SSI for ADHD: Filing and Benefits

ADHD is an acronym for attention deficit hyperactivity disorder. ADHD is distinct from ADD, which usually is a diagnosis given to those who are unable to focus and who tend to procrastinate, daydream and have slower than normal cognitive functions.  A person with ADHD will have similar symptoms of ADD, but will also be hyperactive. This means the child may have difficulty sitting still, problems interacting with a peer group, and an inability to behave appropriately in social settings. ADHD can be a severe diagnosis that requires treatment with medication and/or behavioral therapy. It can also entitle a child or an adult to collect benefits through a program called SSI. 

ADHD vs. ADD

There have been several medical studies done on the differences between ADD and ADHD. Many of these studies seem to indicate that the differing disorders are caused by problems with different parts of the brain. Those with ADD, for example, generally have fully intact frontal lobes but problems in the partial lobe of the brain. Those with ADHD, on the other hand, usually exhibit insufficient activity in the frontal lobe of the brain and may have additional impaired brain function in other parts of the brain as well. 

The symptoms are also different, likely as a result of the different parts of the brain that are affected. The main distinguishing feature of ADHD patients is that they are hyperactive (hence the name) and more impulsive than those with just ADD. 

Applying For Benefits For ADHD

Children who suffer from ADHD may require specialized care and treatment, such as behavioral therapy or special schooling, while adults who suffer from the disorder may have difficulty finding or keeping a job. As such, those with ADHD be eligible for benefits through a program called Supplemental Security Income (SSI). It is very important to note that SSI is NOT the same thing as SSDI, or social security disability insurance.

• SSDI is for workers who have become disabled after meeting a requirement of a minimum number of work hours. 
• SSI is instead intended to provide income for people who have a very low income and who otherwise fit into a qualifying category. One of those qualifying categories is to be a disabled child or a disabled adult. 

Proving Eligibility for Benefits

Not every child or adult with ADHD is necessarily going to be eligible for benefits through SSI. There are three fundamental requirements that are in place in order to qualify for benefits based on a diagnosis of ADHD. These there requirements are:

• Exhibiting significant inattentiveness
• Exhibiting significant hyperactivity
• Exhibiting significant impulsivity

It is not enough for the patient to simply say he or she is experiencing these symptoms. There must be clear, medically documented proof. In addition, other criteria must also be met as well. The specifics of these criteria will depend on the age of the patient. For those who are aged 3-18, the requirements to get SSI benefits based on ADHD include at least two of the following:

• Lack of cognitive function appropriate for the patient's age
• Lack of social skills appropriate to the patient's age
• Lack of personal skills and ability to provide self-care appropriate to the patient's age

Again, there must be clear medical evidence that the patient is exhibiting these symptoms. 

Problems with ADHD Claims

While ADHD is a serious and legitimate medical problem that is well-established within the medical community, qualifying for SSI benefits on the basis of ADHD is difficult. In fact, some believe that it should not be possible to qualify for benefits at all based on the disorder. The main problem with getting benefits as a result of ADHD is that the diagnosis is largely subjective. There are few or no medical tests that can conclusively prove a person has ADHD, or that can conclusively prove just how severe the ADHD is. The SSA requires significant or "marked" impairment, but it is difficult to decide what exactly "significant" means or how impaired someone actually is by the condition. 

The SSA often requires a patient applying for SSI benefits based on ADHD to undergo an examination with an SSA-selected psychiatrist. In addition to this examination, the more medical evidence one can provide and the more documentation the applicant has regarding this condition, the better the applicant's chances are of actually being approved for a benefits claim. 

Getting Help

Because of the challenges associated with applying for disability benefits as a result of ADHD, it is imperative you consult with a lawyer early in the process. Expert legal advice on the evidence you need and on how to complete the application can go a long way towards helping you to get your claim approved.