In order for a child to be found disabled, they must either meet or functionally equal a “listing” (a list of impairments that the Social Security Administration (“SSA”) has said will result in a finding of disability if the impairment is severe enough). Thus, if a child has an impairment that is on the list, and it is as severe as required by SSA, that child “meets” the listing. However, if the impairment does not meet the specific criteria in the listing, the child can still be found disabled if the impairment “functionally equals” a listing. This is done by showing that the child is either “marked” in 2 of the 6 domains, or “extreme” in 1 of the 6. SSA has defined being marked or extreme in a domain as having impairment or impairments that interferes seriously with your ability to independently initiate, sustain, or complete activities. Obviously to prove an extreme limitation, you would have to prove it interferes more substantially than a marked limitation, although the definition is more involved than this.
The 6 domains are: “acquiring and using information; attending and completing tasks; interacting and relating with others; moving about and manipulating objects; caring for yourself; and health and physical well-being. This article deals with the third domain: “interacting and relating with others.”
So, how does one prove that a child is marked or extreme in the domain of attending and completing tasks? Social Security Ruling (“SSR”) 09-4 gives us some guidance. This domain considers “…a child’s ability to initiate and respond to exchanges with other people, and to form and sustain relationships with family members, friends, and others. This domain includes all aspects of social interaction with individuals and groups at home, at school, and in the community. Important aspects of both interacting and relating are the child’s response to persons in authority, compliance with rules, and regard for the possessions of others. In addition, because communication is essential to both interacting and relating, we consider in this domain the speech and language skills children need to speak intelligibly and to understand and use the language of their community.”
Interact with others refers to a child’s ability to approach another person or a group of people, and how to respond in an age-appropriate manner to others who approach them. They must be able to words, facial expressions, gestures, and actions appropriately when interacting.
Relating to others refers to the child’s ability to form relationships with family members, friends, and others, and to sustain those relationships over time in an age-appropriate manner. This includes both creating and sustaining these relationships.
To adequately interact and relate, a child must have the ability to communicate in an age-appropriate manner. This includes both speech (production of sounds) and language (the message relayed by the sounds).
The ultimate question is whether a child’s medical impairment is so severe that it interferes seriously with the child’s ability to appropriately behave around other people.