Fetal Alcohol Syndrome and Social Security Disability Benefits

Fetal alcohol syndrome (FAS) is not a singular birth defect, but rather a series of related medical problems that can occur if a mother consumes alcohol while pregnant. FAS can cause a variety of debilitating symptoms including problems with learning, memory, communication, vision, and hearing.

Caretakers and parents of children with FAS often face significant financial challenges. The medical care, educational support, and corrective therapies necessary for many children with FAS can be very expensive. Unfortunately, not all families can afford to cover these costs. 

If your child has FAS and you find that you can no longer support them financially, he or she may be eligible for Social Security Disability benefits.  The following article is intended to provide a general overview of Social Security Disability benefits and to prepare families for the application process.

Definition of Disability

To qualify for Social Security benefits, children with FAS must meet the SSA’s definition of child disability. The SSA considers a child under the age of 18 to be disabled if he or she meets the following criteria:

•         The child does not earn a substantial income; and

•         Has a physical or mental condition (or a combination of conditions) that very seriously limits his or her activities; and

•         The condition(s) has lasted, or is expected to last, at least one year or is expected to result in death. 

Children who do not meet these criteria will not be eligible to receive Social Security Disability benefits.

Social Security Disability Benefit Programs

The SSA offers two types of disability benefits to those who meet their official definition of disability. These benefits are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Each program has its own set of technical requirements.

The first type of benefit—SSDI—is intended to provide financial assistance to disabled workers and their eligible family members.  Eligibility for SSDI is dependent upon an applicant’s employment history and past Social Security tax contributions.  This program is not typically a good fit for children as they lack employment history. However, children whose parents already receive SSDI are the exception to this rule.  In this case the child may qualify under the parent’s record. This is known as dependent or auxiliary benefits. Learn more here. (http://www.disability-benefits-help.org/glossary/auxiliary-benefits)

SSI, on the other hand, is intended to provide financial assistance to disabled individuals of all ages who earn very little income.  There are no age or work requirements associated with this program, making it a better option for children. Eligibility for SSI is based solely on strict financial limits.  Because most children are not responsible for their own finances, the SSA will evaluate a child’s disability claim based on the income of their entire household.  The process of allocating a parent or guardian’s income to the record of a child applicant is called deeming. Deeming applies to children who are younger than 18, unmarried, and who still live with a parent or guardian. Learn more about deeming and SSI eligibility, here. (http://www.socialsecurity.gov/ssi/spotlights/spot-deeming.htm).

Medical Eligibility

In addition to being technically eligible for disability benefits, applicants must also be medically eligible. Medical eligibility requirements are listed within the SSA’s official guidebook of disabling conditions—commonly referred to as the SSA’s Blue Book.

Within the Blue Book, there is no specific listing for FAS. However, Children with FAS may qualify under a number of listings related to their impaired body system. Below are many related Blue Book listings:

·         Section 100.00- Growth Impairment –helpful for children with FAS who suffer from low body weight.

·         Section 101.00- Musculoskeletal System—applies to children who have problems with their bones and joints.

·         Section 102.00- Special Senses and Speech—vision and hearing problems.

·         Section 104.00- Cardiovascular System—cardiovascular impairments such as chronic heart failure and congenital heart disorders.

·         Section 105.00- Digestive System—relevant health problems like chronic liver disease, liver transplants, and malnutrition.

·         Section 106.00- Genitourinary Impairments—helpful to children with impairments of kidney function or urinary system.

·         Section 111.00- Neurological—applies to children who suffer from seizures, motor dysfunction, and communication disorders.

·         Section 112.00- Mental Disorders—helpful for children who have mental disorders like ADD/ADHD, mood disorders, and psychotic disorders.

 

Under each of these listings you will find the medical criteria for specific health conditions and diseases. To qualify for disability benefits, your child must meet the criteria of at least one Blue Book listing. You can find all Blue Book listings, here. (http://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm)

Social Security Disability Application Process

To begin the SSI application process on behalf of a child, you should call the SSA immediately to schedule a disability interview. The next available appointment may not be for several months. While you wait, you should use the time to collect all necessary medical and non-medical records.  You can find a complete list of these records, here. (http://www.ssa.gov/disability/Documents/Checklist%20-%20Child.pdf)

The actual application for SSI is made up of two separate forms:

1.       Application for Supplemental Security Income

2.       Child Disability Report

Although the first form can be completed online, the second cannot. Therefore many parents find it easier to complete both forms during the scheduled disability interview.

Receiving a Decision

After submitting an application on behalf of your child, you may have to wait several months before receiving a response. During this time the SSA may contact you for additional information concerning your child’s medical condition. Be sure to respond to these requests promptly in order to avoid any further delays in the approval process.

Due to strict requirements, many initial applications for benefits are denied. If your child’s initial application is denied, you have 60 days in which to appeal this decision. During the appeals phase it may be in your best interest to seek the assistance of a Social Security Disability attorney or advocate. A legal professional will be able to help prepare you for the appeals process and will prevent you from making costly mistakes.

Although the appeals process may seem complicated and overwhelming, it is often an essential step toward being awarded benefits. In fact, many more applicants are awarded benefits during the appeals processes than during the initial application. For this reason, it is important that you do not give up.

For more information visit Social Security Disability Help (http://www.disability-benefits-help.org/blog) or contact Molly Clarke at mac@ssd-help.org.