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 they have a physical or mental condition or conditions that:
Can be medically proven, and
Results 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 DHS's Medical Review Team (MRT). See Supplemental Handbook Chapter 820 (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 Data Exchanges 3 (BENDEX) or 6 (SDX).
An SSI award letter and termination letter indicating the reason for termination. The reason must be non-medically related.
A copy of the disability certification from the State MRT. The disability certification is provided with the MRT Transmittal (PA 749).
If Children with Special Needs are found ineligible for SSI benefits due to a non-disability related reason (ex. income), the child or children will be referred to DAP for a determination of permanent and total disability by the MRT.
NOTE: If the child was eligible for SSI in the past but lost SSI eligibility for non-disability reasons, then the disability determination made by SSA remains valid until the child turns age 18. An MRT referral should not be created.
If the family reports a change in the child’s medical condition after SSA determined the child to meet disability criteria, an MRT referral should be generated to review for a new disability determination.
NOTE: The child should not be referred to SSA to apply for SSI benefits (unless the family wants to apply) as it is assumed by the child’s eligibility in the Children with Special Needs category that the child does not qualify for SSI.
Updated March 24, 2025, Replacing April 12, 2018