The Social Security Administration (SSA) not only provides financial assistance to adults living with disabilities but also to children. But which childhood disabilities are covered by the SSA, and what are your options?
There are many childhood disabilities that would make children eligible for disability benefits. The two primary disability programs that exist are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Furthermore, children are also eligible for Medicare to help with their medical expenses.
Read on as we go into great detail about the disabilities that these programs cover, their causes, and the options that parents have.
Types of Childhood Disabilities
We’ll discuss the various childhood disabilities that the SSA covers in this section.
Low Birth Weight and Failure to Thrive
Low birth weight can often cause complications for a child and keep them at risk of many other disorders. It is often associated with a failure to grow or developmental delays. The SSA defines low birthweight as having a weight of 1200 grams or less at the gestational age of 32 weeks.
In order to evaluate a child’s eligibility based on this condition, the SSA reviews medical records and documentation and analyzes the history of the child’s growth. The low birth weight is then compared with a growth table based on gestational age and the appropriate weight.
Musculoskeletal Disorders
There are three types of disorders that are considered under this category:
- Disorders of the skeletal spine: These comprise disorders that affect the bony structure of the spinal cord and may include injuries, deformities, or amputations. Disorders related to muscles, tendons, or soft tissues may also be included.
- Soft tissue injuries: These can occur on any part of the body and include burns or other injuries that continue to be followed or managed by surgical intervention.
- Curvatures of the skeletal spine: For these disorders to be considered, they must affect the musculoskeletal functioning of the body. This means that it should cause symptoms such as pain, muscle fatigue, paresthesia, and physical limitations requiring the need for external support like walkers, canes, scooters, crutches, and other mobility aids
Disorders of the Special Senses and Speech
These are disorders that affect hearing and vision, including loss of visual acuity, hearing loss (regardless of whether it requires the use of a cochlear implant or not), loss of visual efficiency, mutism, and disturbance of the labyrinth.
In order to evaluate a child’s eligibility for benefits, the SSA may require them to undergo testing (such as visual field testing) or analyze their medical records for evidence of such disorders.
Respiratory Disorders
These are disorders that result in difficulty moving air in and out of the lungs or that interfere with diffusion (the exchange of gases). Disorders such as chronic pulmonary disease, asthma, and cystic fibrosis would fall into this category.
The SSA will look at the child’s medical records in order to assess the presence and severity of the disorder. Medical records may include the results of imaging tests, any past treatments, and the child’s response to those treatments.
Disorders of the Cardiovascular System
These include disorders or illnesses that will either directly affect the heart or its associated arteries, veins, capillaries, or lymphatic system. In order to assess a child’s eligibility for disability benefits, the SSA will look at medical records pertaining to history, physical examinations, results of testing, any past treatment records, and responses to past treatments.
The SSA will also consider the duration and severity of the disorder when evaluating the disorders.
Disorders of the Digestive System
This category comprises any disorders that affect the digestive system, such as gastrointestinal hemorrhage, hepatic (liver) dysfunction, inflammatory bowel disease (IBD), etc. These disorders can affect the individual’s development, nutrition, and growth and cause further complications, such as obstruction or symptoms in other body parts.
To prove eligibility, you will be required to submit medical documentation such as results of endoscopy, any past surgeries, imaging studies, etc. This is one category where duration and severity are key as these disorders of the digestive system commonly respond well to treatment.
Genitourinary Disorders
This category includes disorders that result in chronic kidney disease, such as diabetic nephropathy, chronic obstructive uropathy, and hereditary nephropathies. Like other disorders, the SSA will look closely at all the associated medical evidence and any further evidence of dialysis or transplants.
Hematological Disorders
This category consists of disorders that disturb the normal functioning of white blood cells, red blood cells, and platelets.
They may include non-cancerous disorders like homeostasis, hemolytic anemias, disorders of thrombosis, conditions related to HIV, etc., or cancerous disorders like leukemia, lymphoma, or multiple myeloma.
Medical evidence pertaining to these conditions most commonly includes the results of various laboratory tests.
Skin Disorders
It is quite difficult to obtain approval for skin disorders because the related disabilities are quite difficult to prove, but having extensive medical evidence is usually helpful. It is also recommended to be under the treatment of a physician or skin specialist.
Examples of skin disorders considered by the SSA include ichthyosis, bullous diseases, chronic infections of the skin or mucous membranes, and dermatitis.
Endocrine Disorders
Endocrine disorders are those that disrupt the hormonal levels in the body. They are the result of a problem within the endocrine system (a system of various glands that secrete hormones). Common examples are conditions relating to the thyroid (such as hypo- and hyperthyroidism), pituitary gland disorders, or endocrine disorders such as diabetes mellitus.
Congenital Disorders that Affect Multiple Body Systems
The two types of conditions included in this category are non-mosaic Down syndrome and catastrophic congenital disorders. Non-mosaic Down Syndrome is a genetic disorder resulting in chromosome 21 trisomy, or chromosome 21 translocation.
This syndrome is associated with further conditions, such as visual impairment, hearing impairment, heart disease, and more.
Catastrophic congenital disorders are disorders resulting from an abnormal genetic makeup. Examples include anencephaly, cyclopia, chromosome 13 trisomy (Patau syndrome or trisomy D), and chromosome 18 trisomy.
These disorders either shorten the child’s lifespan or interfere severely with their growth and development.
Neurological Disorders
Neurological disorders are those that affect the brain or spinal cord. They can interfere with neuromuscular functioning, cause speech impairment, or result in issues with motor functioning. Mental disorders resulting from neurological causes, such as Autism Spectrum disorder, are categorized separately under the “Mental Disorders” category (discussed below).
