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Clinics

CAC Takes SSI Fight for Child in Structured Setting to Third Circuit

This article appears in the Fall 2012 CLINIC NEWS. 

The Child Advocacy Clinic has filed a potentially precedent-setting appeal in the Third Circuit challenging the denial of Supplemental Security Income (SSI) benefits to one of the clinic’s child clients. While the case concerns the general denial of benefits to the now 11-year-old child, it has the potential to create law in the Circuit for many children with disabilities on one particular issue – the Social Security Administration’s (SSA’s) consideration of a specialized setting and supports in determining whether a child is disabled for SSI purposes.

The CAC contends that the SSA failed to take into account the highly-structured and sheltered setting that the client required to perform activities associated with daily living, especially at school. Federal regulations require the SSA to consider whether a child needs a specialized setting, and how the child would function in the absence of a structured setting and therapeutic services should s/he need the same. Structured and supportive settings tend to minimize the symptoms of a child’s impairments and improve the child’s functioning while the child is present. Therefore, in determining disability, courts must consider how the child would function outside of these settings, without the benefit of the specialized services and programming. This analysis is critical to deciding whether a child is disabled for SSI purposes.

While numerous district courts have rendered decisions on this issue, with some finding for the SSI child applicant and others not, the Third Circuit has yet to issue a published decision. The CAC seeks not only to obtain SSI benefits for this child client, but also to ensure that this regulation is followed properly in the future through a precedential Third Circuit decision mandating compliance.