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Approximately 1 in 700 children is born with some form of Down syndrome. There are several types of Down syndrome that can determine how impaired the child is. A diagnosis of Down syndrome can be overwhelming for parents who may scramble to figure out how to absorb the extra costs associated with raising a child who has Down syndrome.

Approximately 1 in 700 children is born with some form of Down syndrome. There are several types of Down syndrome that can determine how impaired the child is. A diagnosis of Down syndrome can be overwhelming for parents who may scramble to figure out how to absorb the extra costs associated with raising a child who has Down syndrome. There is help available from the Social Security Administration. Children who are born with Down syndrome can qualify for Supplemental Security Income, or SSI. SSI benefits can help pay for any extra care or treatment that the child needs so that parents don’t have to worry about how to afford what their child needs.

Types Of Down syndrome and Qualifying For SSI Benefits

There are two primary types of Down syndrome: trisomy 21 and Mosaic Down syndrome. trisomy 21 is the most common form of Down syndrome. A child with trisomy 21 has three 21 chromosomes instead of the usual pair. This is what causes that Down syndrome. According the Blue Book, which lists all of the conditions that qualify for SSI benefits, children who have trisomy 21 can qualify for SSI benefits as long as they have the results of one of these:

  • a laboratory report of karyotype analysis signed by a doctor
  • a laboratory report of karyotype analysis not signed by a doctor with a statement by a physician that the applicant has Down syndrome
  • a doctor’s report stating the applicant has chromosome 21 trisomy or chromosome 21 translocation consistent with a prior karyotype analysis, with the distinctive physical features of Down syndrome.
  • a doctor’s report stating the applicant has Down syndrome with the distinctive physical features of Down syndrome and evidence demonstrating the applicant’s functioning is at a level consistent with non-mosaic Down syndrome.

Mosaic Down syndrome is rare, but it does happen. A child that has Mosaic Down syndrome has a different set of requirements that must be met in order for that child to qualify for SSI benefits. There is no listing for Mosaic Down syndrome, so a child with Mosaic Down syndrome must meet the requirements listed in the Blue Book for another condition in order to qualify for SSI benefits:

  • congenital heart disease
  • sleep-related breathing disorders, such as obstructive sleep apnea
  • hearing loss, such as that caused by recurrent ear infections
  • intellectual disability or low IQ
  • thyroid disorders

Parents will need to provide medical documentation in order to prove that the child meets those requirements. In addition, parents will need to financially qualify for SSI benefits.

Financial Requirements

SSI benefits were created to help families that don’t have a lot of income. So in order to qualify for benefits parents must provide proof that the income of all of the working adults in the household falls below the income cap set by the SSA. Parents will need to provide proof of income like W-2s, bank statements, or Federal tax returns in order to prove that their income falls below the cap.

Starting A Claim For SSI Benefits

You will need to apply in person for SSI benefits for a child with Down Syndrome. You can make an appointment at a Social Security office. When it’s time for the appointment bring all of your child’s medical records and well as the financial information for everyone in the house to the appointment. A staff member at the SSA will help you fill out and file the claim application and submit all of your medical and financial documentation.

 

Helpful Links:

https://www.ssa.gov/disability/professionals/bluebook/110.00-MultipleBody-Childhood.htm – 110_06

https://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm

https://www.disabilitybenefitscenter.org/glossary/acceptable-medical-source

https://www.ssa.gov/ssi/text-child-ussi.htm

https://www.disabilitybenefitscenter.org/state-social-security-disability

Rachel Gaffney is an Outreach Specialist at Disability Benefits Center, an independent organization dedicated to helping people of all ages receive the Social Security disability benefits they deserve. If you have any questions on this article or would like a little more information on how to qualify for disability benefits, she can be reached at [email protected]. By Rachel Gaffney

Source: Karen Gaffney