Evaluating Functional Equivalence In Childhood Disability

In children’s disability cases, if the child’s impairment is not severe enough to meet a Social Security “listing”, meaning an approval for disability benefits, then an assessment must be done to determine if the impairment functionally equals a listing.  For functional equivalence, the child must have one “extreme” or two “marked” limitations in the six domains of functioning. 

The six domains of functioning are:

  1. Acquiring and using information
  2. Attending and completing tasks
  3. Interacting and relating with others
  4. Moving about and manipulating objects
  5. Caring for oneself, and
  6. Health and physical well-being.

The evaluation of how functioning is affected will be done during all of the child’s activities; meaning activities done at home, at school, and in the community.   First, Social Security will identify which of the child’s activities are limited, and which domains are involved in those activities.  They will then determine whether the child’s impairment(s) could affect those domains and account for the limitations.  Second, Social Security will then rate the severity of the limitations in each affected domain(s).  If SSA finds one extreme limitation, or two marked limitations, the child will be approved for disability benefits.

Disability Benefits For Children With HLHS

I’ve addressed children’s disability benefits in previous posts, but would like address a specific disability, hypoplastic left heart syndrome, in this post.  Hypoplastic Left Heart Syndrome (HLHS) is a congenital heart defect where most of the structures on the left side of the heart are too small and underdeveloped (hypoplastic) to provide enough red blood flow for the body’s needs.  The Social Security Administration has listed HLHS on their list of compassionate allowances. Compassionate allowances are medical conditions so serious that their conditions obviously meet disability standards.  Compassionate Allowances are a way of quickly identifying diseases and other medical conditions that will ultimately qualify for benefits.

To recap, children’s disability benefits will be awarded to those children with:

  1. physical or mental condition(s) , or combination of conditions, that results in marked and severe functional limitations;
  2. The condition(s) must have been disabling, or expected to be disabling, for at least 12 continuous months; and
  3. The child must not be working and earning more than $1,010 per month.

HLHS is a rare congenital congenital heart defect (CHD) that may be diagnosed at birth or on a prenatal ultrasound.  HLHS consists of under-development of the left side of the heart.  Usually, the entire left side of the heart is affected, and can include the left ventricle, mitral valve, the aortic valve and the aorta.  Because of the under-development of the left side of the heart, the right side of the heart must work harder to maintain circulation to sustain both lungs and the rest of the body.  This, in turn, may cause heart failure.

A social security disability claim can take up to 2 years to process before being awarded benefits or ultimately denied, depending on many factors.  Because HLHS is listed on SSA’s list of compassionate allowances, the process may be expedited, and families may receive benefits in a matter of weeks versus a matter of months or possibly years.

Social Security Disability Benefits

Social Security Disability and Supplemental Security Income are federal programs that provide assistance to people with disabilities.  Both SSDI and SSI are administered by the Social Security Administration and are only available to individuals who have a disability and meet medical criteria.

  • SSDI – SSDI pays benefits if you worked long enough and paid social security taxes
  • SSI – SSI pays benefits based on financial need

What is the definition that Social Security uses to determine if an individual is disabled?

         Under the Social Security Act, “disability” means “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.”  Unfortunately, there is no set list of disease, injury or disability that Social Security uses to determine eligibility for benefits.  Social Security will make a decision based on the severity of the disability and how it affects the specific claimant.

Please call our office for questions regarding your claim or application or to schedule an initial consultation.

Protecting Assets From The Costs of Long Term Care

WHEN IS THE RIGHT TIME TO BEGIN PLANNING?

As everyones financial and medical backgrounds are different, so is the “right” time to begin planning.  The more time you have to plan before long term care is needed, the more options you may have and less stress you and your family will endure.  Anytime you have a concern about how you will pay for long term care for yourself or a loved one, it  may be time to begin the planning process.  Preemptive planning will give you peace of mind and allow you to:

  • Analyze your financial background
  • Ensure your legal documents are up to date and distribute your estate as you wish
  • Make sure the distribution of your estate will not jeopardize public benefits for others
  • Discuss options to allow loved ones to remain at home instead of a nursing home
  • Take steps to protect and preserve your assets, including your home
  • Research all community benefits programs applicable to your situation
  • Designate agents to make medical and financial decisions for you in the event you are unable to make decisions for yourself

Long term care, incapacity and death are not subjects we are comfortable discussing.  The earlier and more comprehensive we plan, the less stress our families will be faced with in the event uncomfortable decisions need to be made.

What If I Die Without A Will?

When discussing estate planning, I often hear the remark “I don’t need a Will”.  Many think that they don’t have a large enough estate, or that everything will automatically pass to their spouse.  That is not always the case.

If you die without a Will, Massachusetts law will control how your property will be distributed.  After payment of debts, expenses, administration and funeral costs, your property will be distributed as follows:

  • If the deceased leaves kindred but no children, the surviving spouse will get the first $200,000, plus one-half of the remaining personal and real property.  The balance will go to the kindred.
  • If the deceased leaves children, the surviving spouse will get one-half of the real and personal property and the balance will go to the children.
  • If the deceased leaves children but no spouse, all real and personal property will be distributed to the children.
  • If the deceased dies with no children or kindred, the surviving spouse will take all real and personal property.
  • If the deceased leaves no spouse, children or kindred, the estate passes to the Commonwealth.

Unless you have a valid Will at death, the State will determine exactly who receives your property.  Having a Will ensures that you, not the State, choose who receives your property.