’s official Listing of Impairments. (Social Security?s Listing of Impairments contains a list of illnesses and impairments which SSA finds acceptable to base an award of disability benefits.)

Specifically, a child who applies for Supplemental Security Income (SSI) benefits from the SSA is ??disabled?? under the law if the child is not engaged in substantial gainful activity and has a medically determinable physical or mental impairment or combination of impairments  that result in ??marked and severe functional limitations.?? This means that the impairment(s) must meet or medically equal a listing in the Listing of Impairments, or functionally equal the listings (also referred to as ??functional equivalence??). To functionally equal the listings, an impairment(s) must be of listing-level severity; that is, it must result in ??marked?? limitations in two domains of functioning or an ??extreme?? limitation in one domain. Domains are broad areas of functioning intended to capture all of what a child can or cannot do. SSA uses the following six domains:
(1) Acquiring and using information,
(2) Attending and completing tasks,
(3) Interacting and relating with others,
(4) Moving about and manipulating objects,
(5) Caring for yourself, and
(6) Health and physical well-being.

SSA always evaluates the ??whole child?? when the agency makes a finding regarding functional equivalence. The functional equivalence rules require SSA to begin by considering how the child functions every day and in all settings compared to other children the same age who do not have impairments. After the agency determines how the child functions in all settings, SSA uses the domains to create a picture of how, and the extent to which, the child is limited by identifying the abilities that are used to do each activity, and assigning each activity to any and all of the domains involved in doing it. SSA then determines whether the child?s medically determinable impairment(s) accounts for the identified limitations. Finally, the agency rates the overall severity of limitation in each domain to determine whether the child is ??disabled?? as defined in the Social Security Act.

The new Social Security Rulings clarify each of the six separate domains of functioning, and update the process of determining ?functional equivalence? under the law. While the new rules are important for any special needs planner, they are especially useful for any practitioner or parent who works on Social Security disability claims and appeals. Each of the new rulings are attached and described below:

SSR 09-1p Title XVI: Determining Childhood Disability Under the Functional Equivalence Rule - The “Whole Child” Approach — This rule gives a broad introduction to the “whole child” approach, lays out the procedure for determining childhood disability, and provides background for the remaining rules.

SSR 09-2p Title XVI: Determining Childhood Disability–Documenting a Child’s Impairment-Related Limitations — This rule outlines the documentation needed for the SSA to make a proper determination of disability.

SSR 09-3p Title XVI: Determining Childhood Disability–The Functional Equivalence Domain of “Acquiring and Using Information” — This rule updates information about the first of six domains of functioning, “acquiring and using information.”

SSR 09-4p Title XVI: Determining Childhood Disability–The Functional Equivalence Domain of “Attending and Completing Tasks” — This rule updates information about the second of six domains of functioning, “attending and completing tasks.”

SSR 09-5p Title XVI: Determining Childhood Disability–The Functional Equivalence Domain of “Interacting and Relating With Others” — This rule updates information about the third of six domains of functioning, “interacting and relating with others.”

SSR 09-6p Title XVI: Determining Childhood Disability–The Functional Equivalence Domain of “Moving About and Manipulating Objects” — This rule updates information about the fourth of six domains of functioning, “moving about and manipulating objects.”

SSR 09-7p Title XVI: Determining Childhood Disability–The Functional Equivalence Domain of “Caring for Yourself’” — This rule updates information about the fifth of six domains of functioning, “caring for yourself.”

SSR 09-8p Title XVI: Determining Childhood Disability–The Functional Equivalence Domain of “Health and Physical Well-Being” — This rule updates information about the sixth of six domains of functioning, “health and physical well-being.” This category differs from the previous five domains because it broadly relates to the child as a whole, and does not focus on one specific type of functionality.

Full post as published by Law Office of Donald D. Vanarelli Blog on March 29, 2009 (boomark / email).