To assess eligibility for disability benefits, the SSA will take a close look at both medical (results of laboratory testing, imaging tests, and past treatments) and non-medical (statements from family or a doctor) evidence. Common examples of neurological disorders include cerebral palsy and epilepsy.
Mental Disorders
This category consists of disorders that directly affect cognitive function and cause emotional dysregulation and behavioral issues. The SSA considers 12 categories of mental disorders for disability benefits:
- Neurocognitive disorders
- Schizophrenia spectrum and other psychotic disorders
- Depressive, bipolar, and related disorders
- Intellectual disorder
- Anxiety and obsessive-compulsive disorders
- Somatic symptoms and related disorders
- Personality and impulse-control disorders
- Autism spectrum disorder
- Neurodevelopmental disorders
- Eating disorders
- Developmental disorders in infants and toddlers
- Trauma- and stressor-related disorders
Mental disorders are some of the hardest to prove because, oftentimes, there is no straightforward way to test them. This is why extensive medical and non-medical evidence can be helpful in boosting your claim.
Cancer
The spread of abnormal body cell growth to various body parts is a common cause of these disorders. The SSA covers almost all cancers, except for certain cancers related to HIV. When determining eligibility for disability benefits, the SSA carefully analyzes the origin of the disorder, duration of treatment, and response to treatments like chemotherapy.
Immune System Disorders
These disorders dysregulate or compromise single or multiple components of the immune system. This happens because the immune system damages the body’s own cells. Disorders in this category are put into three further subcategories:
- Autoimmune disorders
- Immune deficiency disorders (except HIV infection)
- HIV infection
Causes of Childhood Disabilities
In this section, we will cover the causes of the various types of childhood disabilities described above.
Low Birth Weight or Failure to Thrive
By conventional standards, the SSA’s proposed low birth weight criteria are actually “very low birth weight.” According to the CDC, 1.38% of children are born with a very low birth weight of less than 1,500 grams. The two most common causes of low birth weight are preterm births and fetal growth restriction.
Musculoskeletal Disorders
Approximately 8.5% of children all over the United States suffer from some sort of musculoskeletal pain. Common causes include injuries resulting in a sprain or repetitive use of the same body part.
Special Senses and Speech Disorders
In 2021, 9,809 children were found to be deaf-blind from all over the United States. There are many causes of such special sense disorders, including CHARGE Syndrome, Down Syndrome, Usher Syndrome, and Congenital Cytomegalovirus (CMV).
Respiratory Disorders
It was found that respiratory disorders were the cause of 725 ER visits per 10,000 visits. Common causes include exposure to tobacco smoke, air pollutants, allergens, or congenital problems.
Cardiovascular Disorders
In 2016, one in 77 U.S. children had a cardiovascular disorder. Causes include prenatal exposures to cigarettes or alcohol, family history or genetics, or associations with other conditions such as diabetes.
Digestive Disorders
The occurrence of digestive disorders increases with age, but many children continue to suffer from these disorders all over the United States. Common causes include an injury to the intestine, Crohn’s disease, blocked blood vessels, etc.
Genitourinary Disorders
One study found that approximately 9% of girls suffer from UTIs, as opposed to 1% of boys. Common causes of genitourinary disorders include having a family history of such disorders, exposure to cigarette smoke, or association with other conditions such as diabetes.
Hematological Disorders
Approximately 2.90% to 3.57% of children suffer from a spectrum of hematological disorders. The most common causes include genetic abnormalities, malnutrition, or complications due to medications.
Skin Disorders
Children commonly suffer from skin disorders, with one of the most common being papular urticaria and dermatitis. Viral infections, bacterial infections, fungal infections, or connections with other conditions are frequently the causes of these conditions.
Endocrine Disorders
Endocrine disorders are common in children, with the most commonly diagnosed disorders being growth hormone deficiency, precocious puberty, and thyroid-stimulating hormone deficiency. The causes are usually either genetic or involve prenatal exposure to harmful substances.
Neurological Disorders
Approximately 3.4 per 1,000 children are diagnosed with a neurological disorder per year. Most conditions have genetic causes, but some are due to other conditions such as trauma or other birth defects.
Mental Disorders
According to the NIH, approximately 20% of children in the United States suffer from a mental disorder. The most common causes include witnessing or experiencing abuse, going through a big life change, or trauma.
Cancers
Every year, there are approximately 15,780 children diagnosed with cancer. The most common cause is gene mutations.
Immune System Disorders
About 44.7 per 100,000 children suffer from an autoimmune condition. Causes can be either genetic or environmental.
Options Available for Disabled Children
Following are the disability programs for children offered by SSA:
SSDI
SSDI is a program that aims to provide financial assistance to people unable to work due to a disability. Although disabled children would not meet the criteria for work credits outlined by the SSA, they can still be approved for SSDI based on their parent’s work records. Disabled children can receive up to 50% of their disabled parent’s benefit amount.
SSI
SSI is a program that aims to provide financial assistance to low-income households. Children only need to meet the SSA’s disability requirements to qualify. Generally, SSI offers a lower payout than SSDI.
Medicare/Medicaid
Children who get approved for SSI or SSDI automatically get health insurance like Medicare or Medicaid. This can be a huge plus for parents who are unable to manage their children’s medical expenses.
Conclusion
The SSA covers a wide range of childhood disabilities. This is a huge relief for parents who find it difficult to cope with their child’s medical expenses. If you want to find out whether your child qualifies for disability benefits, it’s recommended that you talk to a Social Security advocate or an experienced disability attorney.
