The Basic Steps to File a Claim

You start a child disability benefits claim by contacting Social Security directly and submitting medical evidence that your child has a condition expected to last at least 12 months or result in death. Social Security will assign a claims representative to your case, and you will need to provide your child's birth certificate, Social Security number, and detailed records from doctors who have treated your child. The entire process from filing to a decision typically takes three to five months, though cases involving multiple conditions or incomplete medical records often take longer.

You can file in three ways: by phone at 1-800-772-1213, in person at your local Social Security office, or online through my Social Security (the official Social Security account portal). Filing online is fastest if you have all documents ready. By phone or in person, a representative will walk you through the questions and tell you what medical records to send. You do not need a lawyer to file, though some families hire one after a denial.

Once you file, Social Security sends you a list of the specific medical evidence they need. You are responsible for gathering these records from hospitals, clinics, and doctors—Social Security will not retrieve them for you. If records are missing or incomplete when your case is reviewed, the decision will be delayed or denied, so it is worth calling your child's doctors' offices directly to confirm what has been sent.

Key Takeaways

  • You file through Social Security by phone (1-800-772-1213), online at my Social Security, or at your local office, and you must provide medical evidence that your child's condition will last at least 12 months or be fatal.
  • Social Security will send you a list of required medical records after you file, and you are responsible for collecting and submitting them from your child's doctors and hospitals.
  • The decision process takes three to five months on average, but incomplete medical records or complex cases can extend this timeline significantly.
  • Your child can receive benefits while you wait for a decision if you file for Supplemental Security Income (SSI) rather than only child disability benefits, because SSI has an expedited review for children under age 18.
  • If Social Security denies your claim, you have 60 days to request reconsideration, and most families who appeal with stronger medical evidence succeed on the second or third attempt.

What Medical Records You Will Need to Gather

Social Security requires detailed medical documentation showing your child's diagnosis, how the condition affects daily functioning, and what treatment your child receives. This means records from every doctor, hospital, therapist, or specialist who has evaluated or treated your child in the past 12 months. If your child has been hospitalized, had surgery, or received ongoing therapy, those records are especially important because they show the severity and ongoing nature of the condition.

The specific records Social Security requests depend on your child's condition. For a child with autism, they want psychological evaluations, school records showing educational impact, and notes from any behavioral therapists. For a child with cerebral palsy, they want imaging studies (MRI or CT scans), orthopedic evaluations, and physical therapy assessments. For a child with asthma or epilepsy, they want hospital discharge summaries, emergency room visits, and medication records showing how often your child needs treatment.

You can request records by calling your child's doctor's office and asking for copies to be sent to Social Security. Provide the office with your child's Social Security number and the address Social Security gives you. Some offices charge a small copying fee (usually $10 to $30 per request). If your child sees multiple providers, start requesting records when ready after you file, because gathering them from several offices can take four to six weeks.

Understanding the Medical Evidence Standard

Social Security does not deny claims because your child "is not sick enough." Instead, they deny claims when the medical evidence does not clearly show that your child cannot do age-appropriate activities because of the condition. This is a crucial distinction. Your child does not have to be completely unable to function—your child has to have a condition that significantly limits what a child of that age can normally do.

For young children (under age 12), Social Security looks at whether your child can care for themselves, play with other children, learn in school, and follow directions. For teenagers, they look at whether your child can attend school, do household chores, interact with peers, and eventually work. The medical records must show specific limitations, not just a diagnosis. For example, "Johnny has autism" is not enough. "Johnny has autism and cannot speak in sentences, cannot be left unsupervised, and cannot attend regular school" is the kind of detail Social Security needs.

If your child's doctors have written notes describing functional limitations—what your child cannot do because of the condition—include those in your submission. If they have not, ask the doctor to write a brief statement about how the condition affects your child's daily life. This takes the doctor five minutes and makes a significant difference in how Social Security evaluates your case.

The Timeline From Filing to Decision

Social Security works through your claim in stages. After you file, you receive a notice within two weeks confirming receipt and listing the medical records they need. You then have 30 days to submit those records, though you can request an extension if your doctors are slow to respond. If you submit everything within 30 days, your case moves to the medical review stage.

During medical review, a doctor or psychologist employed by Social Security (called a Disability information Services examiner) reads all the medical records and writes a report on whether your child meets the medical standard. This stage takes four to eight weeks. You do not meet with this examiner—they work from the written records only. After the examiner completes their report, a Social Security claims representative reviews it and makes the final decision.

You receive a written decision in the mail. If approved, the letter states the effective date (usually the month you filed) and the monthly payment amount. If denied, the letter explains the reason and tells you that you have 60 days to request reconsideration. Most denials cite insufficient medical evidence, which means you can reapply with stronger or more recent records from your child's doctors.

