Thursday, May 5, 2016

Civil Rights and Disabilities in Public Schools

Interesting and sad report! Staffing level at the Office of Civil Rights has been dropping significantly at the same time OCR complaints are at a record high (p. 8). The number of complaints over restraints and seclusion, used as a discipline measure for disabled children, is also at an all time high (p. 9). Highlights (lowlights really) from the 2011-2012 school year include: Only 50% of our country’s public high schools offer calculus and only 63% offer physics; A quarter of high schools with the highest percentage of black and Latino students do not offer Algebra II; a third of these schools do not offer chemistry; Students with disabilities are more than twice as likely to receive an out-of-school suspension (13%) than students without disabilities (6%); and about 40% of school districts do not offer preschool program with 57% of school districts that operate public preschool programs offer only part-day preschool (p. 16). There were about 4,800 complaints sent to the OCR in 2015 concerning students with disabilities on a 504 (p. 33). This is 46% of ALL complaints filed with the ORC in 2015 (p. 8. 33 &; 34)!!! It can take 120 to 256 DAYS to complete a case! This about this in terms of a school year. You lose most if not all of the school year to resolve the issue (p. 34). There were 1,489 complaints concerning FAPE (p. 35). These complaints include students with disabilities not being taught core subjects like math, science, and social studies because they were being pulled out for special education services.

Bullying of disabled students, with 552 complaints, was the second largest issue in 2015 (p. 36) due to schools failing to respond to bullying complaints. On October 21, 2014, the OCR issues a Dear Colleague letter and fact sheet regarding the obligation under Section 504 and Title II and their implementing regulations for schools to respond appropriately to bullying of students with disabilities. These documents clarify that if a student with a disability is being bullied, federal law requires schools to take immediate and appropriate action to investigate and, as necessary, take steps to stop the bullying and prevent it from recurring. Regardless of the basis of the bullying, schools must remedy the effects of bullying on the services that a student with a disability receives (such as special education or other disability-related services) to ensure that the student continues to receive FAPE (p. 36).

There were 214 complaints due to lack of access to programs, services, and facilities. Lack of access occurred in several school districts. One example is a school keeping students of disabilities segregated from all the other students including recess and lunch. Another case involved a school failing to have a sign language interrupter at school events after parental requests were ignored. One school district rescinded their offer for a gifted program after the district learned a child had a disability. Another school district refused to provide a registered nurse for a diabetic baseball player on travel to away games. There are too many examples to list here.

This is a very interesting read. I did not even cover all the other issues OCR covers. If you can take the time to read the report.

http://www2.ed.gov/about/reports/annual/ocr/report-to-president-and-secretary-of-education-2015.pdf

If you ever need to file a report, hopefully you will not, the link is below.

http://www2.ed.gov/about/offices/list/ocr/index.html

Monday, March 21, 2016

Letter Request Initial Educational Testing per IDEA

Okay, I know I homeschool but I still engage in educational advocacy for others.  Why?  Because I feel like I have a lot to offer others in the way of service, and to be honest, I HATE seeing how public schools abuse/misuse special needs students!  So my help for today is how to request educational testing. You must request the start of educational testing!  Should you HAVE to? NO! See here, here, here, here, and here on the case law.  BUT most schools will do nothing until you speak up and start advocating for your child!  Here is a sample letter to request testing by the school district.

Please double check the law quoted in here since the regulations can move from time to time.  I hope you find this helpful!




Dear (Principal,Guidance Counselor, or School Psychologist's name),

I would like to request comprehensive educational testing for my child ________________ who is in _____ grade at __________________school. 

I would like a full psycho-educational evaluation together with appropriate testing for learning disabilities. I request my child be tested in all suspected areas of disability (34 CFR 300.304), including the areas (in this area to add any specific disability such as of auditory processing, executive function, OT, speech and language, reading disability, etc).

I understand I need to sign a consent form so the school can conduct the evaluation (34 CFR 300.300). If I do not hear from you in three days I will call to set up a time to sign the consent form.

After testing, and at least 5 days prior to attending the IEP team meeting to discuss the testing results [34 CFR 300.613(a)], I request I have a chance to review the result and ask any questions I have with the evaluator so that I may be an active part of the team (34 CFR 300.321).

I understand the school system has 60 days to complete testing and hold a meeting to discuss eligibility [34 CFR 300.301(c)(1)(i)]. Please note, at the IEP meeting I will be recording the meeting and any subsequent IEP meetings. I want to make sure I do not miss anything and an audio recording will help me immensely. I look forward to meeting with you on that date. 


Sincerely,
(your name)

When you deliver your letter to the school you need to do so in one of two methods.

Method 1: Write the letter and print out two copies.  Take one copy to the post office and send the letter certified mail with signature card and return receipt. Once you get the signature card back take it and staple it to the other copy you saved.  This copy should then be placed in a file folder, or better yet, hole punched and put into a three ring binder you use and organize for your child each year.

Method 2: Print off two copies.  Take both copies into the front office and ask the secretary to stamp both copies as received with the school stamp WITH DATE! You will give her one of the copies to deliver and the other will be retained for your files.

It is important you keep up with ALL paperwork and have it stored in one place.  I also like to scan all paperwork and store it in a cloud.  I like Dropbox for this purpose because it accepts all file types (so audio records along with paper docs) and it is easy to share files if I wish to do so.  I am not associated with Dropbox in any way.  I just like their product. :)  I hope this helps. If you have questions please write me a post.  I will answer your questions to the best of my abilities.

Thursday, March 10, 2016

Executive Functioning and the Impact on Leaning



Executive functioning is a complex issue.  I know since all my children have executive functioning issues! The real question is how does executive functioning issues impact learning in both the homeschool and public education environment?

First, let's discuss homeschool.  It is easier, when you homeschool, to address executive functioning issues because you can tailor a child'e learning environment around their disabilities.


So what is executive functioning?

WebMD defines executive functioning as a set of mental skills that help you get things done. These skills are controlled by an area of the brain called the frontal lobe.

