ADHD /Attention Deficit Hyperactivity Disorder:
In Social Security's Listing
of Impairments manual there is a special section for
ADHD, more specifically referred to as Attention Deficit Hyperactivity
Disorder. The disability listing is 112.11, and it indicates the
following:
Attention Deficit
Hyperactivity Disorder: Manifested by developmentally
inappropriate degrees of inattention, impulsiveness, and hyperactivity.
This case is win
when the child is attending a special education class which helps
to prove a mental imbalance.
The required level of severity for this disorder is met when the
requirements in both A and B are satisfied.
The "A" criteria is as follows.
A. Medically documented findings of all three of the following:
1. Marked inattention; and
2. Marked impulsiveness; and
3. Marked hyperactivity;
The "B" criteria for this
listing has to do with "conditions resulting from ADHD"
which a claimant must have for an ADHD case to be won. There are
actually two sets of conditions, one for children under 3, the
other for children 3 to 18.
We'll only discuss the "B" criteria for the latter group since
children under 3 have such a limited chance of approval based
on the ADHD disability listing.
Getting
awarded social security benefits for ADHD
For children (3-18) to receive SSI disability benefits based on
this disorder, they must---in addition to possessing 1. marked
inattention, 2. marked impulsiveness, and 3. marked hyperactivity---have
at least two of the three following conditions, resulting
from ADHD:
1. Marked impairment in age-appropriate
cognitive/communication function.
2. Marked impairment in age-appropriate social functioning.
3. Marked impairment in age-appropriate personal functioning.
For each of these marked
impairments (conditions resulting
from ADHD is a good way to think of them), there must
exist supporting documentation.
Supporting documentation, of course,
includes:
- medical findings - such as treatment
notes written by a doctor, mental health professional, or staff
professionals at a mental health facility.
- historical information from parents
and teachers - such as teacher reports and evaluations.
- The results of standardized testing
- such as achievement testing and IQ testing.
How difficult
is it for a child to be approved for disability benefits under
the Social Security Administration's ADHD listing?
In all candor, it is somewhat difficult.
Part of the problem with winning disability approvals based on
this impairment has to do with the subjective nature of how the
Social Security Administration evaluates ADHD.
Exactly
how are ADHD claims evaluated?
As with every claim for disability, a disability examiner at DDS
(disability determination services) reviews a claimant's medical
records and then, after speaking with an in-house consultant,
makes a decision on the case.
With ADHD claims, however, the DDS consultant is not a medical
doctor, but, rather, a Ph.D. level psychologist (although, at
times, DDS will have on staff an M.D.---
a Psychiatrist---who performs essentially the same
duties).
To a large extent, Psychological consultants at DDS do exactly
what their medical consultant counterparts do. They read a claimant's
records and render a professional opinion---one which may or may
not be in agreement with the assessment made by the disability
examiner. (In instances where there
is disagreement, it is left to the disability examiner
to "rethink" his or
her analysis of how a claimant's case should be decided.)
However, unlike physical impairment
cases, DDS psychologists rely greatly on the subjective
observations of others, teachers primarily, to determine if a
child has an impairment and, if so, whether or not the impairment
is mild, moderate,
or marked.
Observations of behavior, of course, are always open to interpretation,
as opposed to objective clinical
observations such as heart rate and blood pressure readings.
The short-comings of this kind of system are readily apparent:
DDS psychologists develop an opinion
about a claimant's social security case based
on the recorded opinions of other individuals and then
use that amalgamated opinion
to determine if a claimant is eligible to receive disability benefits...or
not. In many people's eyes, this type of evaluation system has
all the legitimacy of a rumor twice removed.
In actuality, the only objective standards for evaluating ADHD
disability claims are as such: a student's school
records and the results of standardized psychological
testing.
And this bears out in nearly all instances. For whether or not
a child is found eligible for disability benefits almost always
depends on their academic status, i.e. how
they well they are doing in school.
Why is the
"school work" factor so important in ADHD cases?
It is important for the same reason that the ability (or inability)
to work is so important in adult cases. The social security disability
system is not really concerned with a claimant's diagnosed condition,
but rather the effect that the
condition has on a claimant's ability to engage
in certain specific activities.
For adults, this means the ability to work while earning at least
a certain basic amount (the SGA income amount, which is currently
$810.00 per month, gross).
For children, this means being able to adequately perform age-appropriate
activities, such as adequate functioning in school.
Therefore, to win an ADHD disability claim, it
is not simply enough to be given an ADHD diagnosis.
To win disability benefits from the Social Security Administration
based on this impairment, a child
must have meaurable functional deficits, in the context of school
performance.
To win benefits based on this disorder, in most cases it must
be shown that claimants are taking medications as prescribed and,
despite this, have significant difficulties with various age-appropriate
activities---mainly grade level school work.
Tip 1 regarding Social Security Disability ADHD Cases
Have your child tested for ADHD by a mental health professional.
Symptoms of "poor attention", "hyperactivity", and "inability
to concentrate" written on an SSI application will not suffice.
There must exist in a child's medical records at least one diagnosis
of ADHD for such a case to be seen as credible AND this diagnosis
should, ideally, be based on testing results.
By contrast, an "untested" ADHD diagnosis by a family doctor
or pediatrician may have little significance even if that doctor
prescribes medication. Reason: the diagnosis may be viewed as
arbitrary. And, in reality, many doctors do diagnose ADHD and
prescribe relevant medication simply to satisfy concerned parents.
But Internists and Pediatricians hardly qualify as trained mental
health professionals, and, for that reason, an ADHD diagnosis
by such a doctor will not hold weight with the Social Security
Administration
Tip 2 regarding Social Security Disability ADHD Cases
Have your child tested at school.
While testing by a mental health professional can solidly confirm
the existence of ADHD in a child claimant, school testing can
serve another purpose. School testing can have the effect of determining
whether or not a child will receive individualized attention and/or
be classified as a special needs student.
Though the ADHD disability listing does not specifically mention
this, both Disability Examiners and Administrative Law Judges
examine medical records to see whether or not children with ADHD
are in special or mainstream classes.
Again, a similar reasoning applies: if a school system does
not believe a child's ADHD-related problems are significant enough
to warrant special classes, why should an examiner or judge consider
that child disabled? In most cases, the individual examining the
claim will not.
Other factors that are considered for ADHD cases
Of course, other factors, as specified in the ADHD listing, do
come into play for attention deficit cases, such as how well a
child communicates, how well a child functions socially, and how
well a child takes care of personal needs (dressing, grooming,
and related activities).
But, in the vast majority of disability claims filed for ADHD,
the final determination will be based on how well a child does
academically in relation to peers, with significant attention
paid to the issue of medication involvement.
In other words, if a child diagnosed with ADHD performs well
in school, or performs, at least, at grade level, a strong case
cannot be made for awarding disability. Likewise, a child whose
problems (social, communicative, or cognitive) are only manifested
when a prescribed medication regimen is not followed will have
a poor chance of winning disability benefits.
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WITH SCHIZOPHRENIA DISORDER
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