Three Financial Assistance Programs for Families with Special Needs
If you are an adult living with a physical or mental disability, you can consider a number of federal financial assistance programs for the disabled. On the other hand, if you have a special needs child to care for, you may be investing a lot of time ensuring that he/she maintains good health, receives quality education, and leads a happy, fulfilling life. The sacrifices you make — whether in terms of working fewer hours — or paying for child care when you’re away, can take a toll on your financial health. The government understands this too, and offers a number of programs and resources to alleviate some of your financial concerns. Of these, there are three programs that you absolutely need to examine and leverage.
- Supplemental Security Income (SSI)
Overview
• Supervised by the Social Security Administration (SSA).
• A cash-assistance program that considers the applicant’s medical condition and financial resources (needs-based).
• Applicable for special needs people of any age.
Qualification criteria
Adults
• Must be able to demonstrate through medical records or other evidence that he/she has a severe mental or physical impairment.
• The physical or mental impairment must inhibit their ability to perform gainful activity (substantial gainful activity or SGA) for at least one year. This includes the work activity performed by the applicant over the past 15 years or any work that the applicant can switch to, dependent on his/her age, education and skill. For 2017, the SGA amount is $1170, which is the gross monthly earned income before taxes.
• Individuals can file for SSI and receive disability benefits even if they are working. This is not possible if their earnings exceed the SSG amount, in which case they will lose their disabled status.
Children
• Child applicants need to show records indicating functional limitations that distinguish them from non-disabled kids in certain areas such as interacting with people, getting and using information, performing tasks, moving around and being mindful of their own health and well-being.
• Medical records can be provided to assess disability claims. Additional documents such as school records, questionnaires filled by teachers and other evidence may also be required.
• When determining the eligibility of an individual below 18 years of age, the available resources for both the child and family members living with him/her are considered.
Note: Social Security may decide to have applicants undergo certain special testing or medical examinations — physical or cognitive. Medical document claiming SSI must also include the results of such tests.
For 2017, the maximum federal amount is $735 a month for an eligible individual, and $1,103 a month for a couple.
2. Social Security Disability Insurance (SSDI)
Overview and qualification
• Governed by the SSA.
• Not a needs-based program.
• Also applicable to ‘adult disabled child’, referring to an individual who has suffered serious and complete disability before the age of 22. In this case, at least one parent of the individual must be receiving Social Security retirement or disability benefits OR the parent must be dead or permanently disabled and employed long enough to qualify for Social Security.
• Work credits:
- If the applicant is 31 years or older, he/she must have worked at least five of the past ten years to pass the recent work test. Translating this to work credits, he/she requires 20 credits in the 10 years immediately prior to becoming disabled.
- If the applicant is aged between 24 and 31 years of age, he/she must have worked at least half this duration since turning 21.
- If the applicant is under 24 years of age, he/she must have worked at least a year and a half over the past three years prior to becoming disabled.
- Certain blind applicants may be exempt from these rules.
Applicants who do not qualify under SSDI may be eligible for disability benefits under the SSI program. As discussed previously, this will require them to demonstrate financial need.
Recommendations
• Use the SSA’s screening system to assess your child for disability before he turns 22 years of age.
• With your physician’s assistance, record all the data on your child’s medical condition and functional limitations early on, when the child is still very young.
• If you have a special needs dependent who was disabled prior to turning 22 years of age, you should consider taking benefits early to obtain the early payment of benefits to the child. There really is no benefit to waiting until 70 to claim your benefit.
• When you are disabled and unable to work, file for Social Security benefits immediately. This is because claims can take a long time to get processed, and SSI disability benefits cannot be claimed retroactively.
• Certain other government-administered benefits such as workers’ compensation benefits or temporary state disability benefits can lower your SSDI benefits. If you were receiving such benefits and you terminated them, then your SSDI benefit could increase.
• Note that your SSI benefits may decrease if you are co-habiting with someone who provides you food or shelter, or if you are engaged in part-time work.
• Seek the help of a professional special needs planner to understand the terms surrounding SSDI.
3. Medicaid
The Medicaid program provides healthcare at low costs for adults and children with special needs. It is a means-based program with its own set of income and assets requirements. The Katie Beckett waiver under this program removes a financial eligibility obstacle that previously prevented special needs kids in higher income households from claiming Medicaid benefits. A special needs child who is eligible for Medicaid and requires institutional level of care but can also receive care at home, will not be disqualified based on her parents’ income and assets. But the cost of her in-home care cannot be more than that in an institutional setting.
The Affordable Care Act directs all states to cover all children in families with incomes of up to 138% of the federal poverty level (FPL). For 2016, that translates into $27,821 per year for a family of three. All states are also free to expand financial eligibility for special needs kids above 138% FPL.
Idaho, Missouri, New Hampshire, New York and Wisconsin offer a Medicaid buy-in option for special needs children in families earning up to 300% FPL or $60,480 a year for a family of three in 2016. In this case, SSI eligibility criteria for disability are applied.