Executive function helps you:
  • Manage time
  • Pay attention
  • Switch focus
  • Plan and organize
  • Remember details
  • Avoid saying or doing the wrong thing
  • Do things based on your experience

When executive function isn’t working as it should, your behavior is less controlled. This can affect
your ability to:

  • Work or go to school
  • Do things independently
  • Maintain relationships
This is a huge problem for children with ADHD, depression, and learning disabilities. These conditions are often associated with issues with executive functioning. 

How does executive functioning impact homeschool?

When you have a child with executive functioning problems you cannot expect them to manage their time, day, or classwork.  They will have a difficult time organizing information and paying attention to the task at hand.  They will have problems with switching between tasks and are horrible multi-taskers. This means you will need to give them more one-on-one attention in both tasks and academics.  For my three children this means I have to teach them all separately.  They cannot be taught as a group in reading and math.  We do these separately.  For science, history, and social studies we learn these together.  I often have James or Margaret read while the others listen and ask questions. Since retaining information is also an executive function issue and an issue with working memory (another common problem with EF and in my children) we often will repeat the same lesson 2 to 4 times in the same week.  This helps the children to retain the information they are learning. This is something I can do in a homeschool setting that would not typically occur in the public school setting.


How does executive functioning impact school?

Executive functioning in a public school setting can be a nightmare and this is one of the reasons why I enjoy homeschooling.  It is often called by parents an "invisible" disability.  The signs are often subtle but there. Then there is the challenge for parents to figure out the symptoms are issues of executive functioning and request a school district to test for EF issues. 

So which tests can tell if a child has a problem with executive function issues? Well, the sky is the limit!  LOL   There are a LARGE verity of tests, partially because EF covers so many functional areas, so it is hard to say which test could be used to test your child.  Some of the more common tests are:

  • Wisconsin Card Sorting Test
  • Category Test
  • Stroop Test
  • Trail Making Test-B
  • WAIS Subtests of Similarities and Block Design
  • Porteus Maze Test
  • Multiple Errands Test (MET)
  • Serial Sevens
  • Mini-Mental State Exam
These tests should be used in conjunction with other other testing to examine Intellectual functioning, Academic achievement, Language processing, Visuospatial processing, Attention/ concentration, Verbal learning and memory, Visual learning and memory, Speed of processing, Sensory-perceptual functions, Motivation, and Personality assessment. All of these tests play a role in defining issues with executive functioning and other learning disabilities. Most of these tests are best completed by a neuropsychologist.  I promise you a school district will never have a neuropsychologist on staff no matter what they say.  If it does ever happen someone please let me know but I feel confident in my statement. Why? It is because a neuropsychologist is a specialist and schools tend to only employ psychologist for testing. 

What is a neuropsychologist and how are they different from a school/typical psychologist?

There are basically three types of psychology: clinical, school, and neuropsychology. Clinical psychologists assess and treat children with a wide variety of psychological problems, but particular with emotional/behavioral issues. They may be found working in hospitals, community health centers, or private practice. Although most clinical psychologists are generalists, who work with a wide variety of populations and problems, some may specialize in a specific population and specific disorders (e.g. attachment or post-traumatic stress disorder). They are trained in universities or professional schools of psychology and may not be very familiar with school settings. Clinical psychologists provide both assessment and treatment (psychotherapy).

School psychologists are involved in enhancing the development of children in educational settings. They assess children's psychoeducational abilities and recommend actions to facilitate student learning and overall school functioning. They are typically trained in the Schools of Education at universities and work in school systems, community-based agencies, or private practice. A few may specialize in a particular school-related problem such as learning disabilities or ADHD. While specializing in educational issues, they may not be well trained in medical-based disabilities and disorders. School psychologists usually administer both norm-based psychological tests and criterion-referenced educational (achievement) tests.

Neuropsychologists represent a specialized discipline within the field of psychology that mostly focuses on cognition (the ability to think, remember, learn, etc.) in relation to the effects of brain damage and organic brain disease. A neuropsychologist can administer standardized psychological and neuropsychological tests to patients in private office and hospital settings.

Why is a neuropsychologist examination helpful? 

A pediatric neuropsychologist work closely with schools to help them provide appropriate educational programs for the child. There are five major reasons why a thorough neuropsychological evaluation performed by an pediatric neuropsychologist is superior to a psychoeducational evaluation. These are the inadequate range of a psychoeducational evaluation, the training of the personnel performing psychoeducational evaluations, the narrow focus of psychoeducational evaluations, the level of performance model employed in psychoeducational evaluations, and the failure of psychoeducational evaluations to assess brain behavior relationships. The school and general psychologist tend to focus on achievement and skills needed for academic success. Generally, they do not diagnose learning or behavior disorders caused by altered brain function or development.

Even in the homeschool setting this testing is very helpful to the parent so the parent can understand the learning deficits and strengths of their child.  This will help the parents to better teach their child in the home setting.

Children are referred by a doctor, teacher, school psychologist, or other professional because of one or more problems, such as:

  • Difficulty in learning, attention, behavior, socialization, or emotional control; 
  • A disease or inborn developmental problem that affects the brain in some way; or 
  • A brain injury from an accident, birth trauma, or other physical stress. 

A neuropsychological evaluation assists in better understanding your child’s functioning in areas such as memory, attention, perception, coordination, language, and personality. This information will help you and your child’s teacher, therapists, and physician provide treatments and interventions for your child that will meet his or her unique needs.

A pediatric neuropsychologist can evaluate school-age child many areas such as:

  • General intellect 
  • Achievement skills, such as reading and math 
  • Executive skills, such as organization, planning, inhibition, and flexibility 
  • Attention 
  • Learning and memory 
  • Language 
  • Visual–spatial skills 
  • Motor coordination 
  • Behavioral and emotional functioning 
  • Social skills 
Some abilities may be measured in more detail than others, depending on the child’s needs. A detailed developmental history and data from the child’s teacher may also be obtained. Observing your child to understand his or her motivation, cooperation, and behavior is a very important part of the evaluation. Emerging skills can be assessed in very young children. However, the evaluation of infants and preschool children is usually shorter in duration, because the child has not yet developed many skills.


