A Disabled Adult Child (DAC) claim provides Social Security Disability Insurance benefits to a disabled adult who can prove a medical disability resulting in an inability to work, prior to age 22. An adult disability claim for Social Security disability benefits entails a 5-step sequential evaluation:
First, a person must demonstrate that s/he is not performing Substantial Gainful Activity (SGA). For 2014, the threshold level for SGA is $1070/month for non-blind individuals. For blind individuals, SGA is $1800/month. Second, the Administration asks whether an individual has a Medically Determinable Impairment of at least 12-month duration, or likely to result in death. That is, has the claimant been diagnosed by an acceptable medical source (i.e, a doctor)? Third, a claimant’s impairment (or combination or impairments) are compared to the SSA medical Listings. If a claimant’s condition manifests itself in a way identical to or medically equal to the definitions and descriptions of the SSA medical Listings, the individual can be found disabled. If, however, the claimant’s impairments do not meet or equal the medical Listings, the analysis proceeds to the 4th and 5th steps of the sequence.
At step 4, a claimant must prove that the impairment preclude the ability to return to his/her Past Relevant Work (PRW). PRW is any work a claimant has substantially performed over the preceding 15 years such that it can be assumed s/he acquired the skills and/or familiarity to perform that job. If it is determined that the individual could not return to the PRW, then step 5 analyzes whether there are any other jobs exist in the economy in “substantial numbers” that the claimant could perform despite any limitations caused by his/her medical conditions.
At the time of a claimant’s Initial Application, it does not matter whether s/he is already receiving Supplemental Security Income (SSI) benefits. The claimant need only prove that the disability began prior to his/her 22nd birthday. Additionally, an individual is only technically eligible if s/he has a parent who is retired, deceased or disabled upon application for DAC benefits.
DAC benefits may increase a disabled person’s monthly income as compared to SSI benefits. The 2014 Federal Payment Amount for SSI is $721. However, DAC benefits are based upon the Disability Insurance benefits (DIB) of the parent’s account. Presently, the maximum DIB benefits is $2642 for 2014. As discussed in the first Blog about DAC benefits, a claimant is eligible for 50% of a parent’s monthly DIB if the parent is living, and up to 75% of the monthly DIB if the parent is deceased.
Additionally, a person is eligible only for Medicaid as a recipient of SSI; whereas, Medicare will kick in 29 months after the disabled individual is found disabled as a DAC recipient.
However, the DAC benefit is mainly for unmarried disabled adult children. Generally speaking, upon marriage, the eligibility for DAC ceases. There is an exception for disabled individuals who marry another Social Security disability benefit recipient.
The burden to prove Steps 1-4 of the sequential analysis is upon the person seeking DAC benefits. Overcoming that burden and rebutting the Agency’s findings at Step 5 requires objective medical evidence, sound medical opinion evidence, and a strong knowledge of the Social Security Act and agency policies.