Qualifying for Disability with Down SyndromeOctober 8, 2020
If a family member has Down syndrome that prevents them from working, then he or she might be able to qualify for Social Security disability benefits. The Social Security Administration (SSA) oversees Supplemental Security Income (SSI), which is a needs-based disability program for individuals who have disabilities that prevent them from working and earning a living wage. To qualify for SSI, your loved one with Down syndrome will need to meet both medical and financial qualifications.
To qualify for any kind of disability benefits administered through the SSA, specific medical criteria must be met. If there is a medical diagnosis of Trisomy 21 or Translocation Down syndrome, the individual will automatically qualify for disability benefits. The SSA requires the claimant to have a specific chromosomal analysis done, which is called a karyotype chromosomal analysis. The evidence that is required for non-mosaic Down syndrome includes any one of the following:
- A lab report of a karyotype analysis signed by a physician.
- A lab report of karyotype analysis that is not signed by a physician, but is accompanied by a statement signed by a physician that indicates the claimant has non-mosaic Down syndrome.
- The report from a physician stating the applicant has chromosome 21 translocation or chromosome 21 trisomy that is consistent with a karyotype analysis that was done previously, along with the physical features that accompany such a diagnosis.
- A report from a physician that indicates the claimant has Down syndrome along with its physical characteristics and there is evidence that indicates the claimant’s functioning is consistent with the same level of those with non-mosaic Down syndrome.
There is not a specific disability listing for individuals with mosaic Down syndrome, which represents about 3% of the Down syndrome population. Often, these individuals have many of the same symptoms and characteristics as individuals with non-mosaic Down syndrome, but they’ll still need more medical evidence available to qualify because many people with mosaic Down syndrome have less severe physical or intellectual impairments.
Some impairments that an individual with mosaic Down syndrome might experience that qualify for disability include hearing loss, sleep-related breathing disorders, intellectual disabilities, congenital heart conditions, or thyroid disorders. A claimant can be approved for benefits by meeting the criteria of one of those listings. The SSA’s manual on qualifying criteria can be found online, so you can review listings with your child’s doctor to see where he or she will qualify.
SSI Income Limits
There are specific income limits for SSI benefits. If parents are applying for SSI on behalf of a minor who has Down syndrome, a portion of the parents’ income is counted and considered as it were available for the child. As an example, if all income is earned and there are no ineligible children in the household, a one-parent household can earn $3,125 per month. The SSA’s website has the specifics regarding how income is determined and what is counted. The larger your family, the higher your income limit will be.
Income limitations are the top reason for minors with Down syndrome to be denied benefits. The good news is that once your child turns 18, the SSA will not count your income towards his or her monthly limit and it’ll be much easier to qualify for SSI.
Applying For Benefits
If you are ready to apply for disability benefits on behalf of a child or family member with Down syndrome, you can start the process online on the SSA’s website, by calling 1-800-772-1213, or by visiting your local SSA office and meeting with a representative face to face. Documentation and evidence are the key to a successful disability claim, but so long as your child had a karyotype analysis sometime in the past, it’s almost certain that he or she will medically qualify for benefits.
Pujols Family Foundation: https://www.pujolsfamilyfoundation.org/
Down Syndrome and SSD: https://www.disabilitybenefitscenter.org/social-security-disabling-conditions/down-syndrome
Qualifying Criteria: https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm
SSI for Children: https://www.ssa.gov/ssi/text-child-ussi.htm
Apply Online: https://secure.ssa.gov/iClaim/dib