So what can the results from the testing tell you?


By comparing your child’s test scores to scores of children of similar ages, the neuropsychologist can
create a profile of your child’s strengths and weaknesses. The results help those involved in your child’s care in a number of ways.

Testing can explain why your child is having school problems. For example, a child may have difficulty reading because of an attention problem, a language disorder, an auditory processing problem, or a reading disability. Testing also guides the pediatric neuropsychologist’s design of interventions to draw upon your child’s strengths. The results identify what skills to work on, as well as which strategies to use to help your child.

Testing can help detect the effects of developmental, neurological, and medical problems, such as epilepsy, autism, attention deficit hyperactivity disorder (ADHD), dyslexia, or a genetic disorder. Testing may be done to obtain a baseline against which to measure the outcome of treatment or the child’s development over time.

Different childhood disorders result in specific patterns of strengths and weaknesses. These profiles of abilities can help identify a child’s disorder and the brain areas that are involved. For example, testing can help differentiate between an attention deficit and depression or determine whether a language delay is due to a problem in producing speech, understanding or expressing language, social shyness, autism, or cognitive delay. Your neuropsychologist may work with your physician to combine results from medical tests, such as brain imaging or blood tests, to diagnose your child’s problem.

Most importantly, testing provides a better understanding of the child’s behavior and learning in school, at home, and in the community. The evaluation can guide teachers, therapists, and you to better help your child achieve his or her potential.

Wrap up


Links have been included in the blog to the sources of my information. Some of the information comes from personal experience. All of my children have executive functioning issues.  The executive functioning is also impacted by their working memory issues and ADHD. Knowing my children have executive functioning issues has really given me a lot of patience since I now understand their limitations and issues.  I don't get so annoyed when I have to repeat myself 6 times or get angry when I ask for a task to be completed and it never gets done. I understand now and know the problem.  It has made me think about how I parent my children, my expectations of them working independently, and what I need to do to help them in the future.

I am including a link to a list of accommodations written up by a school district in New York that covers all areas of executive functioning and has accommodations from Kindergarten to 12th grade. It is a great resource for both the homeschooled and public schooled child.  The link can be found here and it is a PDF.  I am also including a link (click here) to a redacted version of Margaret's last neuropsych report. It is not as comprehensive as it could be because all my children had neuropsych testing completed three years ago but it gives you a good idea how a report should be written and what to expect. I hope this has been help and always feel free to send me questions in the comment section!


Thursday, March 3, 2016

To the Doctor

Doctor Office Selfie
Thankfully this was not for me.  This visit was for the children.  I kept getting calls from Medicaid for the children.  They kept insisting I take the children in for a well visit check. They were busy reminding me vaccines are important.  Yes, they are but we will agree to disagree on that one.

This turned out to be a good time for me to visit the doctor anyways. I had wanted to talk to her about Joseph and his skinny, slow-growing self. Sigh!  We headed off in the morning to see the doctor. It was a 35 minute drive across town on the interstate.  Margaret sat in the back crying and whining the entire time I am on the highway.  I am not sure where this fear came from but I wish it would go away!

We make it to the doctor's office and there is a small playground.  I have to promise the kids I would let the play afterwards as I shove them into the office door.  I yell at everyone to take a seat on the well side of the office but they kept getting drawn back to the sick side. The LAST thing we needed is to pick up some illness visiting the office. That is why I did not want to visit the doctor yet but the calls from Medicaid were harassing!



Thankfully the Little Mermaid started to play on the well child side and the children stayed seated!

We got back into the patient room.  I swear it is the smallest room I have ever been in!  There was not enough space for me and the kids to sit much less the doctor! Kids were sitting in the floor playing their Kindles.  It was SO loud in the room!  LOL

The doctor comes in and we discuss Joseph's poor weight gain.  She said he had been putting on more weight recently.  She told me to keep it up.  I asked about tube feeding and she said we are not quite there yet. I am pleased because I really do not want to tube feed Joseph.  I think there is too much of a risk of infection. We discuss James's weight.  He could stand to lose about 4 pounds. Margaret is skinny but okay. If she is like any of the other ladies in my family I am not worried about her.  ALL women in my family are fat.  It just varies by degree.  I am one of the fattest while my aunt is rather skinny compared to the rest of us.  So I think Margaret will one day weight plenty.  No reason to rush things!
Right as they were finally settled we were called back to get weights and measures. Isn't that how it always is?  LOL   Kids take off their shoes we height and weight check. James weighted in at 72.4 pounds and 54 inches, Margaret was 48.4 pounds and 49.5 inches, and Joseph weighed in at a tiny 35.8 pounds and 45 inches!  

We discuss other issues and talk about some community supports we could look into.  Overall it was a nice visit with the doctor and I am grateful that Joseph never had to go to Urgent Care or the hospital this winter. Flu is at an all time high here. John was sick with Influenza type A but it did not really bother the kids or I so I think we are immune to that one. Now we just need to stay away from any other sickness until cold/flu/RSV season is over in about 8 more weeks.  Keeping my fingers crossed!

After leaving the doctor's office the kids wanted to play with a little girl (15 months) out on the little playground.  Since I promised I said yes.  The grandmother was outside watching the little girl.  She said she was happy my kids came along and would play with her.  They played for about 10 minuted before the mom came outside.  Then she told me that her daughter was sick.  Don't you know, no good deed goes unpunished?  LOL   Luckily I had hand sanitizer with me. I made the kids use it and get in the car.
Playing with Frisbees in the Park

I went to pick them up some cheap sandwiches and water.  Then I headed to the park for them to play.  There was no one there.  They got to play with their frisbees and basketball.  They had a blast!  They ran outside in the 90 degree weather for an 1.5 hours before I told them we needed to go.  Joseph had stopped sweating so I knew he had gotten too hot. I rubbed him down with ice and we left.  Did you know those darn kids did not fall asleep for 2 hours after bedtime!  I thought I had worn them out.
Got a picture of everyone before we left the park.

