""

Changes in Benefits when You Turn 18

What to Expect as You Approach Your 18th Birthday


If you or your family receive a monthly check from the government because you have a disability, there are several things you need to be aware of as you approach your 18th birthday.

  • The monthly check you receive is called SSI (Supplemental Security Income).
  • You may see changes in your Supplemental Security Income.
  • At age 18, youth who get SSI must go through two kinds of medical reviews to keep their benefits. This is called age 18 redetermination.
African american teen looking confused.

Information & Services


Age 18 Reedetermination

At age 18, youth who get SSI must go through two kinds of medical reviews to keep their benefits. More information about Age 18 Redetermination.

Section 301

Section 301 is a work incentive that lets you keep SSI and medical insurance longer while you prepare for employment. More information about Section 301.


WIPA

WIPA benefits counselors can proactively advise you about requesting Section 301. More information about WIPA.


Medical Reviews under Age 18

If you are under age 18 and receiving SSI, you may have a medical review. More information about medical reviews under age 18.

Age 18 Redetermination

The Social Security Administration’s (SSA) disability rules for adults are different from disability rules for children. If medical reviews don’t show that you meet Social Security’s adult disability standard or you have medically improved, benefits usually stop.

The review usually happens within a year after you turn 18. This is called age 18 redetermination. Social Security will contact you to complete a medical review. Social Security will send a letter and it will do one of two things.

  • Ask you to come to their office, or
  • Send forms in the mail to complete.

Forms and documents required for the age 18 redetermination include:

NOTE:  If you do not meet the adult standard, your SSI will stop. However, SSI may continue through Section 301 if you take part in special education with an IEP, vocational rehabilitation, or certain other employment programs.


What is Section 301?

Section 301 is a work incentive that lets you keep SSI and medical insurance longer while you prepare for employment, even though you may no longer meets Social Security’s adult disability definition or you have “medically improved”.

You must take part in an approved program such as Division of Rehabilitation Services or receive special education services, and other services designed to help you gain work skills and experience.

Other benefits of Section 301 are:


  • Automatic elibility for SSI

    If you participate in special education — with an Individualized Education Program (IEP) — then you are automatically eligible to keep SSI through Section 301.

  • SSI payments can continue

    SSI payments can continue until either you stop participating in a program, OR you reach age 21, whichever comes first.

  • Ability to transition into another employment program

    If a program ends prior to you turning 21, you can transition into another employment program – especially through the Division of Rehabilitation Services (DORS) – and possibly still continue SSI payments through Section 301.

NOTE: You must start the other program within 3 months after the end of the month that your program participation stops or the program ends. Social Security will review your participation in these programs to decide whether it will reduce the chances you will return to SSI rolls in the future.

For Maryland PROMISE, it is important to note the following:

  • You must start participation in PROMISE employment services before the Social Security results of the age 18 redetermination or medical review are mailed to you.
  • Because the age 18 redetermination can happen at any time after you turn 18, you should start engaging in PROMISE employment services before you turn 18.
  • You must participate in PROMISE for at least 2 months after the month you receive the denial letter to qualify for Section 301, and must continue longer to remain eligible for Section 301.
  • If you are closed out of PROMISE, you must enroll in DORS or other employment services within 3 months for Section 301 to potentially continue.
  • Being engaged in PROMISE is important because it gives you and your family time to adjust to the loss of SSI, and for you and other members of your family to get training and support, locate jobs and start working for pay to make up the the loss of SSI.

How can I get qualified for Section 301 if I am not enrolled/eligible for Maryland PROMISE?

If you have not yet been determined medically improved and have a case open with DORS, then DORS could pay for benefits counseling. Please talk with your DORS counselor and request benefits counseling from someone with knowledge of 301.

What is WIPA?

If you have received notice of a medical review from Social Security and have not yet received the decision, the Maryland Work Incentives Planning and Assistance (WIPA) can serve you. Benefits counselors can proactively advise you about requesting Section 301 if necessary, and which forms need to be completed. However, once Social Security has issued the decision that you are no longer eligible for SSI, WIPA can no longer help you.

It may be hard for you to navigate Section 301 without a benefits counselor, so you should reach out to a WIPA as soon as possible prior to turning 18 or as soon as you know you are under review for medical improvement. For more information visit the Maryland WIPA Website or call the Ticket to Work Helpline (866) 968-7842. The Helpline refers callers to local WIPA projects when appropriate, but can also refer callers to other resources as needed.

Maryland’s WIPA Contact Information

Maryland WIPA Website
Phone: (301) 277-2839

Medical Reviews under Age 18

If you are under age 18 and receiving SSI, you may have a medical review.

  • The reviews happen every 1 – 7 years, depending on how likely it is that the disability will improve.
  • The Social Security Administration checks to see if you continue to meet Social Security’s definition of disability for children.
  • If you still meet the childhood disability standard and have not “medically improved”, then your SSI payments will continue.
  • If you have “medically improved”, then SSI usually stops, but may continue through Section 301 if you are engaged in 301 approved services

Some forms for the medical review are online:

Appealing a Medical Review Determination

Even if you are not eligible for Section 301, you can always appeal if you are not happy with the result of the age 18 review. However, there are timelines and steps that must be taken.

Form for Appealing a Medical Review Determination

You can keep benefits, pending the result of the appeal (through the second level of appeal, a hearing with an administrative law judge), if you submit the appeal request within 15 days of date on the notice of the unfavorable decision on the medical review (Note: It’s supposed to be within 10 days of receiving the notice, and Social Security assumes it takes 5 days to receive the notice).

IMPORTANT:   If your benefits continue pending the result of the appeal and the appeal is unsuccessful, you are likely to have an overpayment. You must repay the benefits sent after they would ordinarily have stopped (usually, any payments received after the second calendar month following the month of the unfavorable decision).

If you qualify for Section 301, though, you do not have to repay the benefits.