How Do SSI Recipients Fare at Age 18 Reviews?

March 1, 2009

Author: Catherine M. Callery (Kate)| Louise M. Tarantino

Ann Biddle, Esq., Paul M. Ryther, Esq.

A report published in the Employment and Disability Institute Collection and available at http://digitalcommons.ilr.cornell.edu/edicollect/1253, presents some findings that might not be surprising to advocates who have represented SSI recipients at their “age 18” reviews. “Changing Circumstances: Experiences of Child SSI Recipients Before and After Their Age-18 Redetermination for Adult Benefits (2009), by Jeffrey Hemmeter, Jacqueline Kauff, and David Wittenburg, analyses the dynamics of the transition from childhood SSI recipients into adulthood. The report relies on data from the Social Security Administration (SSA), the 2001-2002 National Survey of Children and Families, and earlier studies.
 
The authors primary objective was to examine differences in pre-age-18 subgroups to determine whether the differences influence post-age-18 participation and employment outcomes. They found that after controlling for factors such as disability severity, duration, and human capital (e.g., work experience or schooling), youth with mental and behavioral disorders other than mental retardation were much less likely to remain on SSI.  Also, non-health factors, particularly education, employment and social indicators, play an important role in whether a child will remain on SSI after age 18.
 
The report is chock full of statistics and interesting factoids about children on SSI.  It starts with the premise that one-third of childhood SSI recipients will lose eligibility when, as mandated by 42 U.S.C. §1382c(a)(3)(H)(iii), they undergo review under the adult standard. Children with a diagnosis of mental retardation, who comprise fifty percent of the childhood SSI population, were the most likely to be found eligible as adults.  Mental disorders were the primary diagnosis for seventy-five percent of the population studied. Those who began collecting SSI at earlier ages, which were more likely to be those with primary impairments such as mental retardation, system disorders and other physical impairments, were also more likely to remain. 
 
The SSI recipients with primary impairments classified as other mental and behavioral disorders had significant barriers to success on many levels – not the least of which is remaining on SSI after age 18!  For example, forty-five percent of them dropped out of school during the course of the study, as opposed to thirty percent of all SSI child recipients, and compared to ten percent of the general population.  They also experienced higher arrest records. Post SSI-eligibility, their earnings were generally lower than what they received on SSI
 
The authors suggest that further research is needed to determine whether effective intervention options can be developed to better prepare and support those not likely to continue receiving SSI benefits after age 18.  They acknowledge many of the factors that advocates recognize as problematic in these cases. For example, once SSI recipients leave the school system, they lose relatively easy access to services from one provider – the school – and face difficulties accessing adult services. 
 
The authors also suggest that SSA review the role it has in influencing “human capital” decisions of child SSI recipients, including expanding work incentive opportunities and implementing extensions to the “Section 301” program, which allows children to remain on SSI if in an approved vocational rehabilitation program. They cite, without taking a position on, arguments that Congress should extent the childhood SSI program beyond age 18 to allow recipients to obtain skills to find jobs and live independently – an argument based on the premise that IDEA (Individuals with Disabilities Education Act) entitles children to special education services through age 21.
 
The authors also cite recommendations made by the Social Security Advisory Board (SSBA) in 2006 that SSA take a more active role in informing parents and educators about the implications of age 18 reviews, and broadening the opportunities for human capital development. The SSBA specifically recommended that SSA begin notifying youth and their caregivers about these opportunities as early as age 14. In short, more must be done to prepare the unfortunate one-third of the SSI child population for life without SSI!