Thursday, February 18, 2016

Going to Church & Making Friends

Photo credit: wikimedia.org
We are religious.  I may be less religious than my husband though I was raised in a religious household and went to church regularly.  John and I have discussed on many occasions what we thought we could do better with the children we have now versus my older children.  We both thought more religious and good character instruction would be important.

John is more about religion and not as concerned with denomination. I, on the other hand, was brought up Church of Christ and that is where I feel more at home. We went to several churches locally.  We had been taking the children to one Church of Christ for a while on Wednesday night. This church seems to have an older congregation that attends on Wednesday night. Overall, it has worked well for us and allows the children a chance to learn how they should behave at church.

They are learning. We still have incidences like James asking me a question in his regular voice instead at a whisper.  I swear none of the children have a volume control!  After singing a song, loudly and out of tune, Margaret ends the song by saying, "Woohoo!" or "Good job!"

Last night James sat at the end of the pew near the isle. As people passed he would say hi to each of them.  As part of James's autism "symptoms" he is often overly friendly.  We inadvertently taught this when we were teaching him social scripting. I don't mind but it can be a problem because he does not always understand when he has gone too far (crossed personal boundaries/becomes annoying) and he is very naive.  He still cannot look new people in the face when he greets them but we are making progress!

Who can say no to this sweet face?
James greeted people as they passed by and there were several elderly ladies who he had invited to sit by him.  One lady, June, was kind enough to accept his invitation.  She said she would let her sister know but she would be right back.  True to her word, she sat next to him until the children were dismissed to children's church.

While she sat there next to James he was so loving to her.  To me also as I was sitting on the other side of him.  He took her hand and held it.  He accidentally scratched himself on her bracelet. He took his hand away and rubbed his arm explaining what happened (rather loudly since he seems not to know how to whisper), apologized to her that he scratched himself on her bracelet, and then resumed holding her hand. At one point, during a story given by one of the men at the podium, James held his arms up as if was stretching and put his arm behind June and myself. Towards the end he was holding June's hand again and he took it and kissed it.

When the children were dismissed from the service James looked at her and said he would love to see her again and would she back back to church.  She said she would.  He asked if she would sit again with him. She said she would and she got up to sit next to her sister as James and the rest of the children went to children's church.

I won't lie when I said I had tears in my eyes as I watched James. We have no family here.  He knows he has grandparents but doesn't remember them. He has not seen them since he was 2. I was saddened to see the love he has and that his grandparents were not around to enjoy it.

I went to June after the service and told her how much I appreciated her sitting next to James. I told her I don't think she realizes how happy that made him!  How he had asked several people but no one accepted his invitation. June tells me she had never met such a polite and loving young man before. She goes on to tell me she never had children of her own and she would be happy to be James's friend.

James has a lot of love to give.  He is a big flirt though he does not know it. He will flatter women, all be accident, from 2 to 102. Someday, if continues along the same path,  he will make a good husband and father. I just need to make sure he finds a woman worthy of that sweet love.

Tuesday, February 16, 2016

Social Security Income (SSI) for Disabled Children

Common Problem. Rejected Claims   Photo Credit: Huffington Post.com
Having multiple disabled children I have had my own few rounds with Social Security.  There are people who say you are living off the system if you get SSI for your children. All I can say is that they have NEVER had to go and get benefits because if they did they would understand the angst in applying for and keeping the benefits. If you have any questions please leave them in the comments below and I will answer them the best I can. 

To get started you need to make sure your child meets the disability requirements and your family meets the income requirements. You can find the information for 2015 and other requirements at the link here.  I copied and pasted some of the information below.


SUPPLEMENTAL SECURITY INCOME (SSI) FOR CHILDREN
WHO IS A "CHILD" FOR SSI?


A person who is neither married (as determined by Social Security) nor head of a household and:

is under age 18; or

is under age 22 and is a student regularly attending school (as determined by Social Security).
HOW DOES THE SSI DISABILITY PROGRAM WORK FOR A CHILD?

To be eligible for SSI benefits, a child must be either blind or disabled.

A child may be eligible for SSI disability benefits beginning as early as the date of birth; there is no minimum age requirement.

A child may be eligible for SSI disability benefits until attainment of age 18 (see definition of disability for children).

When the child attains age 18, we evaluate impairments based on the definition of disability for adults (see definition ofdisability for adults).

A child with a visual impairment may be eligible for SSI benefits based on blindness if the impairment meets the definition of blindness (see blindness requirements).
WHAT ARE THE CRITERIA FOR A “DISABLED” OR “BLIND”
CHILD?


If under 18, whether or not married or head of household, the child has a medically determinable physical or mental impairment or impairments which result in marked and severe functional limitations; and

The impairment(s) has lasted or can be expected to last for a continuous period of at least 12 months or be expected to result in death; or

If the child is blind, he or she meets the same definition of “blind” as applies for adults. See WHAT IS "BLINDNESS" FOR AN ADULT OR CHILD?. Unlike the requirement for SSI disability benefits, there is no duration requirement for SSI blindness benefits.

SSA has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards. The Compassionate Allowances (CAL) initiative allows Social Security to target the most obviously disabled individuals for claims approval based on objective medical information that we can obtain quickly. Fifty medical conditions were initially selected for this initiative. Since that time we have added 150 conditions bringing the total number of conditions to 200. The list may expand over time. A complete list of CAL conditions may be viewed online at: http://www.socialsecurity.gov/compassionateallowances/conditions.htm.

HOW DOES DEEMING WORK FOR A CHILD?

If a child is under age 18, not married, and lives at home with parent(s) who do not receive SSI benefits, we may consider a portion of the parents' income and resources as if they were available to the child. We may also count a portion of a stepparent’s income and resources if the child lives with both a natural or adoptive parent and a stepparent. We also do this when a child is temporarily away at school, returns home during weekends, holidays or during the summer and remains subject to parental control. We call this process "deeming."

We make deductions from deemed income for parents and for other children living in the home. After we subtract these deductions, we use the remaining amount to decide if the child meets the SSI income and resource requirements for a monthly benefit.

