DAC benefits denied for my disabled son - told 'insufficient information' after SSA agent said no medical records needed

Unfortunately, what you experienced is increasingly common with SSA. The representative was incorrect about not needing medical documentation for DAC benefits. While they do sometimes use the existing SSI determination, it's not automatic, especially for long-term cases. The DAC program (formerly called CDB - Childhood Disability Benefits) requires proof that: 1. Your daughter became disabled before age 22 2. She remains disabled according to SSA's definition 3. You (the parent) are receiving Social Security retirement or disability OR are deceased The vague denial letter is typical bureaucratic language when required documentation wasn't submitted. During reconsideration, specifically state that you were advised no medical records were needed, and include: - Your daughter's complete medical history documentation - Evidence showing disability onset before age 22 - Any ongoing treatment records Request a face-to-face interview for the reconsideration if possible.

I went through almost IDENTICAL situation last year with my brother!!! The phone rep told us we didn't need to submit any medical evidence because "the system already knows he's disabled from SSI" (his exact words). Guess what? DENIED for "insufficient information" too. Our reconsideration was approved though after we submitted: - All medical records from before he turned 22 - Letter from his long-term psychiatrist - School records showing special education services - Statement from me about his condition before 22 The MOST FRUSTRATING part was calling SSA to get clarification. I spent HOURS trying to reach someone. When I finally found Claimyr.com (https://youtu.be/Z-BRbJw3puU), I got through to SSA in 20 minutes instead of waiting for days. The agent I spoke with was helpful and specifically told me what was missing from our application. Don't give up! DAC benefits are so much better than SSI because of the Medicare coverage and higher payment amounts.

just wondering has your daughter been working at all during these years? reason i ask is i heard somewhere that if they have significant work history then they might not qualify for DAC even if they were on SSI. something about substantial gainful activity

SSA is a NIGHTMARE to deal with!!! My son was denied THREE TIMES for his DAC benefits even though he's been disabled since birth!! The whole system is designed to make you give up. Don't trust what ANY rep tells you over the phone - half of them don't know their own rules and the other half just want to get you off the line. The "insufficient information" excuse is their go-to when they're too lazy to actually review the case properly. I GUARANTEE they never even looked at your daughter's SSI file even though it's in their system. When you do reconsideration DEMAND a different examiner review the case and specifically state you were given incorrect information by SSA staff. If they deny again, get a disability attorney for the ALJ hearing level - they take cases on contingency.

I process disability claims for a living (not for SSA). Here's what likely happened: The DAC program requires evidence that disability began before age 22. While your daughter has been on SSI for many years, the SSI file may not contain sufficient documentation about her condition prior to age 22, especially if she began receiving SSI at age 19. The rep who told you no medical records were needed was incorrect. There's no new policy allowing automatic approval based solely on SSI receipt. The "Continuity of Care" policy they might have been referencing only applies in very specific circumstances. For your reconsideration, focus on these three elements: 1. Medical evidence from before she turned 22 that clearly establishes disability 2. Continuous medical evidence showing ongoing disability (no significant gaps) 3. Current medical documentation confirming she remains disabled The good news: once approved, DAC benefits are significantly better than SSI - higher payment amounts, no asset limits, and Medicare coverage after 24 months.

my cousins kid got denied for same reason but turned out they sent the paperwork to wrong address so ssa never got it maybe check if they had right mailing info for you

Random question but did your daughter get the letter or did you? My son is on SSI too and I'm his representative payee but sometimes they still send HIM stuff instead of me which makes no sense since he cant manage his own affairs!!

When you submit the reconsideration, include a cover letter that clearly states: 1. You were specifically instructed by an SSA representative on [date] that medical records were not needed due to the long-term SSI status 2. You followed all instructions provided but were not told to submit medical documentation 3. You're now providing comprehensive medical history including: - Records establishing disability before age 22 - Continuous treatment records - Current medical status I'd also recommend trying to reach a supervisor at your local office to discuss the situation. The best way I've found to reach someone quickly at SSA is through Claimyr (claimyr.com). They've got a video showing how it works: https://youtu.be/Z-BRbJw3puU. This saved me days of frustration when dealing with my mother's benefits issues. The DAC benefit approval should be straightforward since your daughter has been on SSI so long, but you do need to provide the right documentation.

Quick update on my brother's situation that I mentioned earlier - we finally got approved after reconsideration and the monthly payment is $1,675 compared to the $943 he was getting on SSI. Plus, no more stressing about the $2,000 asset limit! The Medicare will kick in soon too. Definitely worth fighting for!