Disabled Adult Child Benefits under Social Security

Disabled Adult Child Benefits under Social Security

Better than SSI and no loss of Medicaid benefits!

If you have a child with special needs who is receiving Supplemental Security Income (SSI) benefits, there may be a point when your child will become eligible for a disability benefit based upon your Social Security account. The benefit is called the Social Security Disabled Adult Child (DAC) Benefit.

Who is Eligible for Social Security Disabled Adult Child Benefits?

DAC benefits are only available to a disabled person age 18 or over who is:

·         the child of a parent who is currently receiving Social Security Disability Income (SSDI) or Social Security Retirement Income (SSRI) or;

·         the child of a deceased parent who was insured for Social Security benefits at the time of the parent's death; and

·          the child was disabled before the age of 22 and remained continuously disabled until the parent became disabled, retired or died; and

·         the child does not marry, unless the spouse is also receiving social security benefits.

If the DAC benefit is based upon the parent's disability, the child's benefit will end if the parent no longer qualifies for SSDI benefits because the parent's disability ended.

Benefit Amount

The DAC benefit for the child of a disabled or retired worker is 50% of the parent's benefit amount. The DAC benefit for the child of a deceased worker is 75% of the parent's benefit amount. If both parents are insured and either disabled, retired or deceased, the child's benefit amount will be calculated based upon the higher account of the two parents.

In some cases the DAC benefit may be reduced by the Family Maximum Amount (FMA). This is a cap on the total benefits that the Social Security Administration will pay to the family, including the insured worker, the spouse and other children if applicable. The FMA cap is usually between 150% to 200% of the insured worker's benefit amount.

Typically the DAC benefit is higher than the SSI benefit amount ($721 for 2014). When this happens the SSI benefit ends and is replaced by the DAC benefit.  This can create confusion with regard to the continuation of Medicaid benefits, which will be discussed below.  If the DAC benefit is less than the SSI benefit amount, a child could receive both SSI and the DAC benefit to bring the total monthly income up to the SSI benefit amount plus an additional $20 ($741 for 2014).

The child will be eligible for Medicare 24 months from when the DAC benefits began, so the earliest a child could receive Medicare based upon the parent's account would be age 20.

Medicaid and DAC Benefits

As discussed above, in most cases the DAC benefit will exceed the SSI benefit previously paid.  When this happens, the child will receive a notice from Social Security advising them that their SSI benefit will end and they will instead receive their new monthly benefit under the SSDI program as a Disabled Adult Child.  Many families believe-incorrectly-that switching from SSI to Social Security Disabled Adult Child Benefits means losing Medicaid coverage. In fact, some people may actually have been given this misinformation by SSA or Medicaid staff. 

However, under existing federal law, a disabled adult child in this situation can continue to be eligible for Medicaid (or can become eligible again) as long as the adult child: (1) has income below the SSI limit, after subtracting out the DAC benefit that made them ineligible; (2) continues to be “disabled” as defined by the Social Security Administration; and (3) the child’s assets remain below the Medicaid asset limit (generally $2,000.00).  It is important that they be aware that their Medicaid eligibility is protected by federal law and they must be vigilant to be sure that Medicaid benefits are not automatically terminated and, if Medicaid benefits are incorrectly terminated, they must immediately re-apply for continued benefits on the Department of Children and Families ACCESS website.

Where to Apply

You apply for DAC benefits through the Social Security Administration. You can call them at 1-800-772-1213. You can also get more information on the DAC program from the Social Security Administration's web site at www.ssa.gov.

The federal statute:

42 U.S. Code § 1383c - Eligibility for medical assistance of aged, blind, or disabled individuals under State’s medical assistance plan

(c) Loss of benefits upon entitlement to child’s insurance benefits based on disability

If any individual who has attained the age of 18 and is receiving benefits under this subchapter [SSI] on the basis of blindness or a disability which began before he or she attained the age of 22—

(1) becomes entitled, on or after the effective date of this subsection, to child’s insurance benefits which are payable under section 402 (d) of this title on the basis of such disability or to an increase in the amount of the child’s insurance benefits which are so payable, and

(2) ceases to be eligible for benefits under this subchapter because of such child’s insurance benefits or because of the increase in such child’s insurance benefits,

such individual shall be treated for purposes of subchapter XIX of this chapter [Medicaid] as receiving benefits under this subchapter so long as he or she would be eligible for benefits under this subchapter in the absence of such child’s insurance benefits or such increase.