Down Syndrome and Social Security Disability Benefits

May 18, 2018 | Outreach Team at Disability Benefits Help

If your child or family member has Down syndrome, he or she may be eligible for financial assistance to help pay for any medical care, housing costs, caretakers, and any other daily living needs. The Social Security Administration (SSA) offers benefits for people who are unable to work or participate in typical childhood activities due to a serious disability. Down syndrome almost always medically qualifies for Social Security benefits, but financial eligibility may be a little more challenging.

Medical Qualifications with Down Syndrome

The SSA uses its own medical guide, known as the Blue Book, to evaluate all Social Security disability applicants and deem benefits accordingly. Down syndrome is listed as a qualifying condition in the Blue Book. If your child has Trisomy 21 or Translocation Down syndrome (98% of the Down syndrome population), he or she will automatically qualify.

Those with Mosaic Down syndrome may qualify, but your child would need more than a diagnosis to be approved. Because [according to SSA] people with Mosaic Down syndrome may not have as many intellectual or physical disabilities as those with other forms of Down syndrome, you’ll need to meet another listing in the Blue Book to qualify. Some complications of Down syndrome that may qualify include:

  • Vision loss of 20/200 or worse in the best eye
  • Heart problems
  • Intellectual disabilities that make it impossible to work and earn more than $1,190 (in 2018)
  • An inability to communicate with others verbally or visually
  • Spinal cord injuries resulting in an inability to stand from a seated position or walk without use of crutches or a wheelchair
  • Seizures
  • Hearing loss

The entire Blue Book is available online, so you can review the Down syndrome listing or any other sections with your loved one’s doctor to determine if he or she medically qualifies.

Financially Qualifying with Down Syndrome

People with Down syndrome qualify for Supplemental Security Income, or SSI benefits. These are available for the most financially needy people in the US. There are strict income limits for people receiving SSI benefits. An adult applying for SSI could not earn more than $750 per month. Adults also cannot have more than $2,000 in saved income or available assets, such as a second home or a second car.

If you’re applying on behalf of a minor child, your income limits will not be as severe. You’ll have a monthly pre-tax household income limit depending on the size of your family. Larger families will have higher income limits. A single parent with one child could earn up to $38,000 per year, while a two-parent household with three children could earn up to $55,000 per year. You can review your specific household income limit online on the SSA’s website.

Unfortunately, household income is the top reason why children with Down syndrome are denied benefits. If you earn too much to qualify, try applying once your child turns 18. At that point your income will no longer count against your child, even if he or she lives at home.

Starting an Application

If you’d like to apply for SSI benefits on behalf of a loved one with Down syndrome, you’ll need to do so at your local SSA office. You can start the process online by reviewing the Adult or Child Disability Starter Kits—these will outline exactly what documents you’ll need to apply successfully.

To make an appointment to apply at your closest Social Security office, call the SSA at 1-800-772-1213. Most initial claims are processed within three to five months.

Additional Resources

Contributed by Eric Minghella from Disability Benefits Help