About the Age 18 Re-Determination Process

WHY: Once an SSI recipient becomes 18 years of age, that recipient loses disability eligibility status (meaning that he /she loses the cash benefits and Medicaid) unless the youth applies to be re-determined eligible as an adult and is therefore eligible to receive benefits as an adult. Being on SSI does not mean one cannot pursue a career. It does, however, help a young person get help with health coverage and living expenses while beginning that career exploration process.

WHO: Only the Social Security Administration (SSA) can determine "disability status" and "eligibility" when one applies for SSA benefits. The initial process of determination, however, is executed by the state's Disability Determination Services (DDS) who provides the initial intake, reviews the application and documentation, follows up on documentation verification, and makes their recommendation to SSA.

WHAT: The Social Security Administration (SSA) defines Adulthood as age 18 and older. SSA has different criteria for determining Child Disability Eligibility versus Adult Disability Eligibility.

WHERE: If a youth is receiving SSI, usually by the 17th birthday, SSA will send a letter stating that the youth's benefits will end at age 18 and provide information on when to apply as an adult and how the adult eligibility determination differs from child disability.

WHEN: A youth may only apply at age 18 but preparation for this process should be planned years ahead, starting as early as 14 year of age.

Planning Tips for the Age 18 Re-Determination or Applying for SSA as an Adult

Eligibility for SSI includes three criteria: A "severe" disability as defined and determined by SSA, the inability to earn Substantial Gainful Activity (the ability to earn a living), and is resource and financially limited. The "burden of proof" lies in the individual who is applying to make sure the documentation provided accurately verifies these criteria.

Employment experience, however, is an important element when the DDS team is determining SSA eligibility. The DDS will survey any environment and personnel that can verify the individual's ability to function. They will review any jobs or volunteer work that the individual did to see if that person may (or may not) have transferable skills to earn a living. If a credible professional or reference can verify that yes, the youth did a job but required support and accommodations to stay on task or assistance in getting the work completed, which is a valuable demonstration of possible employment barriers. If there is no work experience, the DDS team will only have the school environment to assess functionality and may potentially miss the employment barriers the individual may have and unfairly determine the youth as ineligible for benefits. Again, the "burden of proof" lies in the application documentation and what is stated during the initial interview.

*Very Important TIPS*:

1) Keep an organized portfolio of files to include: medical and other disability services documentation to include contact information of the service providers, letters of reference for any volunteer or job experience (important for future resume or verification of severity of function as a person who experiences a disability), any communications with Social Security, pictures or anything that describes skills or talents (these will add to a future resume), a written statement of goals and objectives with a timeline of what the individual would like to do or accomplish, etc.

2) Include the individual's interests and career goals with a timeline in the written IEP documentation.

3) Develop a transition team: it could be favorite educators, counselors, neighbors, family members, a business person, whoever has an interest in assisting the youth’s transition from school to community adult life.

4) Research what community services are available to make the transition from school to work easier. Those community services should include vocational, independent living, disabilities rights and recreation. Knowing what services are available will help to plan what to do next, should SSA determine the individual as ineligible for benefits. Also, if you decide to appeal a decision, during the appeals process, SSA cannot terminate the SSI benefits due to being determined ineligible as an adult.

5) Get enrolled in Vocational Rehabilitation (DVR) services prior to age 18. These services will include technical, education or job skills training, job development, supported employment, transportation assistance, etc. If a youth is receiving DVR services, SSA cannot terminate the SSI benefits (Section 301), due to being determined ineligible as an adult, until the individual's case is closed.