What Happens If Social Security Denies Your Claim

A denial is not final. You have three chances to appeal: reconsideration, a hearing before an administrative law judge, and further appeals. Most families who are denied the first time succeed on reconsideration or at a hearing if they submit additional medical evidence or have a representative present their case.

To request reconsideration, you contact Social Security within 60 days of the denial letter and ask for a new review. You can do this by phone, mail, or in person at your local office. When you request reconsideration, submit any new medical records you have gathered since the first decision—recent test results, updated doctor's notes, or records from a new specialist. Social Security will assign a different examiner to review your case, and this second review takes another four to eight weeks.

If reconsideration is also denied, you can request a hearing before an administrative law judge. At a hearing, you can present your child's case in person, answer questions about your child's condition, and have a representative (lawyer or non-lawyer advocate) speak on your behalf. Hearings are held by video or in person, depending on your location. Most families who reach a hearing with strong medical evidence and representation are approved. The hearing stage takes two to four months from request to decision.

Supplemental Security Income (SSI) Versus Child Disability Benefits

There are two ways your child can receive benefits: through Supplemental Security Income (SSI) or as a disabled child on your own Social Security record (called child disability benefits). SSI is based on your child's condition and your family's income and resources. Child disability benefits are based on your work record and are not affected by your income. Most families with children under 18 file for SSI because it is faster and because SSI includes Medicaid coverage in most states.

If you file for SSI, your family's income matters. Social Security counts your household income and assets to determine if your child is financially needy. The income limit varies by state but is roughly $2,000 per month for a family of three. If your income is above the limit, your child may still be approved for a reduced payment, or you may not be approved at all. If you file for child disability benefits instead, your income does not matter—only your work record and your child's medical condition.

When you file, Social Security will ask you which type of benefits you want. If you are unsure, ask the claims representative to explain both options for your situation. You can also file for both at the same time, and Social Security will determine which one your child qualifies for. If your family income is low, SSI is usually the better choice because it includes health coverage. If your income is higher, child disability benefits may be your only option.

Working With Your Child's School and Doctors

Your child's school and doctors are your strongest sources of evidence. Before you file, ask your child's school for copies of evaluations, Individualized Education Plans (IEPs), and progress notes. Schools conduct detailed assessments of how your child learns and functions in the classroom, and these records are exactly what Social Security needs. If your child has an IEP, that document is powerful evidence because it shows the school has formally recognized your child's disability and the support your child requires.

When you contact your child's doctors to request records, also ask them to write a brief statement about your child's functional limitations if they have not already done so. Doctors are used to this request and can usually provide it within a week. The statement should describe what your child cannot do because of the condition—for example, "Due to severe anxiety, [child's name] cannot attend school without a parent present" or "Due to cerebral palsy, [child's name] requires information with all personal care activities."

Keep copies of everything you submit to Social Security. Create a folder with dates and names of documents sent, and follow up with doctors' offices two weeks after you request records to confirm they were mailed. This prevents delays caused by lost records and gives you documentation if you need to appeal.

Frequently Asked Questions

Can my child receive benefits while we wait for a decision?

If you file for SSI, your child may be approved for provisional benefits within 30 days if the case appears strong. This is called an expedited reinstatement or provisional approval, and it provides payment while the full medical review happens. Not all cases may have access to, but it is worth asking the claims representative whether your child's case is may be able to access. Child disability benefits do not have this option—you must wait for the full decision.

Do I need a lawyer to file?

No. You can file and win without a lawyer. However, if your claim is denied and you request a hearing, having a representative (lawyer or advocate) significantly increases your chances of approval. Most representatives work on contingency, meaning they take a percentage of your back pay only if you win. The fee is capped at 25 percent of back pay or $6,000, whichever is less.

What if my child's condition improves?

Social Security conducts periodic reviews to confirm your child still meets the medical standard. For children, these reviews happen every one to three years depending on the condition. If your child's condition improves significantly, Social Security may stop benefits. You are required to report improvements to Social Security. If you do not report and benefits are later stopped, you may have to repay some of the money received.

How much will my child receive each month?

For SSI, the federal payment is $943 per month in 2024, though your state may add a supplement. The actual amount your child receives depends on your family's income and resources. For child disability benefits, the amount is based on your own Social Security earnings record and is typically 50 percent of what you would receive at full retirement age. Social Security will tell you the exact amount when your case is approved.

Can I file for my child if I am not a U.S. citizen?

Yes. Your child can receive benefits if your child is a U.S. citizen or has a valid work permit, regardless of your citizenship status. You will need to provide your child's birth certificate or passport and Social Security number. Your own immigration status does not affect your child's claim, though it may affect whether you can receive benefits on your own record.