For more information, see the SSI Spotlight on Deeming Parental Income and Resources.

WHEN DOES DEEMING NOT APPLY?


Deeming from the parent stops when a child attains age 18, marries, or no longer lives with a parent. Deeming does not apply, and we may pay up to $30 plus the applicable State supplement when:

a disabled child receives a reduced SSI benefit while in a medical treatment facility; and

the child is eligible for Medicaid under a State home care plan; and

deeming would otherwise cause ineligibility for SSI benefits.

Also, we do not consider the income of a parent for deeming purposes if the parent receives a Public Income Maintenance payment (PIM) such as Temporary Assistance for Needy Families (TANF) and his or her other income was used to compute the PIM payment.

See SSI AND ELIGIBILITY FOR OTHER GOVERNMENT AND STATE PROGRAMS for information on TANF.


If either child or parent is temporarily absent from the household (less than 60 days), the rules about deemed income still apply.
CAN A CHILD GET MEDICAID?


In most States, a child who gets SSI benefits can get Medicaid to help pay medical bills.

In some cases, a child may be eligible for Medicaid while in an institution, but not be eligible when living at home either because of the parents' income and resources or because of other income.

At the State's option, children under age 18 who need institutional–level care and live at home may keep Medicaid eligibility while getting home care, if that care is less costly to the government.

Even if the child is not eligible for SSI benefits, the child still may be eligible for Medicaid under other State rules. Always check on Medicaid eligibility with the State.

For more information about Medicaid, you can look on the Internet on the Centers for Medicare and Medicaid Services webpage athttp://www.medicaid.gov/index.html or call toll–free, 1–800–633–4227.

In addition, other State services may also be available.



If you have children or grandchildren under age 19 who are not covered by health insurance, there is a Children's Health Insurance Program that may help. To find out more, you can look on the Internet at www.insurekidsnow.gov or call, toll free, 1–877–KIDS–NOW (1–877–543–7669). The number connects you to your State program.
DEEMING ELIGIBILITY CHART FOR CHILDREN FOR 2015


WARNING: BEFORE USING THIS CHART, SEE SSI FOR CHILDREN. IF THERE IS ANY DOUBT ABOUT WHETHER A CHILD IS ELIGIBLE, CONTACT US FOR HELP.



Gross monthly income BELOW the dollar amounts shown means a disabled child may be eligible for SSI benefits.
Amounts given are general guidelines only.
Number of
ineligible
children in
household
All income is earnedAll income is unearned
One parent in
household
Two parents in
household
One parent in
household
Two parents in
household
0
$ 3,057
$ 3,791
$ 1,506
$ 1,873
1
$ 3,424
$ 4,158
$ 1,873
$ 2,240
2
$ 3,791
$ 4,525
$ 2,240
$ 2,607
3
$ 4,158
$ 4,892
$ 2,607
$ 2,974
4
$ 4,425
$ 5,259
$ 2,974
$ 3,341
5
$ 4,892
$ 5,626
$ 3,341
$ 3,708
6
$ 5,259
$ 5,993
$ 3,708
$ 4,075


The Deeming Eligibility Chart for Children does not apply when:

The parent(s) receives both earned income (for example, wages or net earnings from self-employment) and unearned income (for example, Social Security benefits, pensions, unemployment compensation, interest income, and State disability).

The parent(s) receives a public income maintenance payment such as Temporary Assistance for Needy Families (TANF), or a needs–based pension from the Department of Veterans Affairs. See SSI AND ELIGIBILITY FOR OTHER GOVERNMENT AND STATE PROGRAMS for more information on TANF.

The parent pays court-ordered support payments.

The child has income of his or her own.

Any ineligible child has income of his or her own, marries, or leaves the home.

There is more than one disabled child applying for or receiving SSI benefits.

Your State supplements the Federal benefit.


Use the Deeming Eligibility Chart for Children in the following States or territory, which do not supplement the Federal benefit for children:
Alaska

Arizona                           Maryland                                   Ohio

Arkansas                         Mississippi                                South Carolina

Delaware                         Missouri                                    Tennessee

District of Columbia       North Carolina                           Texas

Florida                            North Dakota                              Virginia

Indiana                            Northern Mariana Islands          West Virginia

Kansas


If you live in one of the States listed below, Social Security administers the State supplement for children. Call us for deeming eligibility information.

California   Montana*       Pennsylvania

Hawaii        Nevada*         Rhode Island

Iowa           New Jersey     Vermont
* Montana supplements disabled and blind children in certified foster homes only. Nevada supplements blind children only.


If you live in one of the States listed below, your State administers the State supplement for children. Contact the State for information.
Alabama

Colorado            Maine                       New York          Washington

Connecticut*      Massachusetts         Oklahoma           Wisconsin

Georgia              Michigan                 Oregon*              Wyoming

Idaho                  Minnesota*              Pennsylvania

Illinois               Nebraska                  Rhode Island

Kentucky           New Hampshire*    South Dakota*

Louisiana           New Mexico           Utah
* Connecticut, Minnesota, and New Hampshire only supplement benefits for blind children. South Dakota supplements disabled and blind children in residential care facilities.


HOW TO APPLY FOR SSI BENEFITS
You can apply for SSI benefits by:

Calling us at 1-800-772-1213 (or TTY 1-800-325-0778 if you are deaf or hard of hearing) and making an appointment to apply for SSI benefits. If you are deaf or hard of hearing, we also will take your telecommunications relay services (TRS) assisted calls at 1-800-772-1213. With an appointment, one of our representatives will help you apply for benefits. You can have an appointment to apply for SSI benefits on the telephone or in person at your local Social Security office.

Having someone else call and make the appointment for you or assist you with your application for SSI benefits. For more information, see our chapter on HOW SOMEONE CAN HELP YOU WITH YOUR SSI.

Visiting our office to apply without making an appointment, but you may have to wait awhile.

You will have to provide information and work with us to get documents concerning SSI eligibility.

You will have to file an application.

