Acceptable documentation of disability must detail the child’s medical condition. Medical verification of a disability which meets the SSA disability criteria may be confirmed by the individual or individual’s physician.
A child is disabled if he has a physical or mental condition or conditions that can be medically proven and which result in marked and severe functional limitations that last or are expected to last at least 12 months or expected to result in death.
The evidence must document the severity of the impairment during the time the child is disabled. The medical evidence must contain the following:
A history of the impairment.
Reports of clinical and laboratory findings which support the diagnosis and show the physical or mental changes which have occurred.
The factual data which is the basis for the diagnosis and prognosis.
A medical assessment describing the child’s ability to do activities such as sitting, standing, moving about, lifting, carrying, handling objects, hearing, and speaking.
If the child has a mental impairment, the assessment should describe the ability to reason or make occupational, personal, or social adjustments.
Children with Special Needs must meet SSA’s disability standards. Verification of the disability is provided by SSA or DPW’s Medical Review Team (MRT) (Supplemental Handbook, Chapter 820, Disability Advocacy Program (DAP).
Acceptable disability verification includes but is not limited to:
A Social Security award letter which lists the type of benefit being received
A collateral contact with SSA.
A disability begin date indicated on IEVS Exchange 3 (BENDEX) or Exchange 6 (SDX).
An SSI award letter and termination letter indicating the reason for termination. The reason must be non-medically related.
A copy of disability certification from the State MRT. The certification appears on an MRT Transmittal (PA 749).
If Children with Special Needs are found not eligible for SSI benefits due to income, the child or children will be referred to DAP for a determination of permanent and total disability by the MRT.
NOTE: The individual must apply for SSI benefits if the individual is potentially eligible based on income.
Updated February 14, 2012, Replacing April 7, 2011