This post discusses Intellectual Disability and SSI/SSDI. If you or someone you care for has been assessed with an intellectual disability, they may be found eligible for disability benefits.
The Bishop Law Firm has represented Social Security Disability clients since 2009 and we do not get paid unless we win. We also offer free case reviews. Start online now!
Types of Social Security Disability benefits
The first step in attaining disability benefits is applying for them at your local Social Security office or online. Generally, there are two types of disability benefits that a claimant can apply for: Social Security Disability and Supplemental Security Income.
Social Security Disability Insurance (SSDI)
SSDI (Social Security Disability Insurance) is based on the credits from the work you have done in your life. You must be found disabled before your date last insured (DLI) to be found eligible for SSDI. Your DLI is calculated by counting your “quarters of coverage” from your earnings record. You must have 20 “quarters of coverage” of the last 40 quarters. Simply put, you must have worked 5 years of the last ten years (in general). In addition, Adult Disabled Children can be eligible for benefits off their parent’s account.
Supplemental Security Income (SSI)
SSI (Supplemental Security Income) is a need-based program and you must meet income/asset standards in addition to being found disabled under the five steps above. In 2024, SSI is $943 a month for an individual and $1,415.00 for an eligible couple. SSI will be reduced by 1/3 if you are receiving financial help from others. In NC, SSI recipients are also entitled to Medicaid.
SSI is also available for disabled children and is evaluated under a different standard than adults. Children must have a medically determinable physical or mental impairment or impairments (including emotional or learning problems) which result in marked and severe functional limitations, and the impairment(s) has lasted or can be expected to last for a continuous period of at least 12 months or be expected to result in death. Child SSI terminates when the child turns 18. The claimant will then have to reapply and be evaluated under the above adult sequential evaluation.
What is an Intellectual Disability?
Intellectual disability varies greatly from one person to another. Common characteristics I have seen in my practice are low IQ scores, placement in special education with IEPs, failing grades and the inability to keep up with one's peers mentally.
Slower than usual development, difficulty remembering appropriate social behavior, and difficulty problem-solving are some additional symptoms. Found here.
In the workplace, those with intellectual disabilities can struggle to remember directions or can be easily distracted from work tasks.
Since intellectual disabilities are so varied, IQ alone can not be used as the sole determining factor of disability. A lower IQ score coupled with a higher skill or ability than others can result in a savant (NIH).
Intellectual disabilities are usually present at birth and are lifelong. However, a child can function normally at birth, but digress as they age. In addition, people who experience a traumatic brain injury or other trauma can also suffer from an intellectual disability. A sudden brain injury can change how you think, remember, and interact with others. Found here.
Regardless of how your intellectual disability occurred, it is still difficult to deal with and can leave you unable to work.
How does SSA evaluate Intellectual Disability?
The Social Security Administration evaluates intellectual disabilities under 12.00 Mental Disorders for adults and 112.00 for children. We below discuss the adult listings.
Listing 12.02, Neurocognitive Disorders (Post Trauma)
This listing is targeted at individuals who have sustained a traumatic brain injury or other condition that has caused dysfunction of the brain. You must meet requirements A and B OR A and C:
Prong A discusses (must have one of these) a significant loss in cognitive ability that affects your ability to sustain complex attention; executive function; learning and memory; language; perceptual-motor; or social cognition.
Prong B requires extreme limitation of one, or marked limitation of two, of the following areas of mental functioning: understand, remember, or apply information; interact with others; concentrate, persist, or maintain pace, or adapt, or manage oneself.
Prong C requires that your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder; AND marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life. In summary, you must show that since the accident or injury, your ability to think has been significantly affected.
Listing 12.05, Intellectual Disorder (From Birth)
This listing is more relevant for someone who was born with an intellectual disability. This listing requires significantly subaverage general intellectual functioning evident in your cognitive inability to function at a level required to participate in standardized testing of intellectual functioning:
AND significant deficits in adaptive functioning currently manifested by your dependence upon others for personal needs (for example: toileting, eating, dressing, or bathing)
AND the evidence about your current intellectual and adaptive functioning and about the history of your disorder demonstrates or supports the conclusion that the disorder began prior to your attainment of age 22
OR an IQ score of 70 or below
AND significant deficits in adaptive functioning currently manifested by extreme limitation of one, or marked limitation of two, of the following areas of mental functioning: Understand, remember, apply information, interact with others or concentrate, persist, or maintain pace; or adapt or manage oneself
AND the evidence about your current intellectual and adaptive functioning and about the history of your disorder demonstrates or supports the conclusion that the disorder began prior to age 22. This listing describes someone who is essentially unable to care even for themselves.
What evidence will SSA need?
School records are imperative for intellectual disability cases. Medical records are also very important, especially in cases where a trauma has caused the intellectual disability.
If the claimant has ever worked, getting statements from their employer about their performance issues is imperative. Also sheltered workshops offered through vocational rehabilitation and "job coaches" are not real employment. They are services are generally designed to help people get a job (Read SSA's Evaluation).
Working for a family member for food and shelter should not be considered "substantial gainful activity" by the Social Security Administration either. "Made work" is not employment.
Do you need a Social Security Disability Lawyer?
As discussed elsewhere on this site, SSA's listings are usually difficult to meet. As you see from the above, the intellectual listings are no exception.
If you meet the above criteria, you may be found disabled based on 12.02 or 12.05, but even if you do not meet this listing, you still may be found disabled in other ways.
If you or someone you care for is unable to work because an intellectual disability, file a claim for Social Security Disability benefits (SSI/SSDI) as soon as possible.
The Bishop Law Firm represents Social Security Disability clients in Raleigh, Durham, Fayetteville, Cary, Rocky Mount, Wilson, Smithfield, Louisburg, Chapel Hill, Roanoke Rapids , Winston Salem, Garner, Greensboro, Greenville and surrounding areas in North Carolina. Call us today for a free case review, (919) 615-3095 or start online now.