We do not have SSI applications online. Most of the forms to apply for SSI are not designed for self-completion. Our claims representative interviews you and uses a computer to complete the forms with information you give to us or someone else gives to us on your behalf.
WHEN TO APPLY

Apply as soon as possible so that you do not lose benefits. We cannot pay benefits for time periods earlier than the effective date of your application.

If you call us to make an appointment to apply and you file an application within 60 days of the call, we may use the date of your call as your application filing date.

If you do not keep this appointment and you do not contact us to reschedule the appointment, we will try to contact you. If we do not get in touch with you to reschedule the appointment, we will send you a letter. The letter will say that if you file an application within 60 days from the date of the letter, we will use the date of your original contact with us as your SSI application date.

If you are in a public institution, but you will be leaving within a few months, you may not be eligible for SSI benefits until you leave. You may, however, be able to apply before you leave so that SSI benefits can begin quickly after you leave. Check with the institution and us about filing an application under the "prerelease procedure."

See our SSI Spotlight on Prerelease Procedure.


If you are a disabled youth in foster care, eligibility for foster care payments in most States ends when you attain age 18. You may need the income support and health services that result from SSI eligibility to ease the transition to independent living. To help with this transition, SSA may accept an SSI application from you up to 90 days before your foster care eligibility ends due to age.

See our SSI Spotlight on SSI Benefits for the Disabled Youth in Foster Care.

YOU HAVE THE RIGHT TO APPLY

Anyone may apply for SSI.

There is no charge to apply.
YOU HAVE THE RIGHT TO RECEIVE HELP FROM SOCIAL SECURITY

We will complete the application forms for you based on information you give to us.

We will help you get documents you need to show that you meet the SSI eligibility requirements.

If you are applying because you have a disability or are blind and we decide that the medical information needed to make a decision is not available from existing sources, we will pay for you to have a medical exam or test and make the appointment for you. If you need a medical exam or test, you must go to the exam or test in order to receive SSI benefits. In some circumstances we may also pay your travel costs to get to this exam or test.

For information on when we pay for travel to medical exams, see our SSI Spotlight on Payment for Travel to Medical Exams or Tests.

YOU HAVE THE RIGHT TO A REPRESENTATIVE

You may appoint someone as your representative to help you with your SSI claim and go with you to your appointment(s) with us.

See our chapter on HOW SOMEONE CAN HELP YOU WITH YOUR SSI.

YOU HAVE THE RIGHT TO A NOTICE

We will notify you in writing of any decision about your SSI eligibility or change in benefit amount. We will also send copies of all notices to your representative if you have one. Each notice about your eligibility or change in benefit amount will explain yourappeal rights.

See our chapter on SSA NOTICES AND LETTERS for further information.

YOU HAVE THE RIGHT TO EXAMINE YOUR FILE

You or your appointed representative may request and examine or get a copy of the information in your case file. Also, you or your representative may review and copy the laws, regulations and policy statements used in deciding your case at: www.socialsecurity.gov/ssi/ssi-law-regs.htm
YOU HAVE THE RIGHT TO APPEAL

You may appeal most determinations we make about your eligibility for SSI or changes we make in your benefit amount.

DOCUMENTS YOU MAY NEED WHEN YOU APPLY FOR SUPPLEMENTAL SECURITY INCOME (SSI)

You may not need all of the following documents. Sometimes one document can substitute for another. The lists are not all–inclusive. We will tell you what you need and what other documents are acceptable. We may be able to help you get them if you are having trouble.
SOCIAL SECURITY CARD OR NUMBER

You will need to apply for a Social Security number if you do not have one. If you need one, a number will be assigned at the time Social Security entitles you to SSI benefits.

PROOF OF AGE


a public birth record recorded before age 5; or

a religious birth record recorded before age 5; or

other documents showing your age or date of birth.

If you already proved your age when you applied for Social Security benefits, you do not need to prove it again for SSI.

CITIZENSHIP OR ALIEN STATUS RECORD


If you are a citizen, examples of documents you may need are:

birth certificate showing you were born in the United States; or

religious record of birth or baptism showing your place of birth in the United States; or

naturalization certificate; or

U.S. passport or passport card; or

certificate of citizenship.

If you are an alien, examples of documents you may need are:

a current immigration document; for example, an I-551 (Permanent Resident Card); or

I–94 (Arrival/Departure Record).

If you are an alien who has served in the U.S. Armed Forces, you may need your military discharge paper (form DD–214).
PROOF OF INCOME


If you have income, you may need to provide the following:

Earned Income – payroll stubs, or if self–employed, a tax return for the last tax year;

Unearned Income – any records you have (for example, award letters, bank statements, court orders, receipts) showing how much you receive, how often, and the source of the payment; and

Work Expenses – see information under SSI WORK INCENTIVES for more information

PROOF OF RESOURCES

bank statements for all checking and savings accounts;

deed or tax appraisal statement for all property you own besides the house you live in;

life or disability insurance policies;

burial contracts, burial plots, etc.;

certificates of deposit, stocks, or bonds;

titles or registrations for vehicles like cars, trucks, motorcycles, boats, campers, etc.

PROOF OF LIVING ARRANGEMENTS


lease or rent receipt

names, dates of births, medical assistance cards or Social Security numbers for all household members

deed or property tax bill

information about household costs for rent, mortgage, food, and utilities.
MEDICAL SOURCES (IF YOU ARE FILING AS BLIND OR DISABLED)


medical reports, if you have them;

names, addresses, and telephone numbers of doctors and other providers of medical services to you and the approximate dates you were treated;

names of the prescription and non-prescription medications that you take.
WORK HISTORY


job titles;

type of business;

names of employers;

dates worked;

hours worked per day and hours worked per week;

days worked per week, and rates of pay for work you did in the 15 years before you became unable to work because of your illnesses, injuries, or conditions;

description of job duties for the type of work you performed.
OTHER SOURCES


If you are applying as a disabled child, or on behalf of a disabled child, we need the names, addresses, and telephone numbers of people (for example, teachers or caregivers) who can provide information about how the child’s medical condition affects his or her daily activities. Also, if the child has an individualized education plan (IEP) at his or her school, it is helpful to submit a copy of the plan.
THINGS TO REMEMBER


Do not wait to apply. If you think you may be eligible for SSI, you should contact us right away. The earliest we will pay SSI is the month after the filing date of your application, or the month after you first meet all the eligibility requirements, whichever is later. We may use the date you contact us as the filing date. If you do not have all of the things we need, we will give you time to provide them.

