Possible SSI Benefits When Your Baby Has Down Syndrome

Applying for SSI Benefits When Your Baby Has Down Syndrome

If you’ve recently learned that your child has or will have Down syndrome, there are many steps you can take to give your a happy, healthy, and rewarding life. Thanks to the Social Security Administration (SSA), it can be possible receive financial benefits to help your family provide the best life possible for your child.

What Disability Benefits Are Available?

Many children born with Down syndrome receive Supplemental Security Income (SSI), which provide monthly cash payments to children and adults with disabilities from lower-income households. SSI is for people of all ages, so your child could receive benefits as an infant and continue to qualify throughout adulthood.

SSI is a means-tested program, so your family income and resources may not exceed a certain threshold. This benchmark will vary depending on whether or not both parents are in the household and how many children there are in addition to your child with Down syndrome. For example, a single parent with two other children is capped at $3,791 per month (about $45,000 per year) in earned income, while a two-parent family with two children will have a much higher monthly income limit at $4,158 a month, or $50,000 per year. The SSA’s website contains a current list of income limits according to family demographic and size.

If your family falls within approved income limits, you can apply for SSI benefits on your son or daughter’s behalf after he or she is born and the Down syndrome diagnosis is confirmed through a karyotype analysis. If the application is approved, you will receive monthly payments as well as access to Medicaid for your child’s healthcare needs in nearly every state.

How to Qualify for SSI with Down Syndrome

To qualify for benefits, any applicant usually needs to meet a listing in the Blue Book, the SSA’s catalog of intellectually and/or physically disabling conditions and the criteria for meeting each one. Down syndrome appears in section 110.06–Non-Mosaic Down Syndrome.

The majority of children with Down syndrome have the “non-mosaic” variety, (Trisomy 21 or Translocation), meaning that they have an extra 21st chromosome on each cell in their body. These children are considered disabled from birth due to the intellectual, physical, and neurological conditions that often accompany Down syndrome. If your child is diagnosed with Mosaic Down syndrome, he or she could still qualify, but your application will be a little more complicated. You’ll need additional medical evidence proving that a physical or intellectual complication caused by Down syndrome keeps your child from participating in usual activities. Some listings your child might meet include:

102.00: Covers hearing loss or vision impairment

104:00: Any cardiovascular disorders are listed here

112.00: Intellectual and mood disorders

The SSI Application Process

When you apply for benefits on your child’s behalf, you will have to fill out a detailed application form, collect financial documents that confirm the household income and resources, and provide medical evidence of the child’s Down syndrome diagnosis. The latter may include:

A karyotype analysis report OR
Documented medical confirmation of a chromosome 21 translocation or trisomy in addition to the physical aspects of Down Syndrome OR
A report confirming that the child’s functional capacity is consistent with non-mosaic Down Syndrome and that an analysis was performed in the past

If your household income falls within approved limits, your child will usually be approved for SSI benefits if your child’s non-mosaic Down syndrome diagnosis is conclusive. Should the application be denied on financial grounds, you may reapply after your child turns 18, as adults with disabilities are evaluated based on their own income or resources. Note: the vast majority of SSI applications are turned down for financial reasons, not medical. This means that your child has a great chance of qualifying once he or she is 18 and your income no longer counts towards the household limit.

For more information on how to apply for SSI benefits on behalf of your child with Down Syndrome, visit the SSA’s website, or schedule an appointment to apply at your closest office (there are over 1300 locations nationwide). You can do so by calling the SSA toll-free at 1-800-772-1213. Monthly disability payments will make it easier for you to meet the daily needs of your son or daughter and cover his or her medical expenses, thereby giving your child the most fulfilling life possible.

Article provided by Disability Benefits Help, an independent resource dedicated to helping people of all ages receive the disability benefits they need. If you’d like to speak with our staff regarding your child’s eligibility, feel free to contact them at help@disability-benefits-help.org.

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