We need to see the original documents. If you do not have an original document, we can accept a certified copy from the office that issued the original document. We do not accept photocopies. We will return the original documents to you.

Try to keep a copy of things you send us. Keep track of the dates you send information to us, or talk to us, as well as the name of the Social Security employee with whom you spoke.



The below portion is when you have to renew your benefit claim after a few years.
SEQUENTIAL EVALUATION FOR CHILDREN (INDIVIDUALS UNDER AGE 18)


STEP 1: IS THE CHILD WORKING?

If a child is working and performing SGA, we cannot consider the child disabled, and the sequential evaluation process ends here. Your local Social Security office determines whether a child is performing SGA. We define SGA for children in the same way that we define it for adults. We define “SGA” in the section WHAT IS SUBSTANTIAL GAINFUL ACTIVITY.
STEP 2: DOES THE CHILD HAVE A SEVERE IMPAIRMENT?

If the child is not performing SGA, we will determine if the child has a medically determinable physical or mental impairment or combination of impairments (hereafter referred to as impairment(s)) and whether it is severe. An impairment(s) is not severe if it is only a slight abnormality or a combination of slight abnormalities that causes no more than minimal functional limitations. If the child does not have a medically determinable impairment(s), or the child has an medically determinable impairment(s) but it is not severe, we will find that the child is not disabled. If the child has a severe medically determinable impairment(s), we will go to the next step.
STEP 3: DOES THE CHILD’S IMPAIRMENT MEET, MEDICALLY EQUAL, OR FUNCTIONALLY EQUAL A LISTING?

If the child has a severe impairment(s), we determine if the impairment(s) meets or ismedically equivalent to the criteria of the listing. The listing of Impairments (the Listing) covers the major body systems and includes descriptions of common physical and mental impairments (such as cerebral palsy, intellectual disability, and asthma) along with specific medical severity criteria.

A child is disabled if he or she has an impairment that:


meets the criteria of one of the impairments in the listings; or

medically equals the criteria of one of the listings; or

functionally equals the listings.

We determine if a child’s impairment(s) “meets” one of the listings by comparing it to the specific requirements in the listings. It is not enough to have a diagnosis that is named in the listings. A child’s impairment medically equals one of the listings if it is at least equal in severity to any listed impairment. If a child’s impairment(s) meets or medically equals the criteria of a listing and meets the duration requirement, we will find the child disabled.

If a child’s impairment(s) is severe but does not meet or medically equal a listing, we determine whether the impairment(s) “functionally equals” the listings. This means that we evaluate the effects of the impairment(s) on the child’s ability to function at home, at school, and in the community.

We will consider questions such as:

how does the child function compared to children the same age who do not have an impairment? That is, what is the child able to do, not able to do, or is limited or restricted in doing?

what type and amount of help does the child need to complete age-appropriate activities?

what are the effects of treatment on the child’s day-to-day functioning?

Once we have a clear picture of a child’s functioning in all activities and settings we evaluate the child’s functioning in six domains. The domains are broad areas of functioning intended to capture all of what a child can or cannot do. They are:


acquiring and using information;

attending and completing tasks;

interacting and relating with others;

moving about and manipulating objects;

caring for yourself; and

maintaining health and physical well-being.

If a child’s impairment(s) results in “marked” limitations in two of these domains of functioning, or an “extreme” limitation in one domain, then his or her impairment(s) functionally equals the Listings.

We define "marked" and "extreme" limitations in several ways in our rules. The most general definition of a "marked" limitation in a domain is when a child's impairment(s) interferes seriously with the child's ability to independently initiate, sustain, or complete activities. An "extreme" limitation in a domain is when a child's impairment(s) interferes very seriously with these abilities.


NOW ONE OF THE MORE IMPORTANT PARTS: IMPAIRMENTS

It is horrible when you have to look at your child, the evaluation reports from a developmental pediatrician, neuropsychologist, therapists, or other specialists and determine if your child meets the requirement for disability. In one way it is a relief because they will qualify for state medicaid, and even as a secondary insurance, it is a MAJOR blessing! On the other hand, you have to accept your child has a pretty profound disability. The feelings are quite mixed. Here is the list of disabilities and their requirements for impairment. You can find the link here but I will copy the information. Please click on the relevant links below and read through each section to determine which best fits your child.




Here is the information you need to prove your medial claim. Remember you can always appeal and then I would suggest hiring an attorney to help you with your case.


Disability Evaluation Under Social Security

Part II - Evidentiary Requirements

Medical Evidence

Medical evidence is the cornerstone of the disability determination under both the title II and title XVI programs.

Each person who files a disability claim is responsible for providing medical evidence showing he or she has an impairment(s) and the severity of the impairment(s). However, the Social Security Administration (SSA), with the claimant’s permission, will help the claimant get medical reports from his or her own medical sources. This medical evidence generally comes from sources that have treated or evaluated the claimant for his or her impairment(s).

Acceptable Medical Sources

Documentation of the existence of a claimant's impairment must come from medical professionals defined by SSA regulations as "acceptable medical sources." Once the existence of an impairment is established, all the medical and non-medical evidence is considered in assessing impairment severity.
Acceptable medical sources are:
Licensed physicians (medical or osteopathic doctors);


Licensed or certified psychologists. Included are school psychologists, or other licensed or certified individuals with other titles who perform the same function as a school psychologist in a school setting, for purposes of establishing intellectual disability, learning disabilities, and borderline intellectual functioning only;


Licensed optometrists, for purposes of establishing visual disorders only (except, in the U.S. Virgin Islands, licensed optometrists, for the measurement of visual acuity and visual fields only). (See paragraph (f) of this section for the evidence needed for statutory blindness);


Licensed podiatrists, for purposes of establishing impairments of the foot, or foot and ankle only, depending on whether the State in which the podiatrist practices permits the practice of podiatry on the foot only, or the foot and ankle; and


Qualified speech-language pathologists, for purposes of establishing speech or language impairments only. For this source, “qualified” means that the speech-language pathologist must be licensed by the State professional licensing agency, or be fully certified by the State education agency in the State in which he or she practices, or hold a Certificate of Clinical Competence from the American-Speech-Language-Hearing Association.

Medical Evidence from Treating Sources

Currently, many disability claims are decided based on medical evidence from treating sources. SSA regulations place special emphasis on evidence from treating sources because they are likely to be the medical professionals most able to provide a detailed longitudinal picture of the claimant's impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from the medical findings alone or from reports of individual examinations or brief hospitalizations. Therefore, timely, accurate, and adequate medical reports from treating sources accelerate the processing of the claim because they can greatly reduce or eliminate the need for additional medical evidence to complete the claim.

Medical Evidence From Health Facilities

SSA also requests copies of medical evidence from hospitals, clinics, or other health facilities where a claimant has been treated. All medical reports received are considered during the disability determination process.

Other Evidence

Information from other sources may also help show the extent to which an individual's impairment(s) affects his or her ability to function in a work setting; or in the case of a child, the ability to function compared to that of children the same age who do not have impairments. Other sources include public and private agencies, non‑medical sources such as schools, parents and caregivers, social workers and employers, and other practitioners such as naturopaths, chiropractors, and audiologists.

Medical Reports

Physicians, psychologists, and other health professionals are frequently asked by SSA to submit reports about an individual's impairment(s). Therefore, it is important to know what evidence SSA needs. Medical reports should include:
medical history;
clinical findings (such as the results of physical or mental status examinations);
laboratory findings (such as blood pressure, x-rays);
diagnosis;
treatment prescribed with response and prognosis;
a statement about what the claimant can still do despite his or her impairment(s), based on the medical source's findings on the above factors.
if the claimant is an adult age 18 or over, this statement should describe, but is not limited to, the claimant's ability to perform work-related activities, such as sitting, standing, walking, lifting, carrying, handling objects, hearing, speaking, and traveling.
in adult cases involving mental impairments or mental functional limitations, this statement should describe the claimant's capacity to understand, to carry out and remember instructions, and to respond appropriately to supervision, coworkers, and work pressures in a work setting.

if the claimant is a child under age 18, this statement should describe the child’s functional limitations compared to children his or her age who do not have impairments in acquiring and using information, attending and completing tasks, interacting and relating with others, moving about and manipulating objects, caring for yourself, and health and physical well-being.


Consultative Examinations

If the evidence provided by the claimant's own medical sources is inadequate to determine if he or she is disabled, additional medical information may be sought by recontacting the treating source for additional information or clarification, or by arranging for a consultative examination (CE). The treating source is the preferred source for a CE if he or she is qualified, equipped, and willing to perform the examination for the authorized fee. Even if only a supplemental test is required, the treating source is ordinarily the preferred source for this service. However, SSA’s rules provide for using an independent source (other than the treating source) for a CE or diagnostic study if:
the treating source prefers not to perform the examination;
the treating source does not have the equipment to provide the specific data needed;
there are conflicts or inconsistencies in the file that cannot be resolved by going back to the treating source;
the claimant prefers another source and has good reason for doing so; or
we know from prior experience that the treating source may not be a productive source.

Consultative Examination Report Content

A complete CE report will involve all the elements of a standard examination in the applicable medical specialty and should include the following elements:
the claimant's major or chief complaint(s);

a detailed description, within the area of specialty of the examination, of the history of the major complaint(s);

a description, and disposition, of pertinent "positive" and "negative" detailed findings based on the history, examination, and laboratory tests related to the major complaint(s), and any other abnormalities or lack thereof reported or found during examination or laboratory testing;

results of laboratory and other tests (for example, X-rays) performed according to the requirements stated in the Listing of Impairments (see Part III of this guide);

the diagnosis and prognosis for the claimant's impairment(s);

a statement about what the claimant can still do despite his or her impairment(s), unless the claim is based on statutory blindness.
  • if the claimant is an adult age 18 or over, this statement should describe the opinion of the consultant about the claimant's ability, despite his or her impairment(s), to do work-related activities, such as sitting, standing, walking, lifting, carrying, handling objects, hearing, speaking, and traveling;
  • in adult cases involving mental impairment(s) or mental functional limitations, this statement should also describe the opinion of the consultant about the claimant’s capacity to understand, to carry out and remember instructions, and to respond appropriately to supervision, coworkers, and work pressures in a work setting.
  • if the claimant is a child under age 18, this statement should describe the opinion of the consultant about the child's functional limitations compared to children his or her age who do not have impairments in acquiring and using information, attending and completing tasks, interacting and relating with others, moving about and manipulating objects, caring for yourself, and heath and physical well-being. 

the consultant 's consideration, and some explanation or comment on, the claimant's major complaint(s) and any other abnormalities found during the history and examination or reported from the laboratory tests. The history, examination, evaluation of laboratory test results, and the conclusions will represent the information provided by the consultant who signs the report.

Evidence Relating to Symptoms

In developing evidence of the effects of symptoms, such as pain, shortness of breath, or fatigue, on a claimant's ability to function, SSA investigates all avenues presented that relate to the complaints. These include information provided by treating and other sources regarding:

  • the claimant's daily activities;
  • the location, duration, frequency, and intensity of the pain or other symptom;
  • precipitating and aggravating factors;
  • the type, dosage, effectiveness, and side effects of any medication;
  • treatments, other than medications, for the relief of pain or other symptoms;
  • any measures the claimant uses or has used to relieve pain or other symptoms; and
  • other factors concerning the claimant's functional limitations due to pain or other symptoms.

In assessing the claimant's pain or other symptoms, the decision makers must give full consideration to all of the above-mentioned factors. It is important that medical sources address these factors in the reports they provide.


I hope this information has been useful. This is the most current information and links to date